Working Papers
2022
September 16, 2022
Rationalizing Pharmaceutical Spending
Description: Pharmaceutical spending accounts for a large share of health spending worldwide. While pharmaceuticals are an indispensable component of effective modern health systems, and their benefits in terms of increasing life expectancy and improving quality of life are unquestionable, the large variation in pharmaceutical spending across countries suggests that there may be large efficiency gains to be realized. This paper reviews the existing literature and databases on the level and composition of pharmaceutical spending and estimates potential efficiency gains from increased use of generics. It also reviews how countries organize the procurement and tendering of pharmaceuticals and the implications for spending. Finally, the paper identifies the various channels through which spending inefficiencies can arise and identifies reform options for reducing pharmaceutical spending while ensuring quality health outcomes.
September 16, 2022
Stress Testing the Global Economy to Climate Change-Related Shocks in Large and Interconnected Economies
Description: We stress test the global economy to extreme climate change-related shocks on large and interconnected economies. Our analysis (i) identifies large and interconnected economies vulnerable to climate change-related shocks; (ii) estimates these economies’ external financing needs-at-risk due to these shocks, and (iii) quantifies the spillovers to the global economy using a global network model. We show that large and interconnected economies vulnerable to climate change could trigger a drain of $1.8 trillion in international reserves (2 percent of 2019’s global GDP). Domestic and multilateral macroeconomic policies can help reduce these global lossess to about $0.8 trillion. The scenario highlights the importance of considering global spillovers when assessing the impact of climate change-related shocks.
September 16, 2022
Shock Absorbers or Transmitters? The Role of Foreign Banks during COVID-19
Description: This paper studies whether bank ownership influenced lending behavior during the COVID-19 shock. It finds that, similar to previous episodes of financial distress, foreign banks appear to have played a shock-transmitting role, as there was a sharp slowdown in lending by foreign banks’ affiliates relative to domestic banks. However, given the uniqueness of the COVID-19 shock and the impact of lockdowns on economic activity, foreign banks were found to lend at a higher rate than domestic banks once the stringency of mobility restrictions is accounted for, with their lending portfolio concentrated more in the corporate sector. Results also suggest that the difference in lending rates between foreign and domestic banks could be explained by the heterogeneous effects of policy measures in response to the pandemic. In jurisdictions with more stringent mobility restrictions, policy interventions actually encouraged higher lending by foreign banks. These findings suggest that foreign bank presence may have acted as a shock absorber in jurisdictions where economic activity was most affected by the pandemic.
September 16, 2022
Excess Profit Taxes: Historical Perspective and Contemporary Relevance
Description: This paper discusses the design of excess profits taxes (EPTs) that gained renewed interest following the COVID-19 outbreak and the recent surge in energy prices. EPTs can be designed as an efficient tax only falling on economic rent, like an allowance for corporate capital, and drawing some parallels with current proposals for reforming multinationals’ taxation. EPTs can be permanent or temporary as an add-on to the corporate income tax to support revenue during an adverse shock episode. The latter reflects experiences with EPTs during and after the World Wars. Different from that era, though, profit shifting is now a challenge. Estimation using firm-level data suggest that, at present, locations of excess profit across countries are consistent with profit shifting practices by multinationals. Destination-based EPTs can address this concern. Estimates suggest that a 10 percent EPT on the globally consolidated accounts of multinationals (on top of the current corporate income tax), with the EPT base being allocated using sales, raises global revenue by 16 percent of corporate income tax revenues. The analysis suggests that international coordination would be desirable to mitigate the risks of profit shifting and tax competition. Eventually, EPTs could mark an evolution of corporate taxation toward a non-distortionary rent tax.
September 9, 2022
Closing Peru's Ethnic Gaps Amidst Sustained Economic Growth
Description: We analyze the recent evolution of ethnic economic inequality in Peru, a major source of social discontent in the country. Household survey data indicates that recent decades of high output growth also witnessed a substantial narrowing of socioeconomic gaps among ethnicities. Most notably, the Mestizo ethnic group surpassed the White group in income per capita, and Native American also experienced a relative improvement. Mincerian regression analysis suggests that the main contributors to these developments were rural-to-urban migration and increased education. Based on our statistical findings, we propose enhancing education and other public services, increasing government revenues, lowering informality, and promoting competition as the main public policies that could accelerate the ongoing narrowing of ethnic gaps.
September 9, 2022
Waiting for Godot? The Case for Climate Change Adaptation and Mitigation in Small Island States
Description: Global warming is the most significant threat to ecosystems and people’s health and living standards, especially in small island states in the Caribbean and elsewhere. This paper contributes to the debate by analyzing different options to scale up climate change mitigation and adaptation. In particular, the empirical analysis indicates that increasing energy efficiency and reducing the use of fossil fuel in electricity generation could lead to a significant reduction in carbon emissions, while investing in physical and financial resilience would yield long-run benefits. From a risk-reward perspective, the advantages of reducing the risks associated with climate change and the health benefits from higher environmental quality clearly outweigh the potential cost of climate change mitigation and adaptation in the short run. The additional revenue generated by environmental taxes could be used to compensate the most vulnerable households, building a multilayered safety net, and strengthening structural resilience.
September 9, 2022
Dirty Dance: Tourism and Environment
Description: Tourism was one of the fastest-growing sectors before the COVID-19 pandemic, accounting for about 10 percent of global GDP. But it has also created a number of challenges including environmental degradation, especially in small island countries where the carbon footprint of tourism constitute substantial share of carbon dioxide (CO2) emissions. This study empirically investigates the impact of tourism on CO2 emissions in a relatively homogenous panel of 15 Caribbean countries over the period 1960–2019. The results show that international tourist arrivals have a statistically and economically significant effect on CO2 emissions, after controlling for other economic, institutional and social factors. Therefore, managing tourism sustainably requires a comprehensive set of policies and reforms aimed at reducing its impact on environmental quality and curbing excessive dependency on fossil fuel-based energy consumption.
September 9, 2022
Home or Away? Profit Shifting with Territorial Taxation
Description: In 2009, the United Kingdom abolished the taxation of profits earned abroad and introduced a territorial tax system. Under the territorial system, firms have strong incentives to shift profits abroad. Using a difference-in-differences research design, we show that the profitability of UK subsidiaries in low-tax countries increased after the reform compared to subsidiaries of non-UK multinationals in the same countries by an average of 2 percentage points. This increase in profit shifting also leads to increases in measured productivity of the foreign affiliates of UK multinationals of between 5 and 9 percent.
September 9, 2022
Private Savings and COVID-19 in Sub-Saharan Africa
Description: The paper reexamines the main private savings determinants in Sub-Saharan Africa (SSA), followed by an analysis of the COVID-19 pandemic impact on private savings in SSA and other country groupings. Using an unbalanced panel data from 1983−2021 for 31 SSA economies, the paper finds that real per capita economic growth remains a key historical determinant of private savings in the region. In contrast with other regions, private saving rates have not increased during COVID-19 in SSA. Instead, COVID-19 deaths in our estimations are significantly associated with a decline in private savings in SSA. Robustness checks and a descriptive analysis of household surveys during the pandemic corroborate those results.
September 9, 2022
Second-Round Effects of Oil Price Shocks -- Implications for Europe’s Inflation Outlook
Description: The pass-through effects of oil price shocks on wage and consumer price inflation vary with the states or structural characteristics of an economy. The effects have declined over time in Europe and been higher in emerging European economies than in advanced economies. The pass-through to wages is found to have been higher when the prevailing level of inflation was higher or when the degrees of unionization and centralized bargaining were higher, while lower under a higher credibility of monetary policy. The effects of oil price shocks on core inflation and inflation expectations are consistent with their effects on wages.