Once upon a time, long ago, the development industry was fixated on measuring aid from richer to poorer countries. They called it ODA, standing for Official Development Assistance. For decades this aid has been codified, reported, and tracked, mostly by the Development Assistance Committee of the Organisation for Economic Co-operation and Development (DAC/OECD), a club of advanced economies. In advance of the Spring Meetings of the IMF and World Bank, the DAC announced that ODA has risen by 6.9% over 2014 levels to 132 billion dollars, a record amount. Importantly, ODA increased even after stripping out funds spent on refugees.

The United Nations has established targets for ODA—like the famous 0.7 percent of national income—which have taken on legendary status as benchmarks of national generosity. Only six out of 28 DAC countries met this target last year: Denmark, Luxembourg, The Netherlands, Norway, Sweden and the United Kingdom.

Some institutions and lobby groups remain fixated on ODA, but many development actors now reject it as flawed. A major theme of the Spring Meetings is how to move beyond ODA and expand other forms of financing for development. ODA is, among other things, symptomatic of a charity perspective, rather than investment; inappropriate for South-South cooperation; and unable to capture the big new landscape of public-private links. What’s more, it is riddled with self-serving quirks like scoring numerous flows—the cost of university places in donor countries, and administrative costs of aid agencies—that never reach developing countries.

Perhaps the most telling weakness of ODA is that emerging powers like China and India see little merit (and arguably, some residual stigma) in this concept and, therefore, will not report on that basis to a club to which they do not belong. As their share of the world economy and their interactions with other “developing” countries continue to grow, this means ODA will inevitably start to represent an ever smaller share of official financing for development.

TOSSD stands for Total Official Support for Sustainable Development. The idea, still being fleshed out, is to have a universally accepted measure of the full array of public financial support for sustainable development. TOSSD should differ from ODA in at least three ways:

• First, it should take a developing country perspective rather than a donor country perspective. So it should cover the value of all funding for development that is officially supported, from pure grants to near-market loans and equity investments, as well as guarantees and insurance.
• Second, it should measure cross-border flows from all countries, not just the rich members of the OECD’s Development Assistance Committee.
• Third, it should include contributions to global public goods needed to support development, like U.N. peacekeeping and pandemic surveillance.

There are many complications behind any international attempt to define and track such a huge range of activities. Some are technical, but can probably be resolved with enough goodwill and professionalism. So, for example, we can debate how to establish whether and how official support to private investors changes their behaviour, delivering “additional” development results compared to a situation without that support. In the end, sensible solutions and workarounds will be found.

More difficult are a couple of politically sensitive challenges, which at the same time underlie the value of reaching consensus on a new measure. How far, for example, should the new measure recognise indirect spending on global public goods? Take for example public research on an AIDS vaccine that could lead to prevention of millions of deaths in developing countries. Right now, this would not count as ODA because the promotion of the economic development and welfare of developing countries is not its main objective.

We tend to think that consideration of globe-spanning benefits like these, which do not fit the simple mould of money crossing borders, is an essential feature of a new measure of development finance. However, it will need to be bounded sensibly, not least because of underlying suspicions that the countries that are today most likely to deploy such tools, and claim them as a large part of their distinctive contribution, are among the “old rich”—though that could change quickly. We suggest that spending on a defined list of global public goods should be included, perhaps those that support Agenda 2030, such as U.N. peacekeeping or a global research consortium like GAVI, the Vaccine Alliance.

A second potentially divisive issue, already alluded to, is how to value non-monetary flows, like technical assistance, and in a fair way across countries. We think it would be a powerful positive signal for international cooperation if even modest contributions by low- and middle-income countries are recognised, celebrated, and valued according to the contribution being made, not the cost of providing the assistance. The assistance provided by professionals from developing countries (think Cuban doctors) should be measured at the same prices as assistance provided by professionals from rich countries. Some form of purchasing power parity equivalence would need to be defined and used.

This is a hugely contentious question. Neither of the most obvious answers, the well-organised but globally unloved OECD and the legitimate but under-resourced U.N. secretariat, are likely to be acceptable without some changes. A preferred candidate has to have a sufficiently broad group of countries prepared to self-report on even a loose set of definitions in order to get momentum. At a minimum all the major economies of the world, for example members of the G-20, should be willing to participate. It should also have the technical capacity to help countries provide information in a consistent way.

The International Monetary Fund or World Bank could be candidates—most countries already report to them on a range of data, including financial flows. The Global Partnership for Effective Development Cooperation, with its membership of many development actors and technical support, could be another. Or a new group could be created in much the same way as the International Aid Transparency Initiative. This could even be a revamped Development Assistance Committee that operates with broader support in much the same way as the OECD’s tax work has many non-OECD members participating. What is important is that the guiding principle be to measure official cross-border financial resources that support the new universally-agreed Sustainable Development Goals, and to start now and learn by doing.  Such initiatives are too easily killed by subjecting them to endless external criticism that a perfect solution has not been found.

TOSSD may be one of the least attractive acronyms on offer today. Without disrespect to its OECD authors, it will anyway have to change to something that works for all the major stakeholders, and is not visibly invented in Paris and that also encourages players who are not strictly speaking “official,” like foundations, to sign up. We tend to favor a plainer, simpler wrapper like International Development Contributions (IDC), or Defined Development Contributions (DDC). 

On September 8, Brookings Senior Fellow Vanda Felbab-Brown participated in a Center for International Policy and Washington Office on Latin America event, “Using Militaries as Police in Latin America: A Discussion on Citizen Security and the Way Forward.” Felbab-Brown was joined on the panel by Adam Blackwell, secretary for multidimensional security at the Organization of American States; Richard Downie, executive vice president for global strategies at OMNITRU; and Adam Isacson, senior associate for regional security policy at the Washington Office on Latin America. Sarah Kinosian, lead researcher on Latin America at the Center for International Policy, moderated the event.

Felbab-Brown argued that police reform across Latin America over the past two decades has often been at best deficient or has failed outright. The lack of rule of law characterizes many countries in the region, including continually Mexico. Police forces are often not only corrupt, but highly abusive, and both police forces and military forces deployed for policing engage in major human rights violations. Even assumed exemplary experiments, such as the Unidade de Polícia Pacificadora (UPP) approach in Rio, have struggled to execute an effective handover from heavily-armed takeover forces to regular policing.

If governments choose to deploy their militaries in local policing roles, suboptimal as that is, the forces should adopt population-centric strategies, immediately develop concrete handover plans to police forces, and operate under a civilian coordinator. A key requirement for military forces is to respect human rights and due process and diligently prosecute perpetrators. Ultimately both police and military forces need to understand that their role is to protect society.

To some extent, Felbab-Brown argues, the resort to military forces for policing purposes is compounded by the lack of expeditionary police capacity by outside partners and donors, who overwhelmingly tend to deploy military forces for training policing. However, if the United States and outside donors want to make their policing assistance more effective, they should consider developing expeditionary police forces for such training purposes as well as a range of stabilization operations.

The most important factor for security efforts is citizen support. Marginalization, exclusion, and abuse from policing forces—be they police or military ones—have often prevented local populations from cooperating with law enforcement units and buying into rule of law: security or insecurity is co-produced as much as by citizens as by the police or military.

In this interview, Vanda Felbab-Brown addresses issues of terrorism, organized crime, and state responses within the context of Boko Haram’s terrorism, insurgency, and militancy in the Niger Delta. She was interviewed by Jide Akintunde, Managing Editor of Financial Nigeria magazine.

Q: The Boko Haram menace has been with Nigeria for seven years. Why is it that the group does not appear to have run out of resources?

A: Boko Haram has been able to sufficiently plunder resources in the north to keep going. It has accumulated weapons and ammunition from seized stocks. It also taxes smuggling in the north. But its resources are not unlimited. And unlike other militant and terrorist groups, such as ISIS or the Taliban, Boko Haram faces far more acute resource constraints.

Q: Boko Haram is both an insurgent and a terrorist group. Does this explain why it is arguably the deadliest non-state actor in the world and the group that has used women for suicide bombings the most in history?

A: Boko Haram’s record in 2015 of being the deadliest group is a coincidence. Very many other militant groups have combined characteristics of an insurgency and a terrorist group. Its violence belies its weaknesses as much as its capacities.

Boko Haram’s resort to terrorism, often unrestrained terrorism and unrestrained plunder, reflect its loss of territory and most limited strategy calibration and governance skills. Its terrorist attacks, including by female suicide bombers, also reflect the limitation of the military COIN (counter-insurgency) strategy. For instance, after the international clearing, little effective control and “holding” is still exercised by the Nigerian military or its international partners.

Q: Although many views have rejected economic deprivation or poverty as the root cause of the insurgency, almost everyone agrees that military victory over the group would not help much if economic improvement is not brought to bear in the Northeastern Nigeria – the theatre of the insurgent activities. Is this necessarily contradictory?

A: Economic deprivation is hardly ever the sole factor stimulating militancy. There are many poor places, even those in relative decline compared to other parts of the country, where an insurgency does not emerge. But relative economic deprivation often becomes an important rallying cause. And indeed, there are many reasons for focusing on the economic development of the north, including effectively suppressing militancy but it also goes beyond that. Improving agriculture, including by investing in infrastructure and eliminating problematic and distortive subsidies in other sectors, would help combat insurgency and prevent its reemergence.

Q: While Nigerians remain befuddled about the grievances of Boko Haram, we are clear about the gripes of the militants in the oil-rich Niger Delta: they want resource control, since the Nigerian state has been unable to develop the area that produces 70 per cent of the federal government’s revenue. So, is the state always just and right in suppressing militant groups?

A: Indeed not; the state is hardly always just in suppressing militancy, even as suppressing militancy is its key imperative. Economic grievances, discriminations, and lack of equity and access are serious problems that any society should want to tackle. Even if there are “no legitimate grievances,” the state does not have a license to combat militancy in any way it chooses. Its own brutality will be discrediting and can be deeply counterproductive.

The Nigerian state’s approach to MEND (Movement for the Emancipation of Niger Delta) is fascinating: essentially the cooptation of MEND leaders through payoffs, but without addressing the underlying root causes. The insurgency quieted down, but the state’s approach is hardly normatively satisfactory nor necessarily sustainable unless new buyoffs to MEND leaders are again handed over. But that compounds problems of corruption, accountability, transparency, and inclusion.

Q: We can raise the same issue about economic justice in the way criminal and terrorist organizations operate their underground economies. How flawed have you found the alternative social orders that the leaders of criminal and terrorist organizations claim to foster?

A: The governance – the normative, political, and economic orders -- that militant groups provide are often highly flawed. They often underdeliver economically and they lack accountability mechanisms, even when they outperform the state in being less corrupt and providing swifter justice.

However, the choice that populations face is not whether the order that militants provide is optimal or satisfactory. The choice that matters to people is whether that order is stable and better than that provided by the state. So the vast majority of people in Afghanistan, for example, say they don’t like the Taliban. But they don’t like corrupt warlords or corrupt government officials even. It’s not the absolute ideal but the relative realities that determine allegiances or at least the (lack of) willingness to support one or the other.

Moreover, the worst outcome is constant contestation and military instability. A stable brutality is easier to adjust to and develop coping mechanisms for than capriciousness and unstable military contestation.

Q: The Nigerian amnesty programme seemed to be a model in resolving issues between the state and the non-state actors in the Niger Delta, given the quiet in that region in the past few years of the programme. But since the political power changed at the federal level, we are seeing signs of the return of sabotage of oil installations. What models, say in Latin America or elsewhere, can help foster more sustainable peace between governments and non-state actor militant groups?

A: I don’t think that the MEND programme is a model, precisely because of the narrow cooptation I alluded to. Many of the middle-level MEND commanders as well as foot soldiers are dissatisfied with the deal. And much of the population in the Delta still suffers the same level of deprivation and exclusion as before. The deal was a bandage without healing the wounds underneath. It’s a question how long it will continue sticking. Despite its many urgent and burning tasks and a real need to focus on the north, the Nigerian government should use the relative peace in the Delta to move beyond the plaster and start addressing the root causes of militancy and dissatisfaction there. 

This interview was originally published by Financial Nigeria.

Event Information

On April 24, 2015, the United States assumed chairmanship of the Arctic Council for a two-year term. Over the course of the last year, the United States has outlined plans within three central priorities: improving economic and living conditions for Arctic communities; Arctic Ocean safety, security, and stewardship; and addressing the impacts of climate change. Working with partners on the Council, U.S. leaders have moved forward policies ranging from joint efforts to curb black carbon emissions to guidelines for unmanned aerial systems conducting scientific research. With half of its short chairmanship behind it, what has the United States accomplished over the last 12 months? What work remains to be done?

On April 25, the Energy Security and Climate Initiative (ESCI) at Brookings hosted U.S. Special Representative for the Arctic Admiral Robert J. Papp, Jr. for a keynote address on the state and future of U.S. leadership in the Arctic. ESCI Senior Fellow Charles Ebinger moderated the discussion and audience Q&A.

Join the conversation on Twitter using #USArctic

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• The halfway point of the U.S. Arctic Council chairmanship: Where do we go from here?

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• The halfway point of the U.S. Arctic Council chairmanship: Where do we go from here?

Some quick thoughts on Indian Prime Minister Narendra Modi's trip to China thus far, following the release of the Joint Statement, and Modi’s remarks at the Great Hall of the People, at Tsinghua University, and at a bilateral forum of state and provincial leaders:  

1. Candid Modi. In his statement to the media, Modi noted that the bilateral discussions had been “candid, constructive and friendly.” He was definitely more candid in his remarks about Indian concerns than is normal for Indian leaders during China-India summits. While senior Indian policymakers often downplay the bilateral differences during visits (incoming and outgoing) and focus more on cooperative elements, in two speeches and in the joint statement released, Modi mentioned them repeatedly. He talked about the relationship being “complex,” as well as about issues that “trouble smooth development of our relations” and held back the relationship. He urged China to think strategically (and long-term) and “reconsider its approach” on various issues. First and foremost: its approach toward the border, but also visas and trans-border rivers, as well as the region (read China’s relations with Pakistan among others). China’s approach on economic questions was also put on the table, with Modi stating that, in the long-term, the partnership was not sustainable if Indian industry didn’t get better access to the Chinese market. The joint statement acknowledged that the level of the trade imbalance (in China’s favor) was not sustainable either. Modi also made clear that India wants China’s support for a greater role in international institutions. He specifically highlighted that China’s support for a permanent seat for India at the U.N. Security Council (UNSC) and Indian membership of export control regimes would be helpful to the relationship (interestingly, he explained India’s desire for UNSC permanent membership as stemming from the same logic as the establishment of the Asian Infrastructure Investment Bank—part of Asia “seeking a bigger voice in global affairs.” In the joint statement, however, China continued just to recognize India’s aspirations for a greater UNSC role. It did though include mention of India’s Nuclear Suppliers Group aspiration.

There was also an overall message from Modi that these issues couldn't be set aside and that progress was necessary: “…if we have to realise the extraordinary potential of our partnership, we must also address the issues that lead to hesitation and doubts, even distrust, in our relationship.”

2. The Border. Modi put the border at the top of the list of such issues, stating “we must try to settle the boundary question quickly.” Seeming to add a parameter to any potential solution, he stated that the two countries should settle this question “in a manner that transforms our relationship and [will] not cause new disruptions.” In the meantime, he noted that the mechanisms managing the border were working fine, but asserted that it was important to clarify the Line of Actual Control since otherwise there was a persisting “shadow of uncertainty.” He noted that he’d proposed a resumption of “the process of clarifying it.” The joint statement stated a desire for enhanced exchanges between the militaries to better communication on the border and an exploration of whether/how to increase trade at the border.

As is wont for Indian leaders in China, Modi didn’t explicitly assert India’s claim to the state of Arunachal Pradesh, but for those of us who read between the lines, he mentioned the number of states India had, referring to “30 pillars comprising the Central Government and all our States”—those 29 states include Arunachal Pradesh.

3. Economics. Modi’s day in Shanghai on May 16 will feature the economic relationship more. He did note the “high level of ambition” the two sides had for the relationship and his hope to see increased Chinese investment in infrastructure and manufacturing in India. China and India agreed that bilateral trade was “skewed” and likely unsustainable if that didn’t change.

At his speech at Tsinghua he linked both Mumbai’s rise to trade with China and the evolution of silk tanchoi sarees to skills learnt by Indians from Chinese weavers—thus both pointing out that the trade relationship is an interrupted one and (to his domestic critics) that India stands to gain from this engagement.

4. Building Trust & (People-to-People) Ties. There was a major emphasis in Modi’s remarks on building trust, and improving communication and connectivity, with a special emphasis on enhancing people-to-people ties. On the latter, he stated frankly, “Indians and Chinese don't know each other well, much less understand each other.” Various polls and surveys also show that, what they do know, they often don’t like.

This lack of trust, knowledge, and even interest could limit policymakers’ options (including in settling the border question) down the line. Thus, Modi asserted that China and India “must build more bridges of familiarity and comfort between our people.” To increase travel to India (and bring in tourism revenue), he announced that India’s e-visa facility will be made available to Chinese nationals. The two countries also agreed to establish consulates in Chennai and Chengdu. For greater learning about each other, there were decisions to set up an annual bilateral Think Tank Forum, to institutionalize the High-Level Medium Forum, and establish a Centre for Gandhian and Indian Studies at Fudan University.

Modi also noted that, at the end of the day, improving opportunities for interaction wasn’t sufficient. China would also have to do its bit to shape perceptions of itself in India—since even “small steps can have a deep impact on how our people see each other.”

There was also an emphasis on moving beyond Delhi, including through the establishment of the State and Provincial Leaders' Forum, with a desire to increase and facilitate engagement at the state and city levels.

On the central level, there were decisions announced to enhance or institutionalize engagement at the leaders level, as well as between the foreign policy and planning bureaucracies, as well as the defense establishments. Modi also especially highlighted “Our decision to enhance strategic communication and coordination on our region…”

5. Regional and Global Issues. While there was mention of continuing cooperation towards the Asian Infrastructure Investment Bank, if Beijing was looking for an endorsement of its One Belt, One Road initiatives, it wasn’t forthcoming. Modi noted that both China and India were “trying to strengthen regional connectivity and seeking ‘to connect a fragmented Asia.’” But he distinguished between two types of projects: “There are projects we will pursue individually. There are few such as the Bangladesh-China-India-Myanmar Corridor that we are doing jointly.”

There was special mention of shared interests in West Asia and Afghanistan, as well as counterterrorism and climate change—the latter even got a separate joint statement. The main joint statement had an interesting reference to the two countries broadening cooperation in the South Asian Association for Regional Cooperation—China is not a member, but many believe that it would like to be (India’s traditionally been hesitant for China to go beyond its observer role).

Modi also highlighted a “resurgent Asia” that offers “great promise, but also many uncertainties” and “an unpredictable and complex environment of shifting equations.”

Modi acknowledged China and India’s “shared neighbourhood,” where they were both increasing engagement. He also seemed to admit that this could cause concern and thus “deeper strategic communication to build mutual trust and confidence” was essential. Perhaps pointing to China’s relations with Pakistan and others in India’s neighborhood, Modi stressed, “We must ensure that our relationships with other countries do not become a source of concern for each other.” However, this also acknowledged Chinese anxieties about India’s evolving relationships.

For those in China concerned about India’s relations with the United States and if it was designed to contain China, Modi had a message: “If the last century was the age of alliances, this is an era of inter-dependence. So, talks of alliances against one another have no foundation. In any case, we are both ancient civilizations, large and independent nations. Neither of us can be contained or become part of anyone's plans.”

6. The Image of a Confident India. Modi’s remarks seemed intended to exude confidence about India and its role in the world. He stated that in an age of many transformations, “the most significant change of this era is the re-emergence of China and India.” Laying out why India, in his perspective, is the next big thing, he seemed to suggest that it was in China’s interest to get on board the India train. He noted the political mandate he had, the steps his government had taken, and that “no other economy in the world offers such opportunities for the future as India's.” The Indian prime minister asserted, “We are at a moment when we have the opportunity to make our choices.” He seemed to want to make clear that enhancing engagement with India would be the right one for China.

Bonus Takeaways

Winner: Social media—it's been ubiquitous, from Modi joining China's Weibo to the Modi selfie with Chinese Premier Li Keqiang to the continuation of the Modi-looking-at-things meme.

Loser: Panchsheel. It'd been a bit odd that India had continued to choose to mention Panchsheel and the Five Principles of Peaceful Coexistence—principles that are remembered by many in India as being honored by China in the breach than in the observance in the late 1950s and early 1960s. There was even a shout-out to it in the Modi-Xi joint statement in September 2014. But it's missing in action in the 2015 joint statement and seems to have been replaced by this:

The leaders agreed that the process of the two countries pursuing their respective national developmental goals and security interests must unfold in a mutually supportive manner with both sides showing mutual respect and sensitivity to each other’s concerns, interests and aspirations. This constructive model of relationship between the two largest developing countries, the biggest emerging economies and two major poles in the global architecture provides a new basis for pursuing state-to-state relations to strengthen the international system.

An analysis of the growth and characteristics of the foreign-born in the Philadelphia metropolitan area between 1970 and 2006 finds:

• Among its peers, metropolitan Philadelphia has the largest and fastest growing immigrant population, which now stands at over 500,000, comprising 9 percent of the population. Between 2000 and 2006, greater Philadelphia’s immigrant population grew by 113,000, nearly as many as had arrived in the decade of the 1990s.
• Metropolitan Philadelphia has a diverse mix of immigrants and refugees from Asia (39 percent), Latin America and the Caribbean (28 percent), Europe (23 percent) and Africa (8 percent). The 10 largest source countries are India, Mexico, China, Vietnam, Korea, Italy, Ukraine, Philippines, Jamaica, and Germany.
• Immigrant growth in suburban Philadelphia has outpaced the city’s growth, but numerically, the city has the largest population of all local jurisdictions. Outside the city, Montgomery County had the earliest post- World War II suburban settlement of the foreign born and has the largest number of immigrants among jurisdictions, while Chester County saw the fastest growth during the 1970-2006 time period.
• Nearly 60 percent of the foreign-born living in metropolitan Philadelphia arrived in the United States after 1990. Although their naturalization rates and educational levels reflect their recentness of arrival, on the whole, greater Philadelphia’s immigrants are doing well on these measures as compared with some other U.S. metropolitan immigrant populations.
• Nearly 75 percent of greater Philadelphia’s labor force growth since 2000 is attributable to immigrants. Immigrants’ contributions to the labor force are considerably higher in this period than in the 1990s, when just 36 percent of the growth was due to immigrants.

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For over 100 years, the driving force of Ohio’s economy has been the state’s so-called Big Eight cities—Columbus, Cleveland, Cincinnati, Toledo, Akron, Dayton, Canton, and Youngstown. Today, though, the driving reality of these cities is sustained, long-term population loss. The central issue confronting these cities—and the state and surrounding metropolitan area—is not whether these cities will have different physical footprints and more green space than they do now, but how it will happen.

The state must adopt a different way of thinking and a different vision of its cities’ future—and so must the myriad local, civic, philanthropic, and business leaders who will also play a role in reshaping Ohio’s cities. The following seven basic premises should inform any vision for a smaller, stronger future and subsequent strategies for change in these places:

• These cities contain significant assets for future rebuilding
  
• These cities will not regain their peak population
  
• These cities have a surplus of housing
  
• These cities have far more vacant land than can be absorbed by redevelopment
  
• Impoverishment threatens the viability of these cities more than population loss as such
  
• Local resources are severely limited
  
• The fate of cities and their metropolitan areas are inextricably inter-connected
  

These premises have significant implications for the strategies that state and local governments should pursue to address the issues of shrinking cities.

Full Paper on Ohio's Cities » (PDF)
Paper on Shrinking Cities Across the United States »

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During the height of the Ebola crisis in September 2014 there were 21 confirmed cases of the virus and 8 deaths in Nigeria. The African nation has the continent’s largest population, a high poverty rate, and the government spends relatively little on health care. At the time many were worried about a scenario where the virus spread throughout Nigeria. But, the Nigerian Minister of Health Onyebuchi Chukwu disagreed with that assessment. He commented to Forbes, “Nigeria will be as clean as any other country as far as Ebola virus disease is concerned.” His comments were proven to be accurate in the coming months. There were a variety of factors that contributed to Nigeria’s success at combating the disease. One important factor was the use of mobile electronic health records programs.

How mobile fights disease

1. Training Healthcare Workers

Training health care providers was a priority at the beginning of the Ebola outbreak. A survey found that 85 percent of health care workers in the country believed you could avoid Ebola by abstaining from handshakes or touching. Correcting these myths about the disease was a critical part of the response effort, especially for health care workers.

2. Rapid Deployment

One of the virtues of mHealth is its speed and flexibility. Mobile allows officials to quickly disseminate the latest information to front line health care workers. Increasing the speed of communication is a general boon to any large public health response.

3. Virtual Records

Ebola Treatment Units (ETU) greatly benefitted from using digital rather than paper records. Paper records cannot be removed from an ETU. Deborah Theobald co-founder of Vecna Technologies that created the mHealth platform in Nigeria has pointed out that, “If the patient is isolated, so is their paperwork”. Electronic records are easy to share and also lower the risk of infection for health care workers.

Mobile health policy challenges

Despite the potential benefits of mHealth, barriers in some countries prevent the full positive impact of these technologies from coming into effect. Many developing nations lack the electrical infrastructure that is necessary to power mobile devices. Health care regulations are often too overly bureaucratic and burdensome. This makes it difficult for innovators to develop and equip workers with mobile tools and applications. It often takes an emergency situation like the Ebola crisis to make substantive changes. Success in the long term is only possible if leaders create an environment that is more hospitable to mHealth.

Mobile interventions have also demonstrated potential to address important public health issues. Recently experts gathered at the Brookings Institution to discuss how mHealth can improve health outcomes. Apps like Mobile Midwife and Text4Baby can encourage healthy pregnancies by providing valuable tips to expecting mothers. Mobile health platforms are successful because they directly inform caregivers. The proliferation of mobile phones through the developing world presents a health opportunity to communicate with the people who need help.

Electronic money, or e-money, emerged in the countries of the West African Economic and Monetary Union (WAEMU) following the adoption, in 2006, of a Central Bank Instruction establishing a flexible regulatory framework aimed at encouraging e-money business. The activity expanded in 2009 with the involvement of telecommunications operators in the provision of mobile telephone-based financial services, which increased the number of users and the volume of transactions.

A growing business

At the end of September 2015, 22 million people, or nearly a quarter of the people in the union, subscribed to financial services via mobile phone. Approximately 30 percent of those subscribers carried out at least one transaction per 90-day period.

Some 500 million transactions took place over the first nine months of 2015. The cumulative value of the transactions was 5 trillion CFA francs ($8.5 billion) by the end of September 2015, a growth of 142 percent from September 2014. Between September 2013 and September 2014, this value grew from CFA 1 trillion to CFA 2.068 trillion, an increase of 107 percent.

The mobile phone financial services distribution network followed a similar upward trend, rising from 93,621 points of services in 2014 to more than 132,658 at the end of September 2015.

Figure 1. Trends in the value of transactions

The socioeconomic environment in the union goes a long way to explaining the success of mobile telephone payment services. Indeed, this method of providing money transfer or payment services is particularly well suited to people who lack access to the mainstream banking system, and also affords non-bank institutions the opportunity to offer users non-cash money against cash deposits, which can then be used for a variety of financial transactions.

The growing involvement of telecommunications operators

The market is increasingly dominated by partnerships between banks and telecommunications operators, which represented 25 of the 33 licensed or authorized e-money issuers at the end of December 2015. In the framework of this model, known as the bank model, the bank has responsibility for issuing the e-money.

The other seven non-bank institutions, under the non-bank model, are authorized to issue electronic money as “Electronic Money Institutions” (EMIs) [1].

In WAEMU, e-money issuers are supported by a regulatory framework that was revised in 2015 to ensure increased security and quality of payment services backed by electronic money.

Figure 2. E-money issuers in WAEMU

Note: DFS denotes microfinance institutions.

A revised regulatory framework

With the expansion of mobile phone financial services and the growing involvement of telecommunications operators, the Central Bank has revised its regulatory framework with the aim of enhancing the security and quality of payment services backed by electronic money. The most salient improvements must focus on:

• Increasing issuer accountability by clarifying users’ roles in partnerships with technical service providers. With this goal in mind, the activities of technical service providers have been restricted to technical processing or the distribution of e-money under the responsibility of the issuer. In addition, issuers are responsible for the integrity, reliability, security, confidentiality, and traceability of all transactions carried out by all of their distributors; Stimulating competition through transparent pricing with an obligation for issuers to publish their rates;


• Specific requirements in terms of governance and internal and external audits for electronic money institutions, standards of integrity on the part of the management, professional secrecy and regular infrastructure audits;


• Increased protection for bearers of electronic money, including keeping funds in dedicated accounts, requiring a constant equivalence between the amount of e-money and the balances in the dedicated accounts, and mandatory creation of a mechanism to take in and deal with complaints by bearers of electronic money;


• Reinforcement of the supervisory mechanism by reducing deadlines for reporting on issuers’ activities to the Central Bank and adopting sanctions for violations of regulatory provisions.

Provision of mobile-phone-based financial services

Mobile-phone-based financial services provided in WAEMU include three categories of services, namely services involving the use of cash (banknotes and coins), e-money services, and so-called “second generation” services.

The first type of service essentially involves deposits of cash or refilling of electronic wallets, as well as withdrawals. This type of service represents 24 percent of user transactions. Cash deposits predominate; they allow customers to provision their electronic money accounts.

Seventy-six percent of the funds deposited into e-money accounts are used, above all, for purchases of telephone credit, payment of bills, person-to-person money transfers, and money transfers from individuals to businesses and from individuals to government agencies. The main payment services found in WAEMU pertain to payment of water or electricity bills, payment of satellite television subscriptions, and purchases of goods in supermarkets or fuel at service stations.

Payments of taxes or income taxes to government agencies and payments of micro-loan installments are also made through mobile phone financial services, but are much less common.

So-called “second generation” services, namely micro-insurance, micro-savings, and micro-credit, are currently emerging in WAEMU. Their development could be an opportunity to provide access to the banking system for the users of the services.

Finally, interoperability is just beginning to be implemented based on bilateral agreements between stakeholders, particularly with a view to offering cross-border payment services between member states of the union.

Challenges

A review of the development of mobile phone financial services in WAEMU reveals some obstacles to the rapid development of this type of financial service within WAEMU. They include:

• a low number of active users, due to the high cost of the services;
• the fact that the services are not well known due to inadequate financial education;
• the low rate of digitization of government agencies’ payment systems; and
• insufficient partnerships between bank and non-bank issuers with a view to developing a more inclusive range of “second-generation” services.

In collaboration with all stakeholders, the Central Bank has developed a financial inclusion strategy to continuously improve, access to and use of diverse, tailored and affordable financial services. The implementation of these actions as described in the Central Bank of West African States (BCEAO) financial inclusion strategy should support the challenges mentioned above.

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[1] EMI: any legal entity, other than a bank, financial payment institution, or decentralized financial system, that is authorized to issue payment instruments in the form of electronic money and whose business activities are restricted to electronic money issuing and distribution.

While much of the outside world has focused on the current wave of violence in Israel and the West Bank, far less attention is paid to the causes behind it and the context in which it is occurring. In meetings last month in Ramallah and Jerusalem with a range of Palestinian politicians, journalists, and analysts, as well as with senior U.S. officials, it was clear that the attacks reflect the deepening anger and despondency among Palestinians.

The current violence is largely despair-driven, but remains individualistic and politically directionless. Palestinians use different terms to describe the current violence. Popularly, and in most local media, it is known as the “Jerusalem Intifada.” But unlike previous Palestinian uprisings, this latest wave of violence lacks both political organization and clear political demands. 

The fact that so many young Palestinians are willing to risk almost certain death in order to carry out otherwise ineffective stabbing attacks on Israelis points to a deep sense of hopelessness and despair. It’s not only that Israeli settlement expansion, home demolitions, land confiscations, and movement restrictions continue to rob Palestinians of their land, livelihoods, and dignity; it’s that Palestinians now must endure Israel’s seemingly endless occupation without any of the “safety nets” they traditionally have fallen back on: the peace process is dead, Arab regional support and solidarity has evaporated, and their political leaders (both secular and Islamist) are ineffective and increasingly discredited. 

In short, Palestinians feel a deep sense of abandonment by the international community, their fellow Arabs, and even their own leaders. Although domestic political considerations as well as Abbas’ own waning credibility have constrained the leadership’s ability to disavow the violence outright, the Palestinian Authority (PA) continues to work quietly with the Israelis to keep the situation under control. The main question now, particularly for U.S. officials, is how long this PA security coordination with Israel can continue given mounting public opposition and the precipitous decline in international aid, which according to the World Bank is down by roughly 60 percent.

As confidence in Abbas’ leadership declines, Palestinian political stagnation and dysfunction is likely to continue. Since a public opinion poll published last September found that an unprecedented two-thirds of Palestinians wanted Abbas to resign, popular frustration with the Palestinian leader seems only to have grown. Many Palestinians lament what they see as the transformation of their national movement from groups and leaders dedicated to national liberation to a ruling class with special privileges (VIP status, travel, etc.) and a stake in the status quo. Even American officials seemed alarmed by the extent to which the PA is now perceived as a “collaborationist” government by ordinary Palestinians. 

At the same time, Abbas’ leadership style and decision-making are also alienating much of the political elite, including within his own Fatah movement. Several Palestinian officials were privately critical of Abbas. Others have been more open in their criticism, including former West Bank security chief Jibril Rajoub, who recently railed against Abbas and his inner clique in a lengthy interview on Palestinian TV. 

Much of the internal frustration with Abbas has to do with recent leadership appointments as well as what many see as his growing paranoia and personal vendettas against perceived rivals like Salam Fayyad, Yasser Abed-Rabbo, and his arch-nemesis, Mohamed Dahlan, the now-exiled former Gaza security chief. Both of these underscore the growing anxiety over the lack of clarity regarding a future succession process (on which I will have more to say in a subsequent post). Many also voiced skepticism about Abbas’ current diplomatic strategy, which is focused on building support for an international peace conference. While most Palestinians support internationalization, and virtually no one supports a return to U.S.-led peace negotiations, there are doubts as to whether Abbas’ international efforts are rooted in a broader strategy. 

The lack of strategic thinking is also fueling frustration over the ongoing stalemate with Hamas in Gaza. Indeed, many view Abbas as the primary obstacle to Gaza reconstruction and progress toward reconciliation with Hamas. Despite Hamas’ clear weakness since 2013, Abbas has been loath to give Hamas anything it could claim as a political concession and is equally reluctant to inherit responsibility for Gaza’s myriad social, economic, and security problems, for which he currently has no solutions. 

[T]here is a growing feeling, both within Fatah and beyond, that things are unlikely to change internally (and perhaps even diplomatically) until Abbas has left the scene.

Consequently, there is a growing feeling, both within Fatah and beyond, that things are unlikely to change internally (and perhaps even diplomatically) until Abbas has left the scene. At the same time, despite the growing frustration with Abbas, most are not eager to accelerate his departure. As I have written elsewhere, the absence of credible alternatives has given Abbas a sort of “legitimacy by default.” This may explain Abbas’ otherwise inexplicable complacency and his sense, as I was repeatedly told, that time is on his side.

Gaza’s Hamas rulers face their own set of equally daunting political, economic, and security challenges. Although I did not visit Gaza or meet with any Hamas representatives, both figured prominently in most of my discussions. Hamas continues to face serious financial problems as a result of the virtual elimination of its tunnels network and the closure of the Rafah border crossing. The scarcity of resources, a major factor in Hamas’ decision to pursue reconciliation with the PA in 2014, is also fueling tensions within the movement. Whereas Hamas’ military wing, the al-Qassam Brigades, seeks to rebuild its military capabilities and restore its ties with Iran, its political leadership is equally keen to avoid another military confrontation with Israel and hopes to capitalize on diplomatic openings with Turkey and Saudi Arabia. 

The main security threat to Hamas rule comes from jihadi groups, most notably Jaysh al-Islam in the Gaza Strip and the Sinai-based Ansar Beit al-Maqdis, both of which have pledged allegiance to ISIS and regard Hamas (as well as its parent, the Muslim Brotherhood) as apostates. Despite occasional tit-for-tat attacks, at the moment neither Hamas nor the jihadis appear eager for a major fight. The potential for escalation remains, however, particularly if jihadi groups decide to exploit internal discontent within Hamas or force its hand militarily by launching rocket attacks on Israel. Such internal instability, along with the slow pace of reconstruction and already abysmal economic and humanitarian conditions in Gaza, highlights the ever-present danger of yet another devastating war between Israel and Hamas. 

In the end, while the outside world’s preoccupation with the current wave of violence is understandable, merely condemning ad hoc violence by Palestinians while failing to address the deeper, institutionalized violence of the Israeli occupation is both morally dishonest and politically untenable.

INTRODUCTION

In an earlier policy brief, Where is the Learning? Measuring Schooling Efforts in Developing Countries, we drew attention to what was labeled “the global learning crisis.” While tremendous progress has been made over the past couple of decades to get tens of millions of additional children to enroll in school, progress in improving learning outcomes has been considerably less impressive. Although, shockingly, comprehensive learning outcome data are not available for most of the developing world, the many small scale, local or, in some cases, national studies that have been done show a dismal picture. For instance, Uwezo, an East African initiative, found that in Tanzania, only 44 percent of students in Grade 4 were able to read a basic story from Grade 2. Similarly, the Annual Status of Education Report (ASER) facilitated by Pratham found that in rural India, less than half of Grade 4 students were able to do basic subtraction. These examples demonstrate the gravity of “the global learning crisis” as students fail to master competencies appropriate for their grade level, hindering the development of life skills and success in further schooling, as well as performance in the labor market.

With about 61 million children in the developing world still not yet in school, it is too early to declare victory on the “enrollment agenda”. But we would do a disservice to the 250 million children around the world who fail to reach Grade 4 or attain minimum learning standards, if we don’t step up efforts to improve learning outcomes.

This policy brief is part of a larger effort to link resources in the education sector with outcome measures. As we have documented elsewhere, few countries systematically collect comprehensive financial data on education, although fortunately an increasing number of initiatives is trying to address this issue by producing, for instance, National Education Accounts (NEAs). When the focus of the sector changes from enrollment to enrollment plus learning, efforts to better grasp the size and use of financial resources should evolve accordingly. For instance, much learning takes place outside of the classroom, especially in the early years. For NEAs to be a useful tool for adjusting the allocation of scarce resources, the “learning” sector should be defined more broadly than the education or “schooling” sector. We will address this and related issues in a subsequent policy brief.

Once our focus becomes enrollment plus learning, we have to broaden our view and look at the entire environment in which a child develops skills, starting with the households in which children are born. It has beenknown for many decades and throughout the world, that among the best predictors of future school performance are some basic household characteristics, such as income and mother’s education level.

Data from international assessments also show a relationship between income and educational performance, exemplified by intra and intercountry results. In Colombia, average Trends in International Mathematics and Science Study (TIMSS) math scores at Grade 8 for the richest quintile of students were close to 100 points higher than those from the poorest quintile. On the other hand, the difference in average scores between the poorest quintile in the United States and the richest quintile in Colombia was about 50 points. Income is not the only predictor of success, as exemplified in Peru, where children whose mothers have completed primary school and whose maternal language is Spanish rather than an indigenous language, have a greater probability of reaching the appropriate school grade for their age. In Kenya, Uwezo found that the higher their father’s educational attainment, the more likely children were able to read a story at Grade 3 or attend extra tutoring sessions.

In addition, the larger environment (such as the village or the urban neighborhood) in which the young child grows up also has a major and lasting impact. In Tanzania, urban students in Grade 3 are three times more likely than their rural counterparts to meet standards in literacy and numeracy. Related to the impact of the larger environment, data from Nigeria suggest that girls are more disadvantaged in school attendance, as parents may be reluctant to send girls to school because of perceived fears for their safety while traveling and concerns about the physical strength required for walking the distance.

Clearly, especially in the early years, most learning takes place outside of the classroom. Consequently, children who grow up in deprived circumstances will start life with a disadvantage leading to a lack of learning in the early grades, which will have lifetime effects.

In the next section, we will summarize the evidence that the early years (ages 0 to 5) are crucial for subsequent learning achievements. From this evidence we conclude that many of the problems with learning outcomes in the developing world (and in many developed countries) need to be addressed well before school age. Before delving into what happens in schools, we explore the relationship between enrollment, learning and dropout. As the crux of this brief is to lay out the evidence on what contributes to learning, we must acknowledge the factors leading to low enrollment and dropout. Next, we turn our attention to what happens in schools and what can be done to improve these activities, as well as try to summarize the evidence about the relationship between specific school-based inputs and learning outcomes. As it turns out, this evidence is, in many cases, rather feeble. Therefore, we will first focus on school-level inputs that are necessary for a good learning environment, i.e. without which we cannot expect any learning to take place. Most of these inputs are rather obvious, but they are worth mentioning. Subsequently, we will discuss additional inputs that have proven to contribute to learning outcomes in some cases, but not in others. Clearly how these inputs are applied matters.

Next, we address factors that contribute to learning outside of a formal environment, after which we review issues in health and nutrition that are closely linked to learning outcomes. We then review the need for the collection and dissemination of learning assessments in order to impact further improvements in these areas and we try to answer the question: what are the building blocks for an education sector that promote learning? Finally we explore needs for future research in learning.

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Employment is down among everyone between the ages of 16 and 64—particularly among teens, but with a great deal of variation by geography, race, and education. The disparity between blacks and whites is especially stark. For example, unemployment among white young adults peaked at 14% in 2010—still considerably lower than unemployment rates for black young adults at any point in the 2008 to 2014 time period. Unemployment for black 20- to 24-year-olds rose to 29.5% in 2010 and fell to 22.3% in 2014, compared to 10.3% among whites in 2014.

While there is no silver bullet, higher levels of education and work experience clearly improve job prospects down the line for young people. There are multiple strategies local and regional leaders can use to build more structured pathways into employment.

Teens and young adults (referring to 16- to 19-year-olds and 20- to 24-year-olds, respectively) are not monolithic populations. Age is an obvious differentiator, but so are a number of other factors, such as educational attainment, skill level, interests, parental support, and other life circumstances.  Schools, families, and neighborhoods all play a role in a young person’s trajectory—both positive and negative. But at the most basic level, a program for a 17-year-old high school student is likely not appropriate for a 23-year-old, regardless of educational attainment. Successful programs integrate education, training, work-readiness, and youth development principles, but the particular blend of these elements and settings vary: more school-based and educationally focused programs for younger youth, and more community-based and career-focused programs with strong ties to education for older youth.

An admittedly non-comprehensive review includes the following types of promising and proven programs:  

For high school students:

• Paid internship programs, such as Urban Alliance and Genesys Works
• High school programs that bridge school and work with occupationally-focused courses and career exposure, such as Career Academies, Linked Learning, High Tech High, Advanced Career, Alamo Academies, and P-Tech, some of which also incorporate post-secondary courses and credentials into their programs
• Youth apprenticeships, such as state programs in Georgia and Wisconsin 

For out-of-school youth and young adults:

• Highly structured programs offering work readiness and technical skills development, often in partnership with community colleges, and coupled with paid internships, such as Year Up, i.c.stars, npower, and Per Scholas
• Programs that offer stipends and combine academics, job training, mentoring, and supportive services while carrying out community improvement projects, such as YouthBuild and Youth Corps

The sobering fact is that promoting employment and economic security among young people is not a straightforward proposition. To succeed in today’s economy and earn middle-class wages, a young person needs to complete several steps: graduate from high school or earn an alternate credential; enroll in and complete some post-secondary education or job training; preferably gain meaningful work experience; and enter the labor market with in-demand skills. (A decent economy and some luck help, too.) There are many points along that path from which a young person can get off-track, particularly young people of color and those from high-poverty neighborhoods. And while high youth unemployment is increasingly in the news these days, the difficulties youth without college degrees face in finding good jobs has been a problem for decades.

Programs such as the ones listed above are part of the solution. But they are not enough, given the magnitude of the problem. In order to produce better employment outcomes at scale, leaders from all sectors and levels of government need to make broader shifts in how education and workforce programs are designed, and how they interact with each other and employers. That is a heavy lift, but it is worth it to address the high costs imposed by the status quo: high unemployment, poverty, and untapped potential.  

Walk Score®, a new Web site popular with urbanists and environmental advocates (www.walkscore.com), rates neighborhoods by their walkability--basically the ease of meeting daily needs on foot. The higher the Walk Score®, the more walkable a place is.

Beyond its utility, however, the rise of Walk Score® is another indicator that how the American Dream lays out on the ground has been fundamentally changing over the past 10 to 15 years. Dallas in general and downtown Dallas in particular is well on its way to accommodating this new version of the American Dream, but more needs to be done.

The Ozzie and Harriet drivable suburban vision of the American Dream is being supplemented by the Seinfeld vision of "walkable urbanism." Led by late-marrying young adults and empty-nester baby boomers, many households are looking for the excitement and options that living and working in a walkable urban place can bring. Current demographic trends promise continued demand.

A recent Brookings Institution survey of the largest 30 metro areas in the country identifies the 157 walkable urban places that play a regionally significant role, such as concentrations of employment, education, professional sports, entertainment and housing. It ranked these metros on their per capita number of walkable urban places. Washington, D.C., was first, followed by Boston, San Francisco, Denver and Portland.

The top 15 metro areas had the vast majority, 85%, of these walkable urban places, though only two-thirds of the surveyed population. This showed that the top 30 metros are dividing between haves and have nots: metropolitan areas that have many walkable urban options and those that are lagging. Additionally, two-thirds of these 157 places had rail transit, demonstrating the importance of rail transit to the emergence of walkable urbanism.

A surprising finding of the survey is that while downtowns are a major location of walkable urbanism, downtown adjacent places are exploding in number and size. Places like Lincoln Park in Chicago, Dupont Circle in Washington, D.C., and the Pearl District in Portland, Ore., are booming alongside their resurgent downtowns.

A major benefit of walkable urban development is that its keeps and attracts young adults to the metro area, many of whom willingly trade crushing car commutes for walkable places to live and work. Walkable urban places seem to attract the well educated, the so called "creative class." Even the nascent revival in downtown Detroit has seen 83% of new residents arriving with a college education, compared to 26% of the national population.

While the Dallas metro ranked only 25th of 30 in the Brookings' survey, there are reasons to believe your destiny is to become a major concentration of walkable urban places. That reasoning starts with your investment in Dallas Area Rapid Transit light rail and the Trinity Railway Express commuter rail. This is being followed by aggressively encouraging high-density zoning around rail stations and in downtown adjacent locations. The combination of rail transit and high density zoning is essential to allow the private real estate community to respond to the pent-up market and economic demand of walkable urban development.

Finally, it is crucial to manage the various walkable urban places that either exist or are evolving. The role model in the Dallas area is the DowntownDallas organization, which provides security, signage and strategic direction for downtown.

The future of the Dallas metro area is linked to your ability to provide both more walkability options and expanded offerings of existing walkable urban places. There should be 15-20 more places like downtown Dallas, downtown Fort Worth, Uptown, Plano Town Center and Addison Circle for the region to meet the pent-up demand for walkable urbanism.

Building those additional walkable urban places will continue the economic development miracle that has been Dallas metro for so many years and it will increase your Walk Scores® as well.

For over 100 years, the driving force of Ohio’s economy has been the state’s so-called Big Eight cities—Columbus, Cleveland, Cincinnati, Toledo, Akron, Dayton, Canton, and Youngstown. Today, though, the driving reality of these cities is sustained, long-term population loss. The central issue confronting these cities—and the state and surrounding metropolitan area—is not whether these cities will have different physical footprints and more green space than they do now, but how it will happen.

The state must adopt a different way of thinking and a different vision of its cities’ future—and so must the myriad local, civic, philanthropic, and business leaders who will also play a role in reshaping Ohio’s cities. The following seven basic premises should inform any vision for a smaller, stronger future and subsequent strategies for change in these places:

• These cities contain significant assets for future rebuilding
  
• These cities will not regain their peak population
  
• These cities have a surplus of housing
  
• These cities have far more vacant land than can be absorbed by redevelopment
  
• Impoverishment threatens the viability of these cities more than population loss as such
  
• Local resources are severely limited
  
• The fate of cities and their metropolitan areas are inextricably inter-connected
  

These premises have significant implications for the strategies that state and local governments should pursue to address the issues of shrinking cities.

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Paper on Shrinking Cities Across the United States »

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An economic analysis of a sample of neighborhoods in the Washington, D.C. metropolitan area using walkability measures finds that:

• More walkable places perform better economically. For neighborhoods within metropolitan Washington, as the number of environmental features that facilitate walkability and attract pedestrians increase, so do office, residential, and retail rents, retail revenues, and for-sale residential values.

• Walkable places benefit from being near other walkable places. On average, walkable neighborhoods in metropolitan Washington that cluster and form walkable districts exhibit higher rents and home values than stand-alone walkable places.

• Residents of more walkable places have lower transportation costs and higher transit access, but also higher housing costs. Residents of more walkable neighborhoods in metropolitan Washington generally spend around 12 percent of their income on transportation and 30 percent on housing. In comparison, residents of places with fewer environmental features that encourage walkability spend around 15 percent on transportation and 18 percent on housing.

• Residents of places with poor walkability are generally less affluent and have lower educational attainment than places with good walkability. Places with more walkability features have also become more gentrified over the past decade. However, there is no significant difference in terms of transit access to jobs between poor and good walkable places.

The findings of this study offer useful insights for a diverse set of interests. Lenders, for example, should find cause to integrate walkability into their underwriting standards. Developers and investors should consider walkability when assessing prospects for the region and acquiring property. Local and regional planning agencies should incorporate assessments of walkability into their strategic economic development plans and eliminate barriers to walkable development. Finally, private foundations and government agencies that provide funding to further sustainability practices should consider walkability (especially as it relates to social equity) when allocating funds and incorporate such measures into their accountability standards.

The Great Recession highlighted the need to change the prevailing real estate development paradigm, particularly in housing. High-risk financial products and practices, “teaser” underwriting terms, steadily low-interest rates, and speculation in housing were some of the most significant contributors to the housing bubble and burst that catalyzed the recession. But an oversupply of residential housing also fueled the economic crisis.

However, a closer look at the post-recession housing numbers paints a more nuanced picture. While U.S. home values dropped steadily between 2008 and 2011, distant suburbs experienced the starkest price decreases while more close-in neighborhoods either held steady or in some cases saw price increases. This distinction in housing proximity is particularly important since it appears that the United States may be at the beginning of a structural real estate market shift. Emerging evidence points to a preference for mixed-use, compact, amenity-rich, transit-accessible neighborhoods or walkable places.

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Thanks in large part to his decision to participate in the war in Iraq, former British Prime Minister Tony Blair is a controversial figure in Europe. Yet, Blair’s legacy as a center-left reformer is alive and well in two of Europe’s ruling center-left forces, France’s Socialist Party (PS) and Italy’s Democratic Party (PD).

Both Italy’s Prime Minister Matteo Renzi from the PD and French Prime Minister Manuel Valls of the PS bear strong similarities to the former leader of Britain’s “New” Labour Party. As Blair was when he took office, they are young–Valls is 52 and Renzi is just 39; they are centrists; and they have excellent communication skills that allow them to present themselves as harbingers of change.

Taking a Page Out of Prime Minister Blair’s Book

Renzi and Valls will have to take three pages out of Blair’s book if they want to replicate his electoral achievements: 

1. They must wrest control of their parties from the old guard; 
2. They must take control of the political agenda by giving it a centrist thrust (along the lines of Blair’s ‘Third Way’ between conservatism and social democracy); 
3. They must take control of the political center, even at the cost of shedding votes on the left.  

Renzi is far ahead of Valls in all three respects. He has taken over the PD (via an open primary election which he won resoundingly) after a bitter fight against the party’s old guard. Since taking office in early 2014, he has shown a remarkable ability to dictate the terms of the political debate. While he became prime minister via an inner party coup rather than a general election, he sailed triumphantly through his first electoral test: the European Parliament elections of May 2014. The PD won a larger share of the votes than any other Italian party since the 1950s (41 percent), tapping into constituencies such as entrepreneurs and businessmen who all have a long tradition of contempt for the left.

However, none of Renzi’s achievements rest on firm ground. The main reason is Italy’s appalling financial predicament. The economy has performed abysmally since the 2008 to 2009 recession. Unemployment is over 12 percent, the labor market is overly protective of certain categories and overly unfair to others (particularly the young), the public sector is costly and ineffective and the judicial system byzantine and not entirely reliable. Renzi continues to face harsh criticisms from within his party as his reform agenda flies in the face of traditionally left-leaning constituencies (a few weeks ago the main leftist trade union managed to get about a million people to the streets in protest against a labor market reform bill). Finally, Renzi’s room for maneuver is severely constrained by the tight fiscal rules imposed by the European Union (EU).

For Valls, the path to leadership is a more complicated matter. This is largely due to France’s constitutional set-up, in which the prime minister runs domestic policies but is second in authority to the president. This involves for Valls a variation from Blair’s three-step process—as prime minister, his most urgent priority is not leading the PS but pushing forward a political agenda capable of winning over the political center. He was appointed to the premiership by the current president, the socialist François Hollande, because his previous stint as a tough-talking interior minister and his profile as a business-friendly politician and skillful local manager made him fairly popular with the public. Hollande’s decision was a desperate attempt to revive his own popularity, which has plummeted to unprecedented lows only half-way into his 5-year term, by imparting a new, essentially more pro-market direction to his presidency. Since he stepped in, Valls has tried to change the political agenda by advocating reduced labor costs and lower taxes on businesses.

Like Renzi, Valls is confronted with both internal and external challenges. The first is of course that, although in charge of domestic policies, he is still second-in-command to a highly unpopular president. Because he does not control the PS, Valls faces stiffer opposition to his centrist agenda from within the party than does his Italian counterpart. His calls for a ‘common house’ for reform-oriented leftists and rightists have, unsurprisingly, met with acerbic criticism in the PS. France is in a better economic state than Italy and the government machine is as efficient as ever; yet the French have shown an idiosyncratic resistance to reform which Valls might lack the political authority to overcome. And Valls, just like Renzi, must also make decisions that both help France and comply with EU fiscal rules.

What to Make of Continental Europe’s New Blairs?

In spite of the huge challenges Renzi faces both at home and in the EU, he seems to be the better positioned. Realistically, the chances that he will successfully revive Italy’s economy are slim. Yet Italians do not dream of an era of prosperity, but one of action. Provided Renzi can show that he has begun to tackle the many roadblocks on the path towards growth, Italians are likely to see him as a safer bet than the opposition, which consists of Silvio Berlusconi’s much weakened center-right party and the comedian-turned-politician Beppe Grillo’s anti-establishment 5 Star Movement.

Valls has a harder road ahead. His approval ratings now hover at just around 36 percent (though no other center-left French politician fares much better). He certainly has a popularity problem in his own party during the last presidential campaign, he won only 5.5 percent of the votes in a PS primary contest. Yet Valls also stood out as a credible politician and is now in a position to attract more support. He encapsulates the second half of Hollande’s presidential term, which has made a decision to openly target centrist voters. If Valls manages to regain, at least in part, the favor of the public, the PS might in the end see him as a more appealing presidential candidate in 2017 than Hollande, whose credibility is in poor shape.

Appearing to the public the safer bet is the mark of shrewd politicians. But strong leadership requires one step further. Blair mapped out a course towards prosperity in the much more competitive world of globalization; this, the Iraq war notwithstanding, secured him three electoral victories in a row. For Renzi and Valls, the time to do something alike cannot come soon enough.

It’s easy to imagine a future in a decade or less when most people will have a smartphone. In our recent paper Pathways to Smarter Digital Financial Inclusion, we explore the benefits of extending financial services to the mass of lower-income people in developing countries who are currently dubious of the value that financial services can bring to them, distrustful of formal financial institutions, or uncomfortable with the treatment they expect to receive.

The report analyzes six inherent characteristics of smartphones that have the potential to change market dynamics relative to the status quo of simple mobile phones and cards. 

Customer-Facing Changes:

1. The graphical user interface.
2. The ability to attach a variety of peripheral devices to it (such as a card reader or a small printer issuing receipts).
3. The lower marginal cost of mobile data communications relative to traditional mobile channels (such as SMS or USSD).

Service Provider Changes:

4. Greater freedom to program services without requiring the acquiescence or active participation of the telco.
5. Greater flexibility to distribute service logic between the handset (apps) and the network (servers).
6. More opportunities to capture more customer data with which to enhance customer value and stickiness.

Taken together, these changes may lower the costs of designing for lower-income people dramatically, and the designs ought to take advantage of continuous feedback from users. This should give low-end customers a stronger sense of choice over the services that are relevant to them, and voice over how they wish to be served and treated.

Traditionally poor people have been invisible to service providers because so little was known about their preferences that it was not possible build a service proposition or business case around them. The paper describes three pathways that will allow providers to design services on smartphones that will enable an increasingly granular understanding of their customers. Each of the three pathways offers providers a different approach to discover what they need to know about prospective customers in order to begin engaging with them. 

Pathway One: Through Big Data

Providers will piece together information on potential low-income customers directly, by assembling available data from disparate sources (e.g. history of airtime top-ups and bill payment, activity on online social networks, neighborhood or village-level socio-demographic data, etc.) and by accelerating data acquisition cycles (e.g. inferring behavior from granting of small loans in rapid succession, administering selected psychometric questions, or conducting A/B tests with special offers). There is a growing number of data analytics companies that are applying big data in this way to benefit the poor.

Pathway Two: Through local Businesses

Smartphones will have a special impact on micro and small enterprises, which will see increasing business benefits from recording and transacting more of their business digitally. As their business data becomes more visible to financial institutions, local firms will increasingly channel financial services, and particularly credit, to their customers, employees, and suppliers. Financial institutions will backstop their credit, which in effect turns smaller businesses into front-line distribution partners into local communities.

Pathway Three: Through Socio-Financial Networks

Firms view individuals primarily as managers of a web of socio-financial relationships that may or may not allow them access to formal financial services. Beyond providing loans to “creditworthy” people, financial institutions can provide transactional engines, similar to the crowdfunding platforms that enable all people to locate potential funding sources within their existing social networks. A provider equipped with appropriate network analysis tools could then promote rather than displace people´s own funding relationships and activities. This would provide financial service firms valuable insight into how people manage their financial needs.

The pathways are intended as an exploration of how smartphones could support the development of a healthier and more inclusive digital financial service ecosystem, by addressing the two critical deficiencies of the current mass-market digital finance systems. Smartphones could enable stronger customer value propositions, leading to much higher levels of customer engagement, leading to more revelation of customer data and more robust business cases for the providers involved. Mobile technology could also lead to a broader diversity of players coming into the space, each playing to their specific interests and contributing their specific set of skills, but together delivering customer value through the right combination of collaboration and competition.

Editor’s Note: Brookings will hold an event and live webcast on Wednesday, August 26 to discuss the findings of the 2015 Financial and Digital Inclusion (FDIP) Report and Scorecard. Follow the conversation on Twitter using #FinancialInclusion 

Access to affordable, quality financial services is vital both for ensuring the financial well-being of individuals and for fostering broader economic development. Yet about 2 billion adults around the world still do not have formal financial accounts.

The Financial and Digital Inclusion Project (FDIP), launched within the Center for Technology Innovation at Brookings, set out to answer three key questions:

• Do country commitments make a difference in progress toward financial inclusion?
• To what extent do mobile and other digital technologies advance financial inclusion?
• What legal, policy, and regulatory approaches promote financial inclusion?

To answer these questions, the FDIP team spent the past year examining how governments, private sector entities, non-government organizations, and the general public across 21 diverse countries have worked together to advance access to and usage of formal financial services. This research informed the development of the 2015 Report and Scorecard — the first in a 3-year series of research on the topic.

For the 2015 Scorecard, FDIP researchers assessed 33 indicators across four dimensions of financial inclusion: Country commitment, mobile capacity, regulatory environment, and adoption of selected basic traditional and digital financial services.

The 2015 FDIP Report and Scorecard provide detailed profiles of the financial inclusion landscape in 21 countries, focusing on mobile money and other digital financial services.

On August 26, the Center for Technology Innovation will discuss the findings of the 2015 Report and Scorecard and host a conversation about key trends, opportunities, and obstacles surrounding financial inclusion among authorities from the public and private sectors.

Register to attend the event in-person or by webcast, and join the conversation on Twitter at #FinancialInclusion.

Technically, all of the Star Wars films occur a long time ago in a galaxy far, far away, but there are countless gadgets featured in the films that human beings in this galaxy can find here on Earth. Here are a handful of gadgets you will see this weekend when the seventh Star Wars film, "The Force Awakens," blasts into theaters.

Drone surveillance

The evil Galactic Empire has long employed drones and machines to do their dirty work. Way back when the empire was just a glint in Darth Sidious' eyes, his merciless apprentice Darth Maul used autonomous drones to search the desert landscape of Tatooine for fugitive Jedi. Later, when Darth Vader tirelessly searched the galaxy for Luke Skywalker and the Rebel Alliance, he sent similar autonomous drones to countless worlds such as the ice planet Hoth.

Sure, the Empire may call them droids, but on the planet Earth these instruments are essentially remote drones you might see flying in cities or around your neighborhood. In the U.S. the use of unmanned drones to aid law enforcement is on the cutting edge of technology and sparks a spirited debate among privacy advocates. Should fear law enforcement as we would a Sith lord and thus burden them with a warrant-based, technology-centric approach to drone surveillance that might curtail the beneficial use of drones?

Gregory McNeal wrote last year in a Brookings report that a property rights-centric approach with limits on surveillance would best appease privacy advocates and law enforcement, enabling drones to protect privacy in ways even manned surveillance can't achieve. By crafting simple, duration based surveillance legislation, law enforcement would only be permitted to surveil a person for a limited amount of time. Additionally, data retention guidelines could limit the amount of time that surveillance would be accessible to law enforcement.

"Legislators should reject alarmist calls that suggest we are on the verge of an Orwellian police state," McNeal writes, as privacy advocates almost always invoke the the novel 1984 when technology makes surveillance more widespread and pervasive.

As McNeal points out, the police state is hardly as nefarious as Darth Vader, so sensible legislation may be enough in this case to keep law enforcement from falling to the dark side.

Holography

In the first Star Wars film, Princess Leia recorded a short holographic message for Obi-Wan Kenobi asking for his help delivering the Death Star plans to the Rebel Alliance. The droid R2-D2 recorded the message almost as succinctly as many of use record short videos on our cell phone. But when can we expect to send and receive holographic messages ourselves?

Barring some laughable election night hologram shenanigans on CNN, there have been some notable uses of holography in this galaxy. In 2012, the late rapper Tupac Shakur took the stage at the Coachella Festival with contemporaries Snoop Dogg and Dr. Dre. At the 2014 Billboard Music Awards, Michael Jackson performed on stage—five years after his death. These holograms were made possible by artful projections and reflections, creating convincing illusions suitable only for crowded concert halls. The technology is especially popular in South Korea where K-Pop performers regularly "perform" at virtual concerts to adoring fans.

But a bona fide hologram? Researchers at Swinburne University this year used lasers and a specialized graphene mesh to project 3D objects in the air very much like you would see in Star Wars. As TIME Magazine reported, "It’s not quite Princess Leia-quality, and researchers say it has a long way to go before commercialization, but it’s a step."

BB-8 Droid

Since the first teaser for the new Star Wars films, fans have had questions about the new droid character BB-8. Rather than resort to computer animation to bring the droid to life, director J.J. Abrams and Lucasfilm designers sought to produce a live prop that could portray the droid on film.

The filmmakers demoed the droid on stage at Comic Con to the roar of audience applause and delight—"It was the first official confirmation that BB-8 was not a CG creation, but rather, a practical effect."

The use of practical effects in "The Force Awakens" is a return-to-form for the filmmakers who have shunned the special effects and digital artistry of the Star Wars prequel trilogies and instead embraced the kinds of practical effects and puppetry that made the original trilogy so beloved.

The droid BB-8 even has a cousin here on Earth—the robotic ball toy Sphero. Inventors Ian Bernstein and Adam Wilson have adapted their smartphone-controlled spherical toy into a BB-8 toy that performs many of the same practical effects the screen version of BB-8 does in "The Force Awakens."

As the new sequel trilogy continues, filmmakers are sure to wow audiences with amazing technologies—some we may even recognize from planet Earth.

Civilian drone activity has increased exponentially as drones become more easily accessible and affordable. With more drones in the sky every day, there have been some creative and sometimes dangerous attempts to disable drones. The reasons for disabling a drone can vary from boredom and curiosity to privacy and safety concerns. To be clear, the Center for Technology Innovation does not condone or promote the act of harming drones.

1. Guns

Shooting a drone out of the sky may be effective, but it’s also extremely dangerous. The consequences for shooting down a drone vary by state, but perpetrators could face reckless endangerment charges or be prosecuted under laws relating to the discharge of firearms. Additionally, the offender could be liable for civil damages paid to the destroyed drone’s owner.

2. Nets

Nets are a much safer alternative to capturing drones than shooting them with guns. Tokyo police are working to implement net-carrying drones that can intercept suspicious smaller drones. The Human-Interactive Robotics Lab at Michigan Tech is working a drone catcher system for removing intruding drones by developing a drone-mounted net cannon that can capture another drone in flight from a distance of up to 40 feet. Lastly, there’s anti-drone technology that can be assembled from hardware store items. The drone net gun is a plastic slingshot that releases a net from the user on the ground to capture a drone in-flight

3. Radio waves

Battelle’s DroneDefender is a device that emits an electromagnetic field meant to disrupt the most popular GPS and ISM radio frequencies, which keep drones in the air. The DroneDefender can then take control and guide the drone safely down to the ground. It is not yet available for consumer use and is awaiting authorization from the Federal Communications Commission.

4. Hacking

As drones are functionally flying computers, it’s been proven possible to hack into their software by using Wi-Fi to connect to an unsecured network port on the device. Conversely, at the DEFCON hacker conference in Las Vegas, David Jordan of Aerial Assault demonstrated a drone that can break into computer networks by scanning for unsecured networks, recording their locations using GPS, and relaying the information to the pilot.

5. Eagles

The Dutch National Police are creatively working with Guard From Above, a raptor training company, to determine whether eagles could be used as anti-drone weapon systems. For those worried about the potential dangers to the birds, Guard From Above responded, “In nature, birds of prey often overpower large and dangerous prey. Their talons have scales, which protect them, naturally, from their victims’ bites. Of course, we are continuously investigating any extra possible protective measures we can take in order to protect our birds. The Dutch National Police has asked the Dutch Organization for Applied Scientific Research (TNO) to research the possible impact on the birds’ claws. The results are not yet known. We are working closely with the Dutch National Police on the development of our services.”

6. Jet Skis

Jet Skis don’t seem to be the most practical way of disabling drones, but one jet skier at the 2016 Yamaha New Zealand Festival of Freeride 4 showed how effectively it could be done.

“If the Americans and their regional allies want to pass through the Strait of Hormuz and threaten us, we will not allow any entry,” said deputy commander of Iran’s Revolutionary Guards, Hossein Salami, last Wednesday. Iran has a long history of making threats against this critical waterway, through which some 17 million barrels of oil exports pass daily, though it has not carried them out. But multiple regional security threats highlight threats to energy transit from and through the Middle East and North Africa (MENA)—and demand new thinking about solutions.

Weak spots

Hormuz attracts attention because of its evident vulnerability. But recent years have seen severe disruptions to energy flows across the region: port blockades in Libya; pipeline sabotage in Egypt’s Sinai, Yemen, Baluchistan in Pakistan, and Turkey’s southeast; attacks on oil and gas installations across Syria and Iraq; piracy off Somalia. Energy security is threatened at all scales, from local community disturbances and strikes, up to major regional military confrontations.

Of course, it would be best to mitigate these energy security vulnerabilities by tackling the root causes of conflict across the region. But while disruption and violence persist, energy exporters and consumers alike should guard against complacency.

A glut of oil and gas supplies globally—with low prices, growing U.S. self-sufficiency, and the conclusion of the Iranian nuclear deal—may seem to have reduced the urgency: markets have hardly responded to recent flare-ups. But major economies – even the United States – still remain dependent, directly or indirectly, on energy supplies from the MENA region. Spare oil production capacity is at unusually low levels, leaving the balance vulnerable to even a moderate interruption.

Most concern has focused on oil exports, given their importance to the world economy. But the security of liquefied natural gas (LNG) shipments is an under-appreciated risk, particularly for countries such as Japan and South Korea which are heavily dependent on LNG. A disruption would also have severe consequences for countries in the Middle East and North Africa, depriving them not only of revenues but potentially of critical imports.

Doing better 

There are three broad groups of approaches to mitigating the risk of energy transit disruptions: infrastructure, institutions, and market. 

1. Infrastructure includes the construction of bypass pipelines avoiding key choke-points and strategic storage.
   
   Existing bypass pipelines include SUMED (which avoids the Suez Canal); the Habshan-Fujairah pipeline in the UAE (bypassing Hormuz); and the Saudi Petroline, which runs to the Red Sea, hence offering an alternative to the Gulf and Hormuz. Proposed projects include a link from other Gulf Cooperation Council (GCC) countries to Oman’s planned oil terminal at Duqm on the Indian Ocean; new or rehabilitated pipelines from Iraq across Jordan and Turkey; an expansion of Petroline; and a new terminal in southern Iran at Jask.
   
   Strategic storage can be held by oil exporters, by importers, or a combination (in which exporters hold oil close to their customers’ territory, as with arrangements between Saudi Arabia and Japan, and between Abu Dhabi and Japan and India).


2. Institutional approaches include mechanisms to deal with disruptions, such as cooperative sharing arrangements.
   
   More analysis has focused on infrastructure than on institutional and market mitigation. Yet these approaches have to work together. Physical infrastructure is not enough: it has to be embedded in a suitable framework of regulation, legislation, and diplomacy. Cross-border or multilateral pipelines require agreements on international cooperation; strategic storage is most effective when rules for its use are clear, and when holders of storage agree not to hoard scarce supplies. 
   
   The effective combination of infrastructure and institutions has a strategic benefit even if it is never used. By making oil exporters and consumers less vulnerable to threats, it makes it less likely that such threats will be carried out.
   
   Alliances can be useful for mutual security and coordination. However, they raise the difficult question of whom they are directed against. Mutually-hostile alliances would be a threat to regional energy security rather than a guarantor. Organizations such as the International Energy Agency (IEA), the International Energy Forum (IEF), Organization of Petroleum Exporting Countries (OPEC), Gulf Cooperation Council, and the Association of Southeast Asian Nations (ASEAN) could all have roles, but none is ideally placed. Rather than creating another organization, reaching an understanding between existing bodies may be more effective.


3. In general, markets cope well with the task of allocating scarce supplies. Better and timelier data, such as that gathered by the IEF, can greatly improve the functioning of markets. Governments do have a role in protecting the most vulnerable consumers and ensuring sufficient energy for critical services, but price controls, rationing, and export bans have usually been counterproductive, and many of the worst consequences of so-called energy crises have come from well-meaning government interference with the normal market process of adjustment.
   
   However, it is generally difficult or impossible for a single company or country to capture all the benefits of building strategic infrastructure—which, as with a bypass pipeline, may only be required for a few months over a period of decades. International financing, perhaps backed by a major energy importer—mostly likely China—can help support such projects, particularly at a time of fiscal austerity in the Middle East.

Energy exporters within the MENA region may often find their interests divergent. But the field of energy security is one area for more fruitful cooperation—at least between groups of states, and some external players, particularly their increasingly important Asian customers. If regional tensions and conflicts cannot be easily solved, such action at least alleviates one of the serious risks of the region’s turmoil.

For more on this topic, read Robin Mills’ new analysis paper “Risky routes: Energy transit in the Middle East.”

Despite widespread agreement that the federal budget is on an unsustainable path, there is also widespread disagreement about what should be done. The Hamilton Project asked leading experts from a variety of backgrounds—the policy world, academia, and the private sector, and from both sides of the political aisle—to develop and share their ideas for addressing the deficit. The proposals will be released at two events scheduled for February 22 and February 26. In a dialogue previewing those events, Hamilton Project Director Michael Greenstone and Policy Director Adam Looney discuss some of the key ideas offered by the experts.

Greenstone stresses that the goal of the papers is to move beyond the fights and disagreements between President Obama and Congress and to provide some of the poetry, or some of the details, on how government might run better. The papers will also be featured in a book, 15 Ways to Rethink the Federal Budget, and will take on a wide-ranging set of topics, including immigration, transportation, health care, defense spending, and tax expenditures.

Video

• Michael Greenstone and Adam Looney: These Authors Have Drafted Policies That Help the Budget and Provide Economic Benefits

Although advancements in medical science have greatly improved overall life expectancy and the ability for many to survive a cancer diagnosis, a recent study predicts that cancer care alone will cost the American health system $157 billion by 2020. It is well known that a major driver of these surmounting costs is the rising cost of chemotherapy and other treatments, in addition to the variation in how these treatments are used across the health care system.  However, there are several ways that providers, payers, and patients can work together to establish a more medically and financially effective cancer care model that also reduce costs and inefficiencies in the system.

Figure 1: Estimates of the national expenditures for cancer care in 2010 and estimated increase in cost in 2020

Source: Journal of the National Cancer Institute

Develop “Clinical Pathways” to Reduce Inappropriate Use
For many cancers, there are multiple drugs that can be equally effective in treating a patient’s condition, but the price of these treatments can differ in cost by tens of thousands of dollars. Currently, oncologists are responsible for purchasing their own chemotherapy drugs, processing and maintaining them in a specialized pharmacy-like set up, and then administering them to their patients. Insurers then reimburse the oncologists for the cost of the drugs plus a margin to defray the price of maintenance and administration. Since oncologists receive a share of their income from the margins on the drugs they prescribe, insurers assert that there is an incentive to prescribe the pricier drugs, even when lower cost options of equal effectiveness exist.

One mechanism for ensuring that the most evidence-based treatment is used in the care of cancer patients is to use a set of “clinical pathways.” These pathways are based on clinical guidelines available to the public, but tailored for a particular set of patients or a type of oncology practice. Many professional societies have contributed to these guidelines and are working on developing more advanced tools to manage a patient’s care. The American Society of Clinical Oncology (ASCO) is developing a system to rate drugs for advanced cancer based on a combination of benefit, side effects and price.

Several health plans and providers are already showing results. A Pennsylvania-based collaboration with the University of Pittsburgh Medical Center and commercial payers achieved savings of more than $1 million in only six months by controlling and reducing the use of Avastin through clinical pathways. A Washington-based health plan also achieved $1 million in cost savings through a partnership with 22 medical oncologists.[i] Most recently, one of the nation’s largest health plans announced a new clinical pathways program that provides oncologists with $350 per patient per month (PMPM) for adhering to specific chemotherapy regimens. The program will be rolled out in July across six states with potential for expansion after its first year.

Develop Appropriate Value-Based Incentives that Improve Care and Reduce Costs
It will also be essential to develop alternative payment models that move away from a volume-based fee-for-service model that only pay oncology practices for traditional face-to-face office visits and parenteral medications. Instead, payers should support the transition to value-based models that reward non-traditional care, such as telephone and e-mail clinician support, patient education, and counseling services with a social worker.

ASCO also released a comprehensive payment reform proposal to transition to an episode-based payment system. The proposal outlines five types of flexible, bundled payments built around (1) taking on new patients; (2) providing treatment during a given month; (3) actively monitoring patients when they are not being actively treated; (4) the progression or recurrence of a patient’s disease that requires significant treatment regimen changes; and (5) a patient’s participation in a clinical trial. Additional recommendations include adding penalties or bonuses of up to 10 percent based on the quality of care provided, and complementing other payment reforms such as primary care medical homes and accountable care organizations (ACOs). A number of potential methods of reforming the oncology payment system have been explored elsewhere, including implementation of the Community Oncology Alliance (COA) Oncology Medical Home.

Replicate value-based models across the private and public sectors. Even with momentum from private insurers, comprehensive change must involve the public sector. When Medicare, the largest health insurer in the country, changes policies, many commercial insurance companies follow suit. Cancer care would be an ideal arena to launch a program like Medicare’s Comprehensive Primary Care Initiative, a multi-payer public sector-private sector collaboration to strengthen primary care.

In many ways, insurers’ decisions to take direct action to minimize variations in care and excessive costs sets the stage for what is to come next in health care reform. Not only does this represent a step toward broad payment reform in oncology, but marks a trend toward exploring new methods of payment in other specialties, and to align those efforts with primary care payment reforms.

To learn more about the Engelberg Center's efforts to reform payment in the field of oncology, join us on July 9th from 10:30 AM to 12:30 PM EST for MEDTalk: Reinventing Patient-Centered Cancer Care.

For over 100 years, the driving force of Ohio’s economy has been the state’s so-called Big Eight cities—Columbus, Cleveland, Cincinnati, Toledo, Akron, Dayton, Canton, and Youngstown. Today, though, the driving reality of these cities is sustained, long-term population loss. The central issue confronting these cities—and the state and surrounding metropolitan area—is not whether these cities will have different physical footprints and more green space than they do now, but how it will happen.

The state must adopt a different way of thinking and a different vision of its cities’ future—and so must the myriad local, civic, philanthropic, and business leaders who will also play a role in reshaping Ohio’s cities. The following seven basic premises should inform any vision for a smaller, stronger future and subsequent strategies for change in these places:

• These cities contain significant assets for future rebuilding
  
• These cities will not regain their peak population
  
• These cities have a surplus of housing
  
• These cities have far more vacant land than can be absorbed by redevelopment
  
• Impoverishment threatens the viability of these cities more than population loss as such
  
• Local resources are severely limited
  
• The fate of cities and their metropolitan areas are inextricably inter-connected
  

These premises have significant implications for the strategies that state and local governments should pursue to address the issues of shrinking cities.

Full Paper on Ohio's Cities » (PDF)
Paper on Shrinking Cities Across the United States »

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• Full Paper

In the marijuana reform conversation, one of the grandest boogeymen is “Big Marijuana.” Reform advocates, opponents of marijuana legalization, patients, consumers, media, and many others worry openly that the marijuana industry will consolidate into a corporate beast and a bad market actor reminiscent of Big Tobacco companies.

In a paper released earlier this month entitled, “Worry about bad marijuana—not Big Marijuana,” Jonathan Rauch and I engage the likelihood and risks of the emergence of such a corporate entity. Although the paper makes several points, we begin with a discussion of exactly what “Big Marijuana” means. What we find is that the concept is tossed around so frequently, assigned to so many different types of market actors, that it has ultimately lost meaning.

Often, the term is used to describe any large corporate entity or consolidation effort within the marijuana industry. In reality, standard corporate consolidation or the existence of large companies in an industry are basic aspects in capitalism. What’s more there are huge differences between marijuana industry actors today and Big Tobacco companies of the middle of the 20^th century—in terms of size, scope, and market power to name a few. It should be expected that an industry that is young, fractured, and rapidly maturing will endure periods of consolidation and in the process, large and successful corporate entities will emerge. One should not assume, however, that such behaviors are sinister, suspect, or intent on engaging in immoral or illegal activities.

Nor should one assume that only large corporate entities can engage in bad behaviors. They surely can, but other market actors may as well. The policy conversation around marijuana industry structure often holds Big Marijuana up as the actor who will bring problems for enforcement, diversion, sale to minors, sale to problem users, etc. The reality is that a marijuana entity of any size can behave in many of those behaviors. The problem with an unending focus on industry structure or corporate size is that policymakers and regulators can give a pass to smaller actors who may engage in the types of behaviors people inside and outside of industry seek to avoid—those same types of behaviors we saw from the tobacco industry.

We argue there is a more sensible, safer step forward that begins with a simple premise. There are certain outcomes that the marijuana industry must avoid, and policy and regulation should preferably ban, but at least disincentivize those outcomes. We mention a few in the paper: antisocial marketing (marketing to children or problem users), regulatory capture, outcomes that hurt medical marijuana patients, and increasing barriers to entry and corporate crowd out—but others like diversion, illegal sales, and more must (and do) concern policy makers. In some cases, certain behaviors are more likely to come from larger corporate entities, but many behaviors can happen, independent of firm size.

There are a variety of ways to avoid some of these outcomes beyond a focus on firm size and corporate consolidation. Some of those options are highlighted by the RAND Corporation’s Drug Policy Research Center. In “Options and Issues Regarding Marijuana Legalization,” the authors argue a shift away from the corporate model—either through the use of non-profit entities or government operation of whole portions of the market (supply, retail, or both) can have real benefit. These approaches can allow regulators greater control over negative market actions and induce incentives focused on public health and good governance, rather than profit maximization. Those arguments are quite convincing, but as states continue to construct medical and recreational marijuana programs using the corporate model, it is important to consider policy approaches within that existing framework.

Thus, we recommend that regulators and policy makers not primarily focus on firm size, corporate consolidation, or the corporatization of the marijuana industry. Instead, they should work to avoid specific outcomes they see as unwanted or bad and pass laws, promulgate regulations, conduct information and education campaigns, and take whatever actions are necessary to stop them in their tracks. At the end of the day, one thing is clear: no one wants “Bad Marijuana” regardless of whether it comes from Big, Small, or Otherwise-Sized Marijuana.

Click through to read the full report, “Worry about bad marijuana—not Big Marijuana.”

Click through to watch the public event and paper release “Big Marijuana: How corporations and lobbies will shape the legalization landscape.”

Many American households do not save for retirement. Those that do save often contribute too little, invest poorly, or withdraw funds early. These patterns leave households, particularly low- and middle-income households, vulnerable to insufficient savings to finance adequate living standards during old age and retirement.

This research report proposes retirement saving reforms designed to help boost saving among low- and middle-income households. These 11 proposals are grouped under five themes: (1) making saving easier, (2) making saving more rewarding, (3) strengthening the market infrastructure for saving, (4) providing private information to savers, and (5) improving public education for saving.

Download the full report at aarp.org »

Editor's note: This piece originally appeared in the Wall Street Journal's Washington Wire on July 11, 2016. Theresa May has since succeeded David Cameron as UK prime minister.

Theresa May is poised to become Britain’s next prime minister on Wednesday. This means there is a reasonable chance the post-Brexit whirlwind of U.K. politics will quiet somewhat. Here are seven things that stand out about the next PM:

1. Her experience. Ms. May has been in the top ranks of British politics for almost two decades. She is one of the longest-serving home secretaries, overseeing domestic security, law and order, and immigration. With the exception of Michael Gove, who was knocked out early in the contest, she was by far the most experienced candidate in the race.

2. Her resilience. Ms. May is what Americans call a tough cookie. When I was in government, she was the Cabinet minister with whom David Cameron least liked to tangle. When Ms. May said no, she meant no. This did not always lead to perfect policy outcomes, of course. But few in Westminster doubt her strength.

3. Modernizing instincts. As the Conservative Party’s first female chairman, Ms. May pointed out in 2002 that to many voters the Tories were seen as the “nasty party” and that reform was essential. She helped to lay the ground for David Cameron to emerge as a new, more moderate face of the Conservative Party. Ms. May was also one of the first senior Conservatives to back same-sex marriage.

4. She backed Remain. As the only leadership candidate who was on the losing side of the Brexit vote, she is, paradoxically, well-placed to unite the Conservative Party in parliament. Most Tory MPs were, like Ms. May, in the Remain camp. But she was a lukewarm Remainer and has a history of being skeptical of European institutions–including the European Convention on Human Rights–which will endear her to Brexiteers. Already she has made it clear that “Brexit means Brexit” and that she will only trigger Article 50, which governs the process by which an EU member exits, when she has her negotiating position worked out. So far, so good. (Particularly for those worried about market volatility and the U.K. economy in the wake of the June 23 referendum.)

5. Government stability. Given her strong support among parliamentary colleagues, Ms. May is not likely to feel any need to trigger an emergency general election. Instead, she can make the case that the U.K. needs a stable government during the lengthy Brexit negotiations to come (and she’ll be right). Labour politicians calling for an election are whistling in the wind, especially given their own leadership civil war.

6. Gender issues and non-issues. Theresa May is about to become the U.K.’s second female prime minister and there has been refreshingly little commentary on her gender. The only real exception was the row caused by her opponent Andrea Leadsom, who clumsily implied in a recent interview that not being a mother made Ms. May less qualified. (Ms. Leadsom apologized shortly before dropping out of the contest.) If Labour MPs manage to dislodge their leader, Jeremy Corbyn (an outcome that may be decided in court), the favorite to succeed him is Angela Eagle, who is married to a woman.

7. Redressing the class balance. The United Kingdom has been run by posh people, since, well, forever. But David Cameron’s crowd was a particularly upper-crust bunch, mostly educated at private schools. Ms. May, by contrast, went to a comprehensive high school (in American English, a public school). To the extent that there is need for more class diversity among governing elites, this is another piece of good news.

None of this alters the disastrous economic implications of the Brexit vote. But by turning to May, the Conservatives will be better prepared to secure a period of stable government, with a little more class and gender diversity thrown in for good measure. That’s about the best one could hope for.

INTRODUCTION

In an earlier policy brief, Where is the Learning? Measuring Schooling Efforts in Developing Countries, we drew attention to what was labeled “the global learning crisis.” While tremendous progress has been made over the past couple of decades to get tens of millions of additional children to enroll in school, progress in improving learning outcomes has been considerably less impressive. Although, shockingly, comprehensive learning outcome data are not available for most of the developing world, the many small scale, local or, in some cases, national studies that have been done show a dismal picture. For instance, Uwezo, an East African initiative, found that in Tanzania, only 44 percent of students in Grade 4 were able to read a basic story from Grade 2. Similarly, the Annual Status of Education Report (ASER) facilitated by Pratham found that in rural India, less than half of Grade 4 students were able to do basic subtraction. These examples demonstrate the gravity of “the global learning crisis” as students fail to master competencies appropriate for their grade level, hindering the development of life skills and success in further schooling, as well as performance in the labor market.

With about 61 million children in the developing world still not yet in school, it is too early to declare victory on the “enrollment agenda”. But we would do a disservice to the 250 million children around the world who fail to reach Grade 4 or attain minimum learning standards, if we don’t step up efforts to improve learning outcomes.

This policy brief is part of a larger effort to link resources in the education sector with outcome measures. As we have documented elsewhere, few countries systematically collect comprehensive financial data on education, although fortunately an increasing number of initiatives is trying to address this issue by producing, for instance, National Education Accounts (NEAs). When the focus of the sector changes from enrollment to enrollment plus learning, efforts to better grasp the size and use of financial resources should evolve accordingly. For instance, much learning takes place outside of the classroom, especially in the early years. For NEAs to be a useful tool for adjusting the allocation of scarce resources, the “learning” sector should be defined more broadly than the education or “schooling” sector. We will address this and related issues in a subsequent policy brief.

Once our focus becomes enrollment plus learning, we have to broaden our view and look at the entire environment in which a child develops skills, starting with the households in which children are born. It has beenknown for many decades and throughout the world, that among the best predictors of future school performance are some basic household characteristics, such as income and mother’s education level.

Data from international assessments also show a relationship between income and educational performance, exemplified by intra and intercountry results. In Colombia, average Trends in International Mathematics and Science Study (TIMSS) math scores at Grade 8 for the richest quintile of students were close to 100 points higher than those from the poorest quintile. On the other hand, the difference in average scores between the poorest quintile in the United States and the richest quintile in Colombia was about 50 points. Income is not the only predictor of success, as exemplified in Peru, where children whose mothers have completed primary school and whose maternal language is Spanish rather than an indigenous language, have a greater probability of reaching the appropriate school grade for their age. In Kenya, Uwezo found that the higher their father’s educational attainment, the more likely children were able to read a story at Grade 3 or attend extra tutoring sessions.

In addition, the larger environment (such as the village or the urban neighborhood) in which the young child grows up also has a major and lasting impact. In Tanzania, urban students in Grade 3 are three times more likely than their rural counterparts to meet standards in literacy and numeracy. Related to the impact of the larger environment, data from Nigeria suggest that girls are more disadvantaged in school attendance, as parents may be reluctant to send girls to school because of perceived fears for their safety while traveling and concerns about the physical strength required for walking the distance.

Clearly, especially in the early years, most learning takes place outside of the classroom. Consequently, children who grow up in deprived circumstances will start life with a disadvantage leading to a lack of learning in the early grades, which will have lifetime effects.

In the next section, we will summarize the evidence that the early years (ages 0 to 5) are crucial for subsequent learning achievements. From this evidence we conclude that many of the problems with learning outcomes in the developing world (and in many developed countries) need to be addressed well before school age. Before delving into what happens in schools, we explore the relationship between enrollment, learning and dropout. As the crux of this brief is to lay out the evidence on what contributes to learning, we must acknowledge the factors leading to low enrollment and dropout. Next, we turn our attention to what happens in schools and what can be done to improve these activities, as well as try to summarize the evidence about the relationship between specific school-based inputs and learning outcomes. As it turns out, this evidence is, in many cases, rather feeble. Therefore, we will first focus on school-level inputs that are necessary for a good learning environment, i.e. without which we cannot expect any learning to take place. Most of these inputs are rather obvious, but they are worth mentioning. Subsequently, we will discuss additional inputs that have proven to contribute to learning outcomes in some cases, but not in others. Clearly how these inputs are applied matters.

Next, we address factors that contribute to learning outside of a formal environment, after which we review issues in health and nutrition that are closely linked to learning outcomes. We then review the need for the collection and dissemination of learning assessments in order to impact further improvements in these areas and we try to answer the question: what are the building blocks for an education sector that promote learning? Finally we explore needs for future research in learning.

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A Q&A with Dennis Lower, president and CEO, Cortex Innovation Community

As leaders scan the landscape for strong examples of innovation districts, their tour is hardly complete without learning of the Cortex Innovation Community—an innovation district in the heart of St. Louis. We sat down with Dennis Lower, president and CEO of the Cortex Innovation Community to learn what kinds of interventions and instruments are driving their success.

What is the Cortex Innovation Community?

Cortex is the region’s largest innovation hub, generating 3,800 tech-related jobs and over $500 million in investment in the last 14 years. It’s located close to downtown and built on the intellectual assets and resources of St. Louis’ leading universities, a premier health care provider, and the Missouri Botanical Garden. The focal point is the 200 acres of old industrial land that one time separated these institutions but that now stitches them together. At full build-out, Cortex will likely generate $2 billion of development and create 13,000 jobs.

What sets Cortex apart from other innovation districts?

Of course, every district is distinctive and unique, building off its local character, culture, and assets. What sets Cortex apart, I would argue, is that we literally have billions of dollars of academic, cultural, and recreational assets in the neighborhoods that surround the district, which other places simply do not have.

We are bookended by two universities—Washington University and St. Louis University—each a magnet for international students and each with a reputation for research and academic excellence. Washington University, for example, was one of five consortium members funded by the National Institutes of Health to map the human genome. These universities, together with the University of Missouri-St. Louis, are the academic bedrock of our local innovation ecosystem.

Recent demographic analysis tells us we are now the most diverse employment environment in the region no matter how you slice it, including by age, ethnicity, and educational attainment.

Another Cortex advantage is the neighborhood that surrounds us. In addition to historic housing, the Grand Center arts district is to the east, to the west is Forest Park, which contains the St. Louis Zoo, fine arts and history museums, two golf courses, the St. Louis Science Center, abundant walking and biking trails, and the internationally renowned Botanical Garden. Restaurant corridors are to the north and south. I tell you all this to say that Cortex is where innovation, tech, culture, and community collide—and people are hungry for this mix.

Cortex Innovation Community is also a tax-exempt 501(c)3 that oversees the design and development of the innovation district. What makes your nonprofit unique in managing this district?

Cortex has been designated the master developer to transform an old industrial district into a center for innovation and commercialization. We are in a particularly advantageous position because the state and the city have granted the 501(c)3 powers of eminent domain, the power to abate taxes, and the power to approve or reject building plans. From a traditional economic development perspective, these powers have been critical in overcoming obstacles that land speculators sometimes put in our way. We have not had to use this power very often, fortunately. Only a handful of properties were acquired under the threat of eminent domain, and we reached an impasse only twice, sending us to court to purchase those properties. We take this responsibility seriously and only use eminent domain powers sparingly. We have a good reputation with the public as a result.

Can you describe one accomplishment you are particularly proud of?

We knew that to jump-start an innovation district it was essential to build entrepreneurial density. We developed an unorthodox strategy of sorts in that we built a concentration of innovation assets all within a block of each other. Today, we have six innovation centers, each with its own community and programming: the Center for Emerging Technologies, a traditional technical assistance incubator for information technology, bioscience, and consumer/manufacturing products; the BioGenerator, an accelerator with shared wet lab space and $3 million of shared core lab equipment; TechShop, a premier maker work space for prototyping and creating; the Cambridge Innovation Center–St. Louis, a co-working office and lab startup space); Venture Café–St. Louis, a shared public space for the startup community to meet weekly with 8 to 12 unconventional breakout educational sessions; and IdeaLabs/MedLaunch, a unique university graduate/undergraduate incubator that develops new technology to solve clinical problems. This strategy is working beyond our wildest expectations. It’s the “secret sauce” for supercharging our district’s innovation ecosystem. 

Venture Café: one of the six innovation centers that weekly draws together over 500 entrepreneurs from all technology sectors.

Can you highlight one particularly interesting innovation or invention coming out of Cortex? 

Let me highlight two. We have over 200 companies in Cortex—there’s too much innovation happening here to highlight only one!

First, we have a medical device company that is changing the way infectious diseases are diagnosed. Its products can rapidly detect bacterial infections, determine if the infection is resistant to a range of antibiotics, and provide clinicians with patient-specific guidance to treat infections quickly and accurately. Their first product can diagnose urinary tract infections in just three hours.

And then we have a company tackling the biggest challenge in agriculture today—preventing insects, diseases, and weeds from destroying food crops. This company is developing a cost-effective technology to produce and topically deliver RNAi for agricultural crops. Put simply, this technology helps plants develop desired genetic traits without the use of genetically modified organisms, or GMOs. This could be transformative.

Many people have asked us how innovation districts are supporting inclusive growth. There is a concern that innovation districts are focusing on innovation to the exclusion of employment of city residents, who may not possess the skills or education the district’s businesses are seeking.

We look at inclusion as an integral part of our work and mission at Cortex. We currently have six inclusion initiatives and will soon introduce two more. One of those is the development of a magnet high school in the St. Louis Public School District, the Collegiate School for Medicine and Biosciences. Working closely with the school district’s superintendent and an important group of institutional and civic leaders, we have been developing an urban high school centered on one of the major strengths of our Cortex sponsors—bioscience. We recruited our first class in 2013, providing instruction in a small, temporary school, and in 2015 moved to a permanent location that can support 400 students.

The students come from all across the region, representing the largest spread of zip codes of any regional public school. Currently, 53 percent of the students are African American, 23 percent are Asian, and 22 percent are white, representing a great mix. Last year’s proficiency testing in math and English revealed that we ranked first across the entire public school system. I find this particularly gratifying because a number of incoming freshmen were not performing at grade level. What this tells us is given the opportunity, creative teaching approaches, and a supportive structure, these kids will excel quickly. With our incoming 9th grade class this August, we will have a full complement of freshmen to seniors, graduating our first class in 2017.

Perhaps one of these students will find the next cure for cancer. To me, this illustrates an important part of our district’s DNA—to grow and cultivate innovation talent for the future.