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The Fiscal Dimension of HIV/AIDS in Botswana, South Africa, Swaziland, and Uganda
(World Bank, 2012) Lule, Elizabeth ; Haacker, MarkusHIV/AIDS imposes enormous economic, social, health, and human costs and will continue to do so for the foreseeable future. The challenge is particularly acute in Sub-Saharan Africa, home to two-thirds (22.5 million) of the people living with HIV/AIDS globally, and where HIV/AIDS has become the leading cause of premature death. But now, after decades of misery and frustration with the disease, there are signs of hope. HIV prevalence rates in Africa are stabilizing. This book sheds light on these concerns by analyzing the fiscal implications of HIV/AIDS in Southern Africa, the epicenter of the epidemic. It uses the toolbox of public finance to assess the sustainability of HIV/AIDS programs. Importantly, it highlights the long-term nature of the fiscal commitments implied by HIV/AIDS programs, and explicitly discusses the link between HIV infections and the resulting commitments of fiscal resources. The analysis shows that, absent adjustments to policies, treatment is not sustainable. But it also shows that, by accompanying treatment with prevention, and making existing programs more cost-effective, these countries can manage both treatment and fiscal sustainability. Even in countries where HIV/AIDS-related spending is high or increasing (as past infections translate into an increasing demand for treatment), the fiscal space absorbed by the costs of HIV/AIDS-related services will decline if progress in containing and rolling back the number of new infections can be sustained. The purpose of this study is to refine the analysis of the fiscal burden of HIV/AIDS on national governments and assess the fiscal risks associated with scaling-up national HIV/AIDS responses. The study complements and contributes to the agenda on identifying and creating fiscal space for HIV/AIDS and other development expenditures. The findings from this study, and the analytical tools developed in it, could help governments in defining policy objectives, improving fiscal planning, and conducting their dialogue with donor agencies. -
Publication
Beyond the Numbers : Understanding the Institutions for Monitoring Poverty Reduction Strategies
(Washington, DC: World Bank, 2006) Bedi, Tara ; Coudouel, Aline ; Cox, Marcus ; Goldstein, Markus ; Thornton, NigelThis volume provides lessons on the design and functioning of such monitoring systems, based on the experience of twelve Poverty Reduction Strategy (PRS) countries (Albania, Bolivia, Guyana, Honduras, the Kyrgyz Republic, Malawi, Mali, Mauritania, Nicaragua, Niger, Tanzania, and Uganda). The focus is on the institutional arrangements of PRS monitoring systems - the rules and processes which bring the various actors and monitoring activities together in a coherent diagnostic tool - and a summary of the situation in these twelve PRS countries. -
Publication
Toward Country-led Development : A Multi-Partner Evaluation of the Comprehensive Development Framework--Findings from Six Country Case Studies
(Washington, DC, 2003) World BankCollectively, the six country case studies provide an unusually rich source of material on the local dynamics of the aid business and the realities that countries face when they try to adopt CDF principles in earnest. In order to make this material more accessible (full case studies are over 70 pages), OED has summarized each study to about 15 pages and gathered all six summaries into this volume, which is intended to complement the main synthesis report for the CDF evaluation, Toward Country-Led Development: A Multi-Partner Evaluation of the Comprehensive Development Framework. This volume can also be used alone, to enrich the discussion of development assistance in a particular case study country or as a basis for comparing country experiences. Since the main purpose of the CDF evaluation was to look at what had happened since the CDF was launched, priority was given to interested countries where pilot implementation of the CDF was the most advanced (on the grounds that these countries would offer the greatest potential for learning). Consideration was also given to Regional balance. One non-CDF pilot country (Burkina Faso) was chosen as a control. -
Publication
Private Solutions for Infrastructure : Opportunities for Uganda
(Washington, DC: World Bank, 2001-07) Public-Private Infrastructure Advisory FacilityThis Country Framework Report for Uganda, is part of a series focused on achieving poverty eradication, rural development, and economic growth through sustained infrastructure programs. Introducing private investment to the infrastructure sectors, lies at the heart of the Government's strategy to achieve combined sector restructuring, and liberalization. To this end, infrastructure development must be responsive to economic, and social needs, based on clear planning, and policy coordination. The report prioritizes on exploiting all beneficial options for private sector involvement, paying close attention to the development of effective incentive frameworks. Moreover, subsidy and donor funding mechanisms should be introduced to support poverty alleviation in the context of reform, while measures should be taken to ensure capacity is available to execute the reform program effectively, and provide for its coordination to maximize economic development. There should be a strong bias toward sector liberalization, except where this would result in significant loss of economies of scale, or scope, and, the establishment of an overall regulatory environment, attractive to private sector participation should be a critical priority, while protecting the interests of consumers. -
Publication
Aid and Reform in Africa : Lessons from Ten Case Studies
(Washington, DC: World Bank, 2001-04) Devarajan, Shantayanan ; Dollar, David R. ; Holmgren, Torgny ; Devarajan, Shantayanan ; Dollar, David R. ; Holmgren, TorgnyThis book synthesizes the findings from ten case studies that investigate whether, when, and how foreign aid affected economic policy in Africa, and reveals the range of African policy experience. Results varied enormously, for example, while Ghana and Uganda were successful reformers that grew rapidly reducing poverty, Cote d'Ivoire and Ethiopia have shown significant reform recently, but its sustainability remains to be seen, and, in other countries, policies changed little, or even worsened. Based on the World Bank's Country Policy and Institutional Assessment, the study relates foreign aid in the 1990s, to a measure of overall economic policy, a broad measure that covers macroeconomic management, as well as effectiveness of the public sector in providing essential services for growth, and poverty reduction. In assessing aid, and reform policy, the study subdivides these countries in three groups: the post-socialist reformers (Ethiopia, Mali and Tanzania); the mixed reformers (Cote d'Ivoire, Kenya and Zambia), and the non-reformers (The Democratic Republic of Congo - Zaire - and Nigeria). Although defining "good policy", and how to measure it may be controversial, research and experience established a fair knowledge: absence of high inflation, functioning foreign exchange, openness to foreign trade, effective rule of law, and delivery of key services. Conclusions stipulate that key to successful reform, is a political movement for change; that key to beneficial aid is its disbursement alongside actual policy improvements; and, that technical assistance, and policy dialogue should continue a high level of finance in productive environments.