We speak with Prof. Smita Srinivas, Professorial Research Fellow, at The Open University (UK), Founder Director of the Technological Change Lab (TCLab) and Visiting Professor at the National Centre for Biological Sciences (India). Her work focusses on economics and public policy. In 2015 she received the EAEPE (European Association for Evolutionary Political Economy) Myrdal Prize for her book on the health industry "Market Menagerie". We discuss her latest paper: Economics and Public Health: a case for interdisciplinary cohesion in the time of Coronavirus and the relevance of her work to the current Covid-19 pandemic.
What are your main research interests?
I am trained in economics and focus on development issues. You could say that I am a non-traditional economist, interested in technological change, but from the standpoint of the processes of innovation and industrial change. I am particularly interested in explanations of institutional change, which is what our economies are based on. I study big picture economics and changes in the discipline; but also examine in detail how institutional change affects a country’s technological capabilities, learning, innovation and developmental outcomes.
For the last 20 years, I have been looking at how vaccines, pharmaceuticals and diagnostics come into being and are regulated. This work spans economics, public policy and public health. I am interested in analysing the firms that exist in these sectors: what do they look like, what do they research, how are the ones that align with public benefit rewarded... From an industry dynamics standpoint, public health is really an industrial organisation problem. Our recent paper published on the Innogen website, covers this in more detail, and argues that the economics basis of public health needs to be updated.
What are you working on at the moment?
I am currently overseeing two projects in India. One of them is the Innovations for Cancer Care in Africa, led by the OU and involving several Innogen members. We are looking at how four countries: India, Tanzania, Kenya and the UK, address different types of cancer. The project is raising interesting questions from both an economics methodology and a comparative policy viewpoint. We are trying to make sense of the different evolutionary pathways that lead to decisions on which technologies to pursue and that shape each country’s outcomes.
The second project I am working on is a collaboration with scientists and clinicians looking at vaccine development against vector borne and infectious diseases. Dengue is a big problem in developing countries with high morbidity every year. The high incidence of dengue, inexplicable fevers and other diseases, such as co-circulating H1N1, that have similar symptoms make identifying Covid-19 cases difficult and sidelines other disease priorities. This project examines the economics questions around vaccine capacity building that need to be at the forefront of policy responses. We have some new writing coming out on Covid-19 testing and economics.
At the TCLab we have launched a new initiative with a strong team and a growing body of global and Indian partnerships. This initiative is based on a unique integrative TCLab lens of Health, Industry, and Ecology (HIE) for our development and economic analysis. One aspect is on resilience of food-health systems in Covid-19, the other is on vaccines and global organisation of health, a third is lessons within and from India or other industrialising countries to the rest of the world about relative successes around planning and policy.
In all of these projects, I am particularly interested in examining the role of the market and the variety of markets that exist, which is extremely important for understanding how they come to be and how they are regulated. The more details you know about how markets function and what their design is meant for, the more precise you can be about economics and deciding what the policy response should be, including what non-market strategies to use. In the case of vaccine development, for example, the market size and demand will determine whether a private-sector led vaccine development initiative is reasonable. At the moment, the market for a Covid-19 vaccine is, in principle, infinite and there has been all kinds of frantic activity to be the first to market. Governments, donors and multilateral institutions have been a little confused about what they should do. It is really important to have some clarity on what types of markets are required and why. Covid-19 is not the only important issue for many countries, since many co-circulating illnesses such as H1N1 or tuberculosis care are important alongside.
A paper I wrote in 2006 on the procurement of critical vaccines in developing countries is especially relevant today. It describes how to induce accountability, data sharing, clarity about the technological advance that is occurring and the need to ensure that there is a public stakeholder process built alongside industrial development. You cannot have a situation of first to market or a monopoly without protections or regulation. If firms have drawn on public resources or public data, a different type of market has to come into being and a long-term economic strategy needs to be put in place for wider public benefit of technology transfer or private firm growth, not just public health outcomes.
What are the main challenges you have come across in your research?
Our recent paper on the need for economics in public health highlighted by the current pandemic, argues that the industrial organisation of public health is not really thought through and that the economics underlying public health is out of date.
The economics discipline is deeply fractured. This is an enormous problem today and it affects not only how we tackle Covid-19, but also climate change, biodiversity, energy challenges, financial crashes…What students are being taught does not capture the enormous advances in evolutionary institutional analyses that have been made. In Europe there has been a big push back against this and huge efforts have been made towards teaching pluralist economics. For example, the EAEPE has been a critical community stimulating new and multiple ways of approaching the same data, which is a very powerful way of advancing a discipline. A theoretical piece focused on inference and judgement in development economics takes apart the notion that even in more pluralist traditions of economics, debates about technological advance are somehow settled (In Press). This work needs to continue. Economists wanting to use a single or small short list of methods are keeping the discipline back and skewing public policy responses in a very alarming way.
What do you find most rewarding about your work?
As a public policy scholar with economics training and prior science and maths background, I find it most rewarding to see different departments and interdisciplinary teams coming together at times like this. I work quite frequently with STEM colleagues and I think that being able to understand how other disciplines think is a critical skill for understanding today’s cross disciplinary problems.
How did you become associated with Innogen?
Since 2013 I have been closely involved with Innogen members at the OU and others at The University of Edinburgh, whose work has not only helped shape my perspectives but has also been incredibly intellectually rewarding. The intellectual partnership of Innogen members and associates means that at times like this they pick up and build momentum in very unexpected ways. Funders and governments should recognise these long-term coalitions and the intellectual and very practical contributions they can make.
Follow Smita on twitter: @Smita_Srinivas