Commercial Funding Research Articles

An alcohol-related liver disease multi-stakeholder hub (ARMS-Hub) to enhance research activity in underserved communities in the UK.

Alcohol use is the third leading risk factor of death and disability in the UK and costs the NHS £3.5 billion per year. Despite the high prevalence and healthcare burden of Alcohol-related Liver Disease (ArLD), there has been minimal research addressing prevention, morbidity and mortality. Reasons for this include stigma and lack of interest from public, charitable and commercial funding bodies. The objectives of this project were to identify and develop interdisciplinary partnerships, to explore stigma in ArLD, to develop a representative Patient and Public Involvement and Engagement (PPIE) group, to build research capacity, and to develop interdisciplinary research proposals targeting key research priorities. ArLD networks were identified by members of the Project Steering Group. Health Care Professionals (HCPs) from different backgrounds were invited to join the ARMS-Hub. PPIE representatives were invited through charities and support groups. Research areas were identified, discussed, prioritised and ranked. Research questions were refined during an in-person symposium. A mentorship programme was created to encourage and facilitate networking and knowledge exchange for early career researchers. We established the ARMS-Hub with 31 HCPs and 40 PPIE members. There were five stakeholder meetings, which included PPIE representation. Three virtual and three in-person PPIE meetings took place. Topics relevant to stigma in ARLD identified during the meetings were education and awareness, language, and access. Priorities identified were the disconnect between mental health and liver services, education around the wider harms of alcohol, and education of HCPs regarding stigma. We established a mentorship network that regularly meets to support development of new research ideas. Stigma is central to lack of research engagement from professionals and PPIE. The main priority identified relates to the disconnect between mental health and liver services. This collaborative study has allowed development of a research agenda to address this priority.

An alcohol-related liver disease multi-stakeholder hub (ARMS-Hub) to enhance research activity in underserved communities in the UK

Background Alcohol use is the third leading risk factor of death and disability in the UK and costs the NHS £3.5 billion per year. Despite the high prevalence and healthcare burden of Alcohol-related Liver Disease (ArLD), there has been minimal research addressing prevention, morbidity and mortality. Reasons for this include stigma and lack of interest from public, charitable and commercial funding bodies. The objectives of this project were to identify and develop interdisciplinary partnerships, to explore stigma in ArLD, to develop a representative Patient and Public Involvement and Engagement (PPIE) group, to build research capacity, and to develop interdisciplinary research proposals targeting key research priorities. Methods ArLD networks were identified by members of the Project Steering Group. Health Care Professionals (HCPs) from different backgrounds were invited to join the ARMS-Hub. PPIE representatives were invited through charities and support groups. Research areas were identified, discussed, prioritised and ranked. Research questions were refined during an in-person symposium. A mentorship programme was created to encourage and facilitate networking and knowledge exchange for early career researchers. Results We established the ARMS-Hub with 31 HCPs and 40 PPIE members. There were five stakeholder meetings, which included PPIE representation. Three virtual and three in-person PPIE meetings took place. Topics relevant to stigma in ARLD identified during the meetings were education and awareness, language, and access. Priorities identified were the disconnect between mental health and liver services, education around the wider harms of alcohol, and education of HCPs regarding stigma. We established a mentorship network that regularly meets to support development of new research ideas. Conclusions Stigma is central to lack of research engagement from professionals and PPIE. The main priority identified relates to the disconnect between mental health and liver services. This collaborative study has allowed development of a research agenda to address this priority.

Cross-sectional examination of commercial milk formula industry funding of international, regional and national healthcare professional associations: protocol

IntroductionCommercial milk formula manufacturers often emphasise their role in supporting infant and young child nutrition and breastfeeding, but their commercial goals to increase volume and profit margin of formula sales...

Transjugular intrahepatic portosystemic shunts for adults with hepatorenal syndrome.

Transjugular intrahepatic portosystemic shunts for adults with hepatorenal syndrome.

Effects of Transformation on Outreach Performance of Microfinance NGOs in Kenya

This research examines how transformation affects the outreach performance of microfinance NGOs in Kenya. Specifically, it analyzes the impact of various transformation indicators on outreach performance. Utilizing a quantitative research approach, the study utilizes unbalanced panel data spanning 19 years (1997 to 2015) obtained from the Microfinance Information Exchange (Mix) Market databank, focusing on six surveyed transformed microfinance NGOs in Kenya. Panel data regression models and instrumental variables estimation methods are employed for model specification. The findings reveal that outreach, measured by the average loan balance per borrower, is significantly and negatively influenced by the debt-to-asset ratio but not significantly affected by the debt-to-equity ratio or deposits-to-total assets ratio. The percentage of female borrowers is significantly influenced by the debt-to-equity ratio and debt-to-asset ratio, while the number of active borrowers is significantly influenced by the debt-to-asset ratio, deposits-to-total assets ratio, institutional size, and institutional age. These results suggest a necessity for microfinance NGOs facing capital funding challenges to devise policies that facilitate the utilization of commercial capital sources to expand outreach to impoverished individuals. Nonetheless, the management of transformed microfinance NGOs must implement safeguards ensuring that the pursuit of commercial funding options and public deposits does not compromise their mission of serving the most vulnerable populations.

Comparative Notes on the use of Commercial Litigation Funding in Insolvency: Australia and South Africa

This article explores the application of third-party litigation funding (TPLF), also referred to as commercial litigation funding, in insolvency litigation by way of a comparison of the legal position in Australia and South Africa. It proposes that TPLF could offer significant benefits by enabling liquidators of insolvent estates to pursue and enforce claims through civil proceedings with the aim of swelling the assets of the insolvent estate, ultimately to the advantage of the creditors. Since both jurisdictions share elements of English law, both were confronted with the English law doctrines of champerty and maintenance initially being regarded as impediments to the development and/or use of TPLF. Currently, and mainly due to developments in terms of case law, the concept of TPLF has in principle been accepted in both jurisdictions. However, in Australia the development originally transpired in the field of insolvency litigation. In South Africa the context was more in the confines of general litigation. It is submitted that the South African system could benefit by considering various aspects of the Australian system regarding the use of TPLF in insolvency litigation. It remains a question whether or not the respective systems would benefit by adopting comprehensive regulatory measures to regulate TPLF.

The Emergence of Large-Scale Bioethanol Utilities: Accelerating Energy Transitions for Cooking

Expansion in access to clean cooking in Sub-Saharan Africa remains well below the UN’s Sustainable Development Goal objectives. In particular, clean and modern forms of cooking have struggled to attract commercial funding at scale. The use of bioethanol in cooking is not new, but until recently, its application has been confined exclusively to small-scale projects. However, a new bioethanol cooking utility in Kenya has now reached mass-market adoption, serving more than 950,000 households with cooking fuel since its launch in late 2019. Its success was made possible by a significant investment in technology to facilitate safe, convenient, and affordable fuel distribution. It is funded by climate finance, which is based on bioethanol fuel replacing the charcoal normally used for cooking; a leading cause of African deforestation. This development is so recent that it has not been widely discussed in the academic literature. More broadly, the health, environmental, and economic impacts of bioethanol for cooking have not been systematically assembled in one place. The main aim of this study is to identify how KOKO Networks has managed to overcome the traditional barriers to scalability, achieving impacts with bioethanol for accelerating energy transitions for cooking. The results show that bioethanol for cooking supports 13 out of 17 SDGs and has significant positive impacts on health, the environment, and the wider economy. The affordability of bioethanol has been made possible because of KOKO Investments in high-tech electronic fuel dispensing machines and through the use of climate financing. KOKO relies both on local and imported fuel to offer reliability and security of supply, as well as to grow commercial bioethanol demand to support the growth of the local bioethanol industry. Bioethanol for cooking also suffers from unfavorable tax regimes. This is because historically, in many countries, ethanol has been imported for use in the beverage industry. In addition, an appropriate commercial supply chain and delivery model which boosts the scalability of business and offers customer convenience is essential. For these conditions to take place, an enabling policy environment is key.

Hormone therapy for sexual function in perimenopausal and postmenopausal women.

Hormone therapy for sexual function in perimenopausal and postmenopausal women.

Fibrin-based haemostatic agents for reducing blood loss in adult liver resection.

Liver resection is the optimal treatment for selected benign and malignant liver tumours, but it can be associated with significant blood loss. Numerous anaesthetic and surgical techniques have been developed to reduce blood loss and improve perioperative outcomes. One such technique is the application of topical fibrin-based haemostatic agents (FBHAs) to the resection surface. There is no standard practice for FBHA use, and a variety of commercial agents and devices are available, as well as non-FBHAs (e.g. collagen-based agents). The literature is inconclusive on the effectiveness of these methods and on the clinical benefits of their routine use. To evaluate the benefits and harms of fibrin-based haemostatic agents in reducing intraoperative blood loss in adults undergoing liver resection. We searched the Cochrane Hepato-Biliary Group (CHBG) Controlled Trials Register, CENTRAL, MEDLINE, Embase, LILACS, Science Citation Index Expanded, and Conference Proceedings Citation Index-Science up to 20 January 2023. We also searched online trial registries, checked the reference lists of all primary studies, and contacted the authors of included trials for additional published or unpublished trials. We considered for inclusion all randomised clinical trials evaluating FBHAs versus no topical intervention or non-FBHAs, irrespective of publication type, publication status, language of publication, and outcomes reported. Eligible participants could have any liver pathology and be undergoing major or minor liver resections through open or laparoscopic surgery. Two review authors independently screened the results of the literature search and used data extraction forms to collate the results. We expressed dichotomous outcome results as risk ratios (RRs) and continuous outcome results as mean differences (MDs), each with their corresponding 95% confidence interval (CI). We used a random-effects model for the main analyses. Our primary outcomes were perioperative mortality, serious adverse events, haemostatic efficacy, and health-related quality of life. Our secondary outcomes were efficacy as sealant, adverse events considered non-serious, operating time, and length of hospital stay. We assessed the certainty of the evidence with GRADE and presented results in two summary of findings tables. We included 22 trials (2945 participants) evaluating FBHAs versus no intervention or non-FBHAs; 19 trials with 2642 participants provided data for the meta-analyses. Twelve trials reported commercial funding, one trial reported no financial support, and nine trials provided no information on funding. Below we present the most clinically relevant outcome results, also displayed in our summary of findings table. Fibrin-based haemostatic agents versus no intervention Six trials (1001 participants) compared FBHAs with no intervention. One trial was at low risk of bias in all five domains, and all other trials were at high or unclear risk of bias in at least one domain. Two trials were at high risk of bias related to blinding. It is unclear if FBHAs compared with no intervention have an effect on perioperative mortality (RR 2.58, 95% CI 0.89 to 7.44; 4 trials, 782 participants), serious adverse events (RR 0.96, 95% CI 0.88 to 1.05; 4 trials, 782 participants), postoperative transfusion (RR 1.04, 95% CI 0.77 to 1.40; 5 trials, 864 participants), reoperation (RR 2.92, 95% CI 0.58 to 14.61; 2 trials, 612 participants), or postoperative bile leak (RR 1.00, 95% CI 0.67 to 1.48; 4 trials, 782 participants), as the certainty of evidence was very low for all these outcomes. Fibrin-based haemostatic agents versus non-fibrin-based haemostatic agents Sixteen trials (1944 participants) compared FBHAs with non-FBHAs. All trials had at least one domain at high or unclear risk of bias. Twelve trials were at high risk of bias related to blinding. It is unclear if FBHAs compared with non-FBHAs have an effect on perioperative mortality (RR 1.03, 95% CI 0.62 to 1.72; 11 trials, 1436 participants), postoperative transfusion (RR 0.92, 95% CI 0.68 to 1.25; 7 trials, 599 participants), reoperation (RR 0.48, 95% CI 0.25 to 0.90; 3 trials, 358 participants), or postoperative bile leak (RR 1.15, 95% CI 0.60 to 2.21; 9 trials, 1115 participants), as the certainty of evidence was very low for all these outcomes. FBHAs compared with non-FBHAs may have little or no effect on the risk of serious adverse events (RR 0.99, 95% CI 0.95 to 1.03; 9 trials, 1176 participants; low-certainty evidence). The evidence for the outcomes in both comparisons (FBHAs versus no intervention and FBHAs versus non-FBHAs) was of very low certainty (or low certainty in one instance) and cannot justify the routine use of FBHAs to reduce blood loss in adult liver resection. While the meta-analysis showed a reduced risk of reoperation with FBHAs compared with non-FBHAs, the analysis was confounded by the small number of trials reporting the event and the risk of bias in all these trials. Future trials should focus on the use of FBHAs in people undergoing liver resection who are at particularly high risk of bleeding. Investigators should evaluate clinically meaningful and patient-important outcomes and follow the SPIRIT and CONSORT statements.

Industry funding of patient organisations in the UK: a retrospective study of commercial determinants, funding concentration and disease prevalence

ObjectivesTo assess the relationship between UK-based patient organisation funding and companies’ commercial interests in rare and non-rare diseases in 2020.DesignRetrospective analysis of the value and volume of payments from pharmaceutical...

Assessing the Robustness of Positive Vascular Surgery Randomized Controlled Trials Using Their Fragility Index

The fragility index (FI) measures the robustness of statistically significant findings in randomized controlled trials (RCTs) calculated as the minimum number of event conversions required to alter the result’s statistical significance. In vascular surgery, many clinical guidelines and critical decision-making points are informed by a handful of key RCTs, especially regarding open surgical vs endovascular treatment. The objective of this study is to evaluate the FI of RCTs with statistically significant primary outcomes that compared open vs endovascular surgery. MEDLINE, Embase, and CENTRAL were searched for RCTs comparing open vs endovascular treatments for abdominal aortic aneurysms, carotid artery stenosis, and peripheral arterial disease to December 2022. RCTs with statistically significant primary dichotomous outcomes were included. Data screening and extraction were conducted in duplicate. The FI was calculated by adding an event to the group with the smaller number of events while subtracting a nonevent to the same group until the Fisher exact test produced a non-statistically significant result (P > .05, Table I). The primary outcome measures were FI and proportion of outcomes where loss to follow-up was greater than FI. Secondary analyses were performed to determine whether FI varied by study disease state, presence of commercial funding, and study design. Overall, 5133 articles were captured in the initial search with 21 RCTs reporting 23 primary outcomes being included in the final analysis. The median FI [first quartile, third quartile] was 3 [3, 20] with 16 outcomes (70%) reporting loss to follow-up greater than its FI. The Mann-Whitney U test revealed that commercially funded RCTs and composite outcomes had greater FIs (20 vs 3, P = .035; 21 vs 3, P = .01, respectively). The FI did not vary between disease states (P = .285) or between index trials vs follow-up analyses (P = .147, Table II). There were significant correlations between FI and P value (Pearson r = 0.901, P < .001) and number of events (r = 0.832, P < .001). A small number of event conversions (median 3) are needed to alter the statistical significance of primary outcomes in vascular surgery RCTs evaluating open surgical and endovascular treatments. Most studies had loss to follow-up greater than its FI, which can call into question trial results, and commercially funded studies had a greater FI. The FI and these findings should be considered in future trial design in vascular surgery.Table ITwo-by-two contingency tables highlighting the calculation of the fragility index (FI), with the FI calculated (FI = 70) for the BEST-CLI trial as an exampleTrial 2 × 2 contingency tableCalculation of the FIEventNo eventEventNo eventOpen surgical treatmentABOpen surgical treatmentA + FIB − FIEndovascular treatmentCDEndovascular treatmentCDFisher exact test: P < .05Fisher exact test: P ≥ .05BEST-CLI 2 × 2 contingency tableCalculation of the FI in the BEST-CLI trialMajor adverse limb event or deathNo eventMajor adverse limb event or deathNo eventBypass with single segment great saphenous vein302416Open surgical treatment372 (302 + 70)346 (416 − 70)Endovascular treatment408308Endovascular treatment408308Fisher exact test: P < .05 (P = .00000002)Fisher exact test: P ≥ .05 (P = .05002)BEST-CLI, Best Endovascular vs Best Surgical Therapy in Patients with Critical Limb Ischemia. Open table in a new tab Table IICharacteristics of the fragility index (FI) of primary outcomes of statistically significant RCTs evaluating open vs endovascular treatment in vascular surgeryCategoryOutcomes, nMedian FI [Q1, Q3]Disease state AAA103 [3, 3] CAS910 [3, 20] PAD415 [5, 46]Study design Index trial133 [3, 4] Follow-up study1014 [3, 21]Funding Commerciala920 [5, 25] Noncommercial143 [2, 6]Outcome Single163 [2, 9] Compositea721 [8, 38]Loss to follow-up <FI73 [3, 8] ≥FI1616 [6, 2, 21]AAA, Abdominal aortic aneurysm; CAS, carotid artery stenting; PAD, peripheral arterial disease.aP < .05. Open table in a new tab

Randomized Controlled Trials in ICU in the Four Highest-Impact General Medicine Journals.

To study ICU trials published in the four highest-impact general medicine journals by comparing them with concurrently published non-ICU trials in the same journals. PubMed was searched for randomized controlled trials (RCTs) published between January 2014 and October 2021 in the New England Journal of Medicine , The Lancet , the Journal of the American Medical Association , and the British Medical Journal. Original RCT publications investigating any type of intervention in any patient population. ICU RCTs were defined as RCTs exclusively including patients admitted to the ICU. Year and journal of publication, sample size, study design, funding source, study outcome, type of intervention, Fragility Index (FI), and Fragility Quotient were collected. A total of 2,770 publications were screened. Of 2,431 original RCTs, 132 (5.4%) were ICU RCTs, gradually rising from 4% in 2014 to 7.5% in 2021. ICU RCTs and non-ICU RCTs included a comparable number of patients (634 vs 584, p = 0.528). Notable differences for ICU RCTs were the low occurrence of commercial funding (5% vs 36%, p < 0.001), the low number of RCTs that reached statistical significance (29% vs 65%, p < 0.001), and the low FI when they did reach significance (3 vs 12, p = 0.008). In the last 8 years, RCTs in ICU medicine made up a meaningful, and growing, portion of RCTs published in high-impact general medicine journals. In comparison with concurrently published RCTs in non-ICU disciplines, statistical significance was rare and often hinged on the outcome events of just a few patients. Increased attention should be paid to realistic expectations of treatment effects when designing ICU RCTs to detect differences in treatment effects that are reliable and clinically relevant.

Increased inhaled corticosteroids for treating acute asthma exacerbations

Increased inhaled corticosteroids for treating acute asthma exacerbations

Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children.

Increased versus stable doses of inhaled corticosteroids for exacerbations of chronic asthma in adults and children.

Business-Like and Still Serving Society? Investigating the Relationship Between NPOs Being Business-Like and Their Societal Roles

Nonprofit organizations (NPOs) becoming business-like is a contested issue. Some understand the adoption of business-like practices by NPOs as a case of adopting rational myths through institutional isomorphism and thus potentially dangerous for NPOs’ ability to fulfill their unique societal roles. Others are more optimistic, arguing that technical rationality is possible in the adoption of business-like practices, and that such practices can therefore support NPOs in fulfilling a wide range of societal roles. Drawing on survey data of NPOs in Flanders, we examine the relationship between the extent to which NPOs use business-like practices, and the extent to which they engage in various societal roles. We find that business-like practices are weakly related to NPOs’ societal roles. All roles are positively related to nonprofit managerialism and unrelated to NPOs’ reliance on commercial funding. Our results suggest that a certain optimism regarding the rational use of business-like approaches is justified.

SME CREDIT RISK MODELLING IN SOUTH AFRICA: A CASE STUDY

This paper examined the funding conundrum by assessing the success rate of applications of small and medium sized enterprises (SME) for commercial bank funding. A quantitative group analysis was done on the overdraft obtained from one of the leading financial institutions in South Africa to determine the drivers of default. The SME scorecard was developed using logistic regression on credit applications over a seven-year observation period to analyse the default experience as part of credit risk management. The robustness, stability and relevance of an application scorecard is enhanced by the reject inference process and inclusion of bureau information. Small businesses operating in the service sector and having a long-standing rapport with the bank can easily access commercial bank funding. SMEs in the construction industry with a high number of credit enquiries are unlikely to survive the stringent conditions of the bank lending criteria. It is the prerogative of the principal business owner to honour their financial obligations across the credit industry if commercial bank funding is desired. Their credit quality, as reflected in the bureau information, forms the fulcrum of the SME application scorecard. The model developed in this study can be used as a tool to reduce defaults and serious delinquencies in boarding new applicants. Furthermore, the model can be applied to determine risk tendency and monitor the performance of SME credit portfolios.

A Systematic Review of Clinical Practice Guidelines for Cataract: Evidence to Support the Development of the WHO Package of Eye Care Interventions.

The World Health Organization (WHO) is developing a Package of Eye Care Interventions (PECI) to facilitate the integration of eye care into Universal Health Coverage. This paper presents the results of a systematic review of clinical practice guidelines for cataract in adults, to help inform PECI development. We searched academic and guideline databases, and websites of professional associations, for guidelines published between January 2010 and April 2020. Guidelines were excluded if there was commercial funding or unmanaged conflicts of interest. Quality appraisal was conducted using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool. We identified 3778 reports, 35 related to cataract guidelines, four of which met the inclusion criteria (United Kingdom: 2, United States: 1, Iran: 1). The recommendations across the four guidelines covered pre-operative (43%), intra-operative (37%), and post-operative interventions (20%). Most ‘strong’ recommendations were supported by good quality evidence. Differences in recommendations across guidelines may be attributable to time of publication or regional differences in surgical practice. Few guidelines met the quality criteria, and only three countries were represented. The results of this step of the PECI development process will inform subsequent phases for development of the WHO’s package of evidence-based eye care interventions for cataract.

Fractal characteristics analysis and fluctuation trend prediction of commercial bank funding liquidity

ABSTRACT Funding liquidity has been considered as the lifeline of commercial banks. If there are abnormal fluctuations in funding liquidity, it may lead to bank runs, which may bring about the destruction of commercial banks and even spread to cause a financial crisis. Therefore, exploring the fluctuation characteristics and trend prediction of commercial bank funding liquidity has traditionally attracted much attention. Based on this, this paper analyzes the fluctuation characteristics of commercial bank funding liquidity by Multi-Fractal Detrended Fluctuation Analysis (MF-DFA), and innovatively uses the Moving Trend Entropy Dimension (MTED) for commercial bank funding liquidity fluctuation trend prediction. The results of the study show that the commercial bank funding liquidity is multifractal, so it has predictability; MTED can not only accurately predict the fluctuation trend of commercial bank funding liquidity, but also has robustness. Through effective monitoring of funding liquidity, commercial banks can develop their funding liquidity risk management programs and improve the effectiveness of their own funding liquidity risk control. At the same time, regulators can also achieve the goal of preventing and resolving funding liquidity risks as well as maintaining financial stability.

Designing micro-fintech models for Islamic micro financial institutions in Indonesia

PurposeThis study aims to design appropriate micro-fintech models for Islamic microfinance institutions (IMFIs), especially Baitul Maal wat Tamwil (BMT) in Indonesia, thus enabling BMT to combine Islamic social and commercial microfinance optimally.Design/methodology/approachThis study uses the analytic network process and Delphi methods, with three groups of experts as the respondents, namely, academician-regulators, BMT practitioners and Fintech practitioners.FindingsThe first results show that the micro-fintech tools needed by IMFI/BMT are digital banking, payment, peer-to-peer (P2P) financing, P2P social and e-commerce. These could be developed by a BMT alone or with an APEX or Association, which could also collaborate with an existing fintech company that specialises in micro-fintech, applying the offline to online approach. This means that commercial funding, as well as social fundraising of zakat and waqf, would be conducted online, whereas commercial financing for micro and small enterprise customers and the disbursement of zakat and waqf would be conducted offline. The second results show that the limited open ecosystem and hybrid ecosystem are the most appropriate micro-fintech ecosystems for IMFIs/BMT, with various alternative models. In addition, the private closed ecosystem preferred by BMT would be feasible if all criteria show improvement in the future.Research limitations/implicationsThis study is qualitative in nature. The methods used have limitations, meaning the models could be improved by incorporating other methods. Moreover, the case and respondents are all Indonesian, which means that the results may only be applicable to BMTs in Indonesia.Practical implicationsA BMT and/or BMT association could immediately apply micro-fintech with a limited open ecosystem, while in the future, they could apply micro-fintech with a private closed ecosystem.Social implicationsThe micro-fintech model could be used to optimise the collections of zakat, infaq and waqf, meaning BMT could provide more social programmes for those in need.Originality/valueThe growth of fintech in Islamic microfinance has occurred only recently, while only a limited number of studies have been conducted; therefore, no study exists on the development of a micro-fintech model appropriate for IMFIs, especially BMT.

How new Fed corporate bond programs cushioned the Covid-19 recession

In the financial crisis and recession induced by the Covid-19 pandemic, many investment-grade firms became unable to borrow from securities markets. In response, the Fed not only reopened its commercial paper funding facility but also announced it would purchase newly issued and seasoned corporate bonds rated as investment grade before the Covid pandemic. We assess the effectiveness of this program using long sample periods, spanning the Great Depression through the Great and Covid Recessions. Findings indicate that the announcement of corporate bond backstop facilities helped stop risk premia from rising further than they had by late-March 2020. In doing so, these backstop facilities limited the role of external finance premia in amplifying the macroeconomic impact of the Covid pandemic. Nevertheless, the corporate bond programs blend the roles of the Federal Reserve in conducting monetary policy via its balance sheet, acting as a lender of last resort, and pursuing credit policies.