Widespread acceptance of COVID-19 vaccines is crucial for achieving sufficient immunization coverage to end the global pandemic, yet few studies have investigated COVID-19 vaccination attitudes in lower-income countries, where large-scale vaccination is just beginning. We analyze COVID-19 vaccine acceptance across 15 survey samples covering 10 low- and middle-income countries (LMICs) in Asia, Africa and South America, Russia (an upper-middle-income country) and the United States, including a total of 44,260 individuals. We find considerably higher willingness to take a COVID-19 vaccine in our LMIC samples (mean 80.3%; median 78%; range 30.1 percentage points) compared with the United States (mean 64.6%) and Russia (mean 30.4%). Vaccine acceptance in LMICs is primarily explained by an interest in personal protection against COVID-19, while concern about side effects is the most common reason for hesitancy. Health workers are the most trusted sources of guidance about COVID-19 vaccines. Evidence from this sample of LMICs suggests that prioritizing vaccine distribution to the Global South should yield high returns in advancing global immunization coverage. Vaccination campaigns should focus on translating the high levels of stated acceptance into actual uptake. Messages highlighting vaccine efficacy and safety, delivered by healthcare workers, could be effective for addressing any remaining hesitancy in the analyzed LMICs.

Background As vaccination campaigns are deployed worldwide, addressing vaccine hesitancy is of critical importance to ensure sufficient immunization coverage. We analyzed COVID-19 vaccine acceptance across 15 samples covering ten low- and middle- income countries (LMICs) in Asia, Africa, and South America, and two higher income countries (Russia and the United States). Methods Standardized survey responses were collected from 45,928 individuals between June 2020 and January 2021. We estimate vaccine acceptance with robust standard errors clustered at the study level. We analyze stated reasons for vaccine acceptance and hesitancy, and the most trusted sources for advice on vaccination, and we disaggregate acceptance rates by gender, age, and education level. Findings We document willingness to take a COVID-19 vaccine across LMIC samples, ranging from 67% (Burkina Faso) to 97% (Nepal). Willingness was considerably higher in LMICs (80%) than in the United States (65%) and Russia (30%). Vaccine acceptance was primarily explained by an interest in personal protection against the disease (91%). Concern about side effects (40%) was the most common reason for reluctance. Health workers were considered the most trusted sources of information about COVID-19 vaccines. Interpretation Given high levels of stated willingness to accept a COVID-19 vaccine across LMIC samples, our study suggests that prioritizing efficient and equitable vaccine distribution to LMICs will yield high returns in promoting immunization on a global scale. Messaging and other community-level interventions in these contexts should be designed to help translate intentions into uptake, and emphasize safety and efficacy. Trusted health workers are ideally positioned to deliver these messages.

Developing and transition countries have increasingly engaged in the signing of bilateral investment treaties (BITs) in order to attract FDI, based on the widely shared view that FDI can contribute significantly to economic development and poverty reduction. However, the degree to which foreign investments can be expected to generate employment, offer access to international technology and know-how, and ultimately create growth, varies considerably depending on the type of investment. It is therefore important to determine what type of FDI is attracted by BITs.By providing a legal commitment to the fair and equitable treatment of foreign investors, BITs aim to decrease investment risk and to attract foreign investors. We argue that BITs can be expected to be most effective in those sectors of the economy with a larger risk of expropriation, i.e. sectors characterized by large sunk costs, relatively low levels of firm-specific know-how and in sectors that are politically sensitive to foreign ownership. This paper represents the first attempt to empirically study the heterogeneous effect that BITs may have across different sectors of investments. We analyze investments made in 13 countries in the former Soviet Union and Central and Eastern Europe, disaggregated over 7 sectors. We indeed BITs refers to the number of ratified BITs. Robust standard errors in parentheses.

The delivery of basic health products and services remains abysmal in many parts of the world where child mortality is high. This paper shows the results from a large-scale randomized evaluation of a novel approach to health care delivery. In randomly selected villages, a sales agent was locally recruited and incentivized to conduct home visits, educate households on essential health behaviors, provide medical advice and referrals, and sell preventive and curative health products. Results after 3 years show substantial health impact: under 5-years child mortality was reduced by 27 percent at an estimated average cost of $68 per life-year saved. (JEL I12, I18, J13, O15, O18)

Does higher resource inequality between ethnic groups lead to ethnic conflict? In this paper, we empirically investigate this question by constructing a new measure of inequality using rainfall on ethnic homelands during the plant-growing season. Our dataset covers the period 1982-2001 and includes 214 ethnicities, located across 42 African countries. The analysis at the country level shows that one standard-deviation increase in rainfall-based inequality between ethnic groups increases the risk of ethnic conflict by 16 percentage points (or 0.43 standard deviations). This relationship depends on the power relations between the ethnic groups. More specifically, the analysis at the ethnicity level shows that ethnic groups are more likely to engage in civil conflicts whenever they receive less rain than the leading group. This effect does not hold for ethnic groups that share some political power with the leading group and is strongest for groups that have recently lost power. Our findings are consistent with an increase in resource inequality leading to more ethnic conflicts by exacerbating grievances in groups with no political power.