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How an evidence-based program from Bangladesh could scale to end extreme poverty

Extreme poverty has risen sharply due to the economic turmoil caused by COVID-19. After decades of progress in international development, up to 150 million people now face a return to severe destitution. Even before the pandemic crisis, progress on povert

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By Lindsay Coates

Extreme poverty has risen sharply due to the economic turmoil caused by COVID-19. After decades of progress in international development, up to 150 million people now face a return to severe destitution.

Even before the pandemic crisis, progress on poverty eradication was slowing globally. While extreme poverty rates fell an average of 1 percentage point per year from 1990 to 2015, new data shows that extreme poverty decreased by less than half a percentage point per year between 2015 and 2017. Between 2017 and 2019, the pace of poverty reduction slowed by an additional two-fifths. As of February 2020, poverty was in fact increasing in several countries, while many others were already off track to achieving Sustainable Development Goal 1.

This need not be a cause for despair. It can be a call to action for the international community to examine what is working in poverty eradication and what is not. On a global scale, we need innovative, evidence-based solutions proven to help people escape extreme poverty. Government programs and policies focused on extreme poverty eradication must not only lift people above the poverty line, but support them in staying above it, building resilience to future climate, disease, and economic-driven shocks.

As we approach upwards of 700 million people living in extreme poverty globally by the end of 2020, governments and international actors are seeking evidence-based interventions that can be implemented on a mass scale.

The poverty trap, a cyclical pattern where the multidimensional causes of extreme poverty prevent people from acquiring the resources to escape it, has been the subject of heated debate. A recent randomized controlled trial, however, proves its existence. A “big push” like a productive asset transfer can help people cross the poverty trap threshold and “graduate” from poverty into long-term self-sufficiency.

The Graduation approach is the most widespread and well-researched version of a “big push” poverty eradication method. Pioneered by BRAC in Bangladesh in 2002, Graduation is a time-bound sequence of interventions built around addressing the multidimensional causes of extreme poverty. These interventions are adapted to local requirements and generally include livelihood training, transfers of cash and productive assets, and encouragement of savings, all facilitated through in-person coaching. They focus on the needs of the household as a whole, with women usually as the primary program participants. The interventions are designed around four pillars: social protection, livelihood promotion, financial inclusion, and social empowerment.

The Graduation approach

The Graduation approach is a series of interventions connected to social protection, livelihoods promotion, financial inclusion, and social empowerment designed to provide a “big push” to help program participants escape extreme poverty long term. (Source: BRAC Ultra-Poor Graduation Initiative)

Once participants cross benchmarks for key criteria, determined by the local context, in areas such as minimum savings, income, health, and child education, they “graduate” from a given program. The Graduation approach has proven effective in not only helping people escape the poverty trap, but also in improving their quality of life well after the intervention ends.

Research from the London School of Economic and Political Science found that more than five years after completing BRAC’s Ultra-Poor Graduation (UPG) program in Bangladesh—and more than seven years after the initial transfer of productive assets—93 percent of participating households experienced long-term gains. On average, participants experienced a 37 percent increase in income, a 361 percent increase in labor productivity, a twofold increase in household asset value and access to land, and a ninefold increase in savings.

Graduation is effective in mitigating the worst economic effects of COVID-19 on households living in extreme poverty. Following extended lockdowns, 95 percent of Graduation participants in Bangladesh and 67 percent of participants in the Philippines were able to continue operating the livelihoods they received through the programs. Meanwhile, the financial literacy training and financial inclusion component of Graduation supported 75 percent of participants in the Philippines to use their savings during lockdowns, a substantial increase given that only 29 percent had any savings at the program start.

In addition to increasing resilience and supporting people in extreme poverty in making long-term gains, academic evaluations of Graduation programs in varied country contexts have found the approach to be a particularly cost-effective solution to poverty reduction. The UPG program costs $500 per household on average over a period of two years, and overall implementation costs can vary from $300-2,000 depending on program design. Based on its long-lasting impacts, researchers estimate that for every dollar spent on a Graduation program there is a return of $2-5 in benefits, with returns ranging from $2-3 in most country contexts. These findings led the U.K.’s public foreign aid watchdog in 2019 to cite the UPG program as one of the “best buys in development.”

As a caveat, cost-benefit analyses of Graduation are highly contextualized to individual programs and implementers. For example, the cost-benefit ratio of the UPG program in Bangladesh, where BRAC implements the program directly, will differ from programs where the Graduation approach is implemented by government and integrated into existing social protection programs to reduce costs. Returns will vary based on program design, local market conditions, and a host of other factors. Further study is needed on the ROI of Graduation programs in fragile settings, urban contexts, and settings with very limited market activity.

The impact of Graduation on extreme poverty globally over the past 18 years has been striking. In Bangladesh alone, the UPG program reached over 9 million people in 2 million households and helped 95 percent of participants to escape extreme poverty. Based on the successes of the program, over 100 partners in nearly 50 countries have either piloted or implemented Graduation, reaching 14 million people and over 3 million total households.

Since 2013, the BRAC Ultra-Poor Graduation Initiative has been scaling Graduation in 13 countries outside of Bangladesh by providing technical assistance to government, multilateral, and NGO partners. This experience has made clear that governments are crucial to scaling anti-poverty programming. Governments have the greatest resources, capacity, and ability to drive systems change in national approaches to poverty reduction. Among other benefits, integrating Graduation into existing government programming makes programs more durable and allows for linkages across ministries and increased possibilities to connect people in extreme poverty to essential government services. By influencing policy change to support uptake of the Graduation approach and partnering with governments to scale Graduation programs, we believe it is feasible to help 21 million people escape extreme poverty by 2026.

Given the dramatic rise in poverty resulting from COVID-19, it is urgent that policymakers consider recovery plans that include the poorest populations and go beyond short-term emergency measures. As we approach upwards of 700 million people living in extreme poverty globally by the end of 2020, governments and international actors are seeking evidence-based interventions that can be implemented on a mass scale. Household-level data supports the efficacy of the Graduation approach, and it has been applied successfully to varied geographies and poverty contexts.

If designed and targeted appropriately, the Graduation approach can reach marginalized population segments often unreachable to government programs. To incorporate the intervention into existing social safety nets, we must build the political will and fiscal space to do so. By partnering with multilateral institutions, policymakers, NGOs, civil society groups, private sector partners, and academic institutions, there is a realistic path to scale the Graduation approach to reverse a substantial amount of lost progress in global poverty eradication.

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Analyst reviews Apple stock price target amid challenges

Here’s what could happen to Apple shares next.

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They said it was bound to happen.

It was Jan. 11, 2024 when software giant Microsoft  (MSFT)  briefly passed Apple  (AAPL)  as the most valuable company in the world.

Microsoft's stock closed 0.5% higher, giving it a market valuation of $2.859 trillion. 

It rose as much as 2% during the session and the company was briefly worth $2.903 trillion. Apple closed 0.3% lower, giving the company a market capitalization of $2.886 trillion. 

"It was inevitable that Microsoft would overtake Apple since Microsoft is growing faster and has more to benefit from the generative AI revolution," D.A. Davidson analyst Gil Luria said at the time, according to Reuters.

The two tech titans have jostled for top spot over the years and Microsoft was ahead at last check, with a market cap of $3.085 trillion, compared with Apple's value of $2.684 trillion.

Analysts noted that Apple had been dealing with weakening demand, including for the iPhone, the company’s main source of revenue. 

Demand in China, a major market, has slumped as the country's economy makes a slow recovery from the pandemic and competition from Huawei.

Sales in China of Apple's iPhone fell by 24% in the first six weeks of 2024 compared with a year earlier, according to research firm Counterpoint, as the company contended with stiff competition from a resurgent Huawei "while getting squeezed in the middle on aggressive pricing from the likes of OPPO, vivo and Xiaomi," said senior Analyst Mengmeng Zhang.

“Although the iPhone 15 is a great device, it has no significant upgrades from the previous version, so consumers feel fine holding on to the older-generation iPhones for now," he said.

A man scrolling through Netflix on an Apple iPad Pro. Photo by Phil Barker/Future Publishing via Getty Images.

Future Publishing/Getty Images

Big plans for China

Counterpoint said that the first six weeks of 2023 saw abnormally high numbers with significant unit sales being deferred from December 2022 due to production issues.

Apple is planning to open its eighth store in Shanghai – and its 47th across China – on March 21.

Related: Tech News Now: OpenAI says Musk contract 'never existed', Xiaomi's EV, and more

The company also plans to expand its research centre in Shanghai to support all of its product lines and open a new lab in southern tech hub Shenzhen later this year, according to the South China Morning Post.

Meanwhile, over in Europe, Apple announced changes to comply with the European Union's Digital Markets Act (DMA), which went into effect last week, Reuters reported on March 12.

Beginning this spring, software developers operating in Europe will be able to distribute apps to EU customers directly from their own websites instead of through the App Store.

"To reflect the DMA’s changes, users in the EU can install apps from alternative app marketplaces in iOS 17.4 and later," Apple said on its website, referring to the software platform that runs iPhones and iPads. 

"Users will be able to download an alternative marketplace app from the marketplace developer’s website," the company said.

Apple has also said it will appeal a $2 billion EU antitrust fine for thwarting competition from Spotify  (SPOT)  and other music streaming rivals via restrictions on the App Store.

The company's shares have suffered amid all this upheaval, but some analysts still see good things in Apple's future.

Bank of America Securities confirmed its positive stance on Apple, maintaining a buy rating with a steady price target of $225, according to Investing.com

The firm's analysis highlighted Apple's pricing strategy evolution since the introduction of the first iPhone in 2007, with initial prices set at $499 for the 4GB model and $599 for the 8GB model.

BofA said that Apple has consistently launched new iPhone models, including the Pro/Pro Max versions, to target the premium market. 

Analyst says Apple selloff 'overdone'

Concurrently, prices for previous models are typically reduced by about $100 with each new release. 

This strategy, coupled with installment plans from Apple and carriers, has contributed to the iPhone's installed base reaching a record 1.2 billion in 2023, the firm said.

More Tech Stocks:

Apple has effectively shifted its sales mix toward higher-value units despite experiencing slower unit sales, BofA said.

This trend is expected to persist and could help mitigate potential unit sales weaknesses, particularly in China. 

BofA also noted Apple's dominance in the high-end market, maintaining a market share of over 90% in the $1,000 and above price band for the past three years.

The firm also cited the anticipation of a multi-year iPhone cycle propelled by next-generation AI technology, robust services growth, and the potential for margin expansion.

On Monday, Evercore ISI analysts said they believed that the sell-off in the iPhone maker’s shares may be “overdone.”

The firm said that investors' growing preference for AI-focused stocks like Nvidia  (NVDA)  has led to a reallocation of funds away from Apple. 

In addition, Evercore said concerns over weakening demand in China, where Apple may be losing market share in the smartphone segment, have affected investor sentiment.

And then ongoing regulatory issues continue to have an impact on investor confidence in the world's second-biggest company.

“We think the sell-off is rather overdone, while we suspect there is strong valuation support at current levels to down 10%, there are three distinct drivers that could unlock upside on the stock from here – a) Cap allocation, b) AI inferencing, and c) Risk-off/defensive shift," the firm said in a research note.

Related: Veteran fund manager picks favorite stocks for 2024

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Major typhoid fever surveillance study in sub-Saharan Africa indicates need for the introduction of typhoid conjugate vaccines in endemic countries

There is a high burden of typhoid fever in sub-Saharan African countries, according to a new study published today in The Lancet Global Health. This high…

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There is a high burden of typhoid fever in sub-Saharan African countries, according to a new study published today in The Lancet Global Health. This high burden combined with the threat of typhoid strains resistant to antibiotic treatment calls for stronger prevention strategies, including the use and implementation of typhoid conjugate vaccines (TCVs) in endemic settings along with improvements in access to safe water, sanitation, and hygiene.

Credit: IVI

There is a high burden of typhoid fever in sub-Saharan African countries, according to a new study published today in The Lancet Global Health. This high burden combined with the threat of typhoid strains resistant to antibiotic treatment calls for stronger prevention strategies, including the use and implementation of typhoid conjugate vaccines (TCVs) in endemic settings along with improvements in access to safe water, sanitation, and hygiene.

 

The findings from this 4-year study, the Severe Typhoid in Africa (SETA) program, offers new typhoid fever burden estimates from six countries: Burkina Faso, Democratic Republic of the Congo (DRC), Ethiopia, Ghana, Madagascar, and Nigeria, with four countries recording more than 100 cases for every 100,000 person-years of observation, which is considered a high burden. The highest incidence of typhoid was found in DRC with 315 cases per 100,000 people while children between 2-14 years of age were shown to be at highest risk across all 25 study sites.

 

There are an estimated 12.5 to 16.3 million cases of typhoid every year with 140,000 deaths. However, with generic symptoms such as fever, fatigue, and abdominal pain, and the need for blood culture sampling to make a definitive diagnosis, it is difficult for governments to capture the true burden of typhoid in their countries.

 

“Our goal through SETA was to address these gaps in typhoid disease burden data,” said lead author Dr. Florian Marks, Deputy Director General of the International Vaccine Institute (IVI). “Our estimates indicate that introduction of TCV in endemic settings would go to lengths in protecting communities, especially school-aged children, against this potentially deadly—but preventable—disease.”

 

In addition to disease incidence, this study also showed that the emergence of antimicrobial resistance (AMR) in Salmonella Typhi, the bacteria that causes typhoid fever, has led to more reliance beyond the traditional first line of antibiotic treatment. If left untreated, severe cases of the disease can lead to intestinal perforation and even death. This suggests that prevention through vaccination may play a critical role in not only protecting against typhoid fever but reducing the spread of drug-resistant strains of the bacteria.

 

There are two TCVs prequalified by the World Health Organization (WHO) and available through Gavi, the Vaccine Alliance. In February 2024, IVI and SK bioscience announced that a third TCV, SKYTyphoid™, also achieved WHO PQ, paving the way for public procurement and increasing the global supply.

 

Alongside the SETA disease burden study, IVI has been working with colleagues in three African countries to show the real-world impact of TCV vaccination. These studies include a cluster-randomized trial in Agogo, Ghana and two effectiveness studies following mass vaccination in Kisantu, DRC and Imerintsiatosika, Madagascar.

 

Dr. Birkneh Tilahun Tadesse, Associate Director General at IVI and Head of the Real-World Evidence Department, explains, “Through these vaccine effectiveness studies, we aim to show the full public health value of TCV in settings that are directly impacted by a high burden of typhoid fever.” He adds, “Our final objective of course is to eliminate typhoid or to at least reduce the burden to low incidence levels, and that’s what we are attempting in Fiji with an island-wide vaccination campaign.”

 

As more countries in typhoid endemic countries, namely in sub-Saharan Africa and South Asia, consider TCV in national immunization programs, these data will help inform evidence-based policy decisions around typhoid prevention and control.

 

###

 

About the International Vaccine Institute (IVI)
The International Vaccine Institute (IVI) is a non-profit international organization established in 1997 at the initiative of the United Nations Development Programme with a mission to discover, develop, and deliver safe, effective, and affordable vaccines for global health.

IVI’s current portfolio includes vaccines at all stages of pre-clinical and clinical development for infectious diseases that disproportionately affect low- and middle-income countries, such as cholera, typhoid, chikungunya, shigella, salmonella, schistosomiasis, hepatitis E, HPV, COVID-19, and more. IVI developed the world’s first low-cost oral cholera vaccine, pre-qualified by the World Health Organization (WHO) and developed a new-generation typhoid conjugate vaccine that is recently pre-qualified by WHO.

IVI is headquartered in Seoul, Republic of Korea with a Europe Regional Office in Sweden, a Country Office in Austria, and Collaborating Centers in Ghana, Ethiopia, and Madagascar. 39 countries and the WHO are members of IVI, and the governments of the Republic of Korea, Sweden, India, Finland, and Thailand provide state funding. For more information, please visit https://www.ivi.int.

 

CONTACT

Aerie Em, Global Communications & Advocacy Manager
+82 2 881 1386 | aerie.em@ivi.int


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US Spent More Than Double What It Collected In February, As 2024 Deficit Is Second Highest Ever… And Debt Explodes

US Spent More Than Double What It Collected In February, As 2024 Deficit Is Second Highest Ever… And Debt Explodes

Earlier today, CNBC’s…

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US Spent More Than Double What It Collected In February, As 2024 Deficit Is Second Highest Ever... And Debt Explodes

Earlier today, CNBC's Brian Sullivan took a horse dose of Red Pills when, about six months after our readers, he learned that the US is issuing $1 trillion in debt every 100 days, which prompted him to rage tweet, (or rageX, not sure what the proper term is here) the following:

We’ve added 60% to national debt since 2018. Germany - a country with major economic woes - added ‘just’ 32%.   

Maybe it will never matter.   Maybe MMT is real.   Maybe we just cancel or inflate it out. Maybe career real estate borrowers or career politicians aren’t the answer.

I have no idea.  Only time will tell.   But it’s going to be fascinating to watch it play out.

He is right: it will be fascinating, and the latest budget deficit data simply confirmed that the day of reckoning will come very soon, certainly sooner than the two years that One River's Eric Peters predicted this weekend for the coming "US debt sustainability crisis."

According to the US Treasury, in February, the US collected $271 billion in various tax receipts, and spent $567 billion, more than double what it collected.

The two charts below show the divergence in US tax receipts which have flatlined (on a trailing 6M basis) since the covid pandemic in 2020 (with occasional stimmy-driven surges)...

... and spending which is about 50% higher compared to where it was in 2020.

The end result is that in February, the budget deficit rose to $296.3 billion, up 12.9% from a year prior, and the second highest February deficit on record.

And the punchline: on a cumulative basis, the budget deficit in fiscal 2024 which began on October 1, 2023 is now $828 billion, the second largest cumulative deficit through February on record, surpassed only by the peak covid year of 2021.

But wait there's more: because in a world where the US is spending more than twice what it is collecting, the endgame is clear: debt collapse, and while it won't be tomorrow, or the week after, it is coming... and it's also why the US is now selling $1 trillion in debt every 100 days just to keep operating (and absorbing all those millions of illegal immigrants who will keep voting democrat to preserve the socialist system of the US, so beloved by the Soros clan).

And it gets even worse, because we are now in the ponzi finance stage of the Minsky cycle, with total interest on the debt annualizing well above $1 trillion, and rising every day

... having already surpassed total US defense spending and soon to surpass total health spending and, finally all social security spending, the largest spending category of all, which means that US debt will now rise exponentially higher until the inevitable moment when the US dollar loses its reserve status and it all comes crashing down.

We conclude with another observation by CNBC's Brian Sullivan, who quotes an email by a DC strategist...

.. which lays out the proposed Biden budget as follows:

The budget deficit will growth another $16 TRILLION over next 10 years. Thats *with* the proposed massive tax hikes.

Without them the deficit will grow $19 trillion.

That's why you will hear the "deficit is being reduced by $3 trillion" over the decade.

No family budget or business could exist with this kind of math.

Of course, in the long run, neither can the US... and since neither party will ever cut the spending which everyone by now is so addicted to, the best anyone can do is start planning for the endgame.

Tyler Durden Tue, 03/12/2024 - 18:40

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