Gabriel Picone

We examine the extent to which recent declines in child mortality and fertility in Sub-Saharan Africa can be attributed to insecticide-treated bed nets (ITNs). Exploiting the rapid increase in ITNs since the mid-2000s, we employ a difference-in-differences estimation strategy to identify the causal effect of ITNs on mortality and fertility. We show that the ITN distribution campaigns reduced all-cause child mortality, but surprisingly increased total fertility rates in the short run in spite of reduced desire for children and increased contraceptive use. We explain this paradox in two ways. First, we show evidence for an unexpected increase in fecundity and sexual activity due to the better health environment after the ITN distribution. Second, we show evidence that the effect on fertility is positive only temporarily – lasting only 1-3 years after the beginning of the ITN distribution programs – and then becomes negative. Taken together, these results suggest the ITN distribution campaigns may have caused fertility to increase unexpectedly and temporarily, or that these increases may just be a tempo effect – changes in fertility timing which do not lead to increased completed fertility.

This paper examines the extent to which bed net usage is responsive to changes in malaria prevalence and whether indoor residual spraying crowds out bed net usage. We show that malaria prevalence increases the probability of sleeping under an insecticide treated net but the implied elasticities are below one. For children under five, a one percentage point increase in malaria prevalence increases the probability of sleeping under a bed net by 0.41 percentage point. We find that indoor residual spraying does not crowd out bed net usage. Instead, children under five who live in houses that were recently sprayed are 3.1 percentage points more likely to sleep under a bed net.

We estimate a dynamic multistage duration model to investigate how early detection of diabetes can delay the onset of lower extremity complications and death. We allow for partial observability of the disease stage, unmeasured heterogeneity, and endogenous timing of diabetes screening. Timely diagnosis appears important. We evaluate the effectiveness of two potential policies to reduce the monetary costs of frequent screening in terms of lost longevity. Compared to the status quo, the more restrictive policy yields an implicit value for an additional year of life of about $50,000, whereas the less restrictive policy implies a value of about $120,000.

Cet article évalue l’effet de différentes politiques de lutte contre le paludisme, et en particulier de la politique dite de « mise à l’échelle » de la distribution de moustiquaires, sur la probabilité d’anémie des enfants en Afrique subsaharienne. Les données combinent des informations individuelles sur plus de 150000 enfants et leur famille, et des informations régionales sur l’intensité du paludisme avant le lancement des campagnes, pour 16 pays, entre 2000 et 2014. La méthode utilisée est celle des différences-en-différences, qui teste si les politiques ont entraîné une baisse plus forte de l’anémie dans les régions où l’intensité du paludisme était plus élevée. Les résultats indiquent que la mise à l’échelle a un effet faible ou négligeable sur la probabilité d’anémie modérée ou sévère, tandis que les autres politiques n’ont pas d’effet significatif.

This paper examines the existence of social interactions in malaria preventive behaviors in Sub‐Saharan Africa, that is, whether an individual's social environment has an influence on the individual's preventive behaviors. We focus on the two population groups which are the most vulnerable to malaria (children under 5 years and pregnant women) and on two preventive behaviors (sleeping under a bednet and taking intermittent preventive treatment during pregnancy). We define the social environment of the individual as people living in the same region. To detect social interactions, we calculate the size of the social multiplier by comparing the effects of an exogenous variable at individual and regional levels. Our data come from 92 surveys for 29 Sub‐Saharan countries between 1999 and 2012, and they cover approximately 660,000 children and 95,000 women. Our results indicate that there are social interactions in malaria preventive behaviors in the form of social multipliers effects of women's education and household wealth. The long‐run effects of these characteristics on preventive behaviors at the regional level are larger than those apparent at the individual level. Copyright © 2014 John Wiley & Sons, Ltd.

This paper examines the existence of social interactions in malaria preventive behaviors in Sub-Saharan Africa, i.e. whether an individual's social environment has an influence on the individual's preventive behaviors. We focus on the two population groups which are the most vulnerable to malaria (children under 5 and pregnant women) and on two preventive behaviors (sleeping under a bednet and taking intermittent preventive treatment during pregnancy). We define the social environment of the individual as people living in the same region. To detect social interactions, we calculate the size of the social multiplier by comparing the effects of an exogenous variable at the individual level and at the regional level. Our data come from 92 surveys for 29 Sub-Saharan countries between 1999 and 2012, and they cover approximately 660,000 children and 95,000 women. Our results indicate that social interactions are important in malaria preventive behaviors, since the social multipliers for women's education and household wealth are greater than one - which means that education and wealth generates larger effects on preventive behaviors in the long run than we would expect from the individual-level specifications, once we account for social interactions.

This paper analyzes the effect of malaria prevalence and indoor residual spraying on the probability of sleeping under an insecticide-treated bed net in nine Sub-Saharan countries. Specifically, it examines whether bed net usage is elastic with respect to malaria prevalence and whether indoor residual spraying, which is a public intervention, crowds out bed net usage, which is a private behavior. Using data on individual bed net usage and household indoor residual spraying combined with local malaria prevalence, we show that malaria prevalence has a positive effect on bed net usage, but that bed net usage is inelastic with respect to malaria prevalence, with elasticity ranging from 0.42 for adult women to 0.59 for older children, in our preferred model. We also find that indoor residual spraying does not crowd out bed net usage. Instead, individuals who live in houses that were recently sprayed are more likely to use a bed net.

This paper explores price differences in the European Union (EU) pharmaceutical market, the EU’s fifth largest industry. With the aim of enhancing quality of life along with industry competitiveness and R&D capability, many EU directives have been adopted to achieve a single EU-wide pharmaceutical market. Using annual 1994–2003 data on prices of molecules that treat cardiovascular disease, we examine whether drug price dispersion has indeed decreased across five EU countries. Hedonic regressions show that over time, cross-country price differences between Germany and three of the four other EU sample countries, France, Italy and Spain, have declined, with relative prices in all three as well as the fourth country, UK, rising during the period. We interpret this as evidence that the EU has come closer to achieving a single pharmaceutical market in response to increasing European Commission coordination efforts.