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  • Publication
    The Fiscal Dimension of HIV/AIDS in Botswana, South Africa, Swaziland, and Uganda
    (World Bank, 2012) Lule, Elizabeth; Haacker, Markus
    HIV/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
    Tanzania: Country Brief
    (World Bank, 2009) World Bank
    The name Tanzania is a portmanteau of Tanganyika, the mainland, and Zanzibar, the nearby archipelago in the Indian Ocean. The two united to become the United Republic of Tanzania in 1964. With a surface area of 947,300 square kilometers, Tanzania is comparable in size to Nigeria and is slightly more than twice the size of the U.S. state of California. Tanzania's population of approximately 40.4 million (as of 2007) is the second largest in East Africa, after Ethiopia's. Dar es Salaam, the most populous city, contains approximately 2.7 million people and accounts for most commercial activity. Swahili (or Kiswahili) and English are the two official languages of Tanzania. A large number of local languages are also spoken. In Zanzibar, Arabic is commonly used. Agriculture remains the mainstay of Tanzania's economy, accounting for one-quarter of gross domestic product (GDP) and approximately 80 percent of employment. Tanzania is endowed with mineral and natural resources, including gold, diamonds, and several other precious and semiprecious stones. The blue gemstone tanzanite is found only in Tanzania. Tanzania accounted for almost two percent of world gold production as of 2006. Tanzania has a long history of hosting refugee's fleeing civil wars in nearby countries. As of January 2008, there were more than 380,000 refugees living in Tanzania, predominantly from Burundi and the Democratic Republic of Congo. Tanzania is an up-market tourism destination. The country is endowed with a variety of tourism assets, including seven United Nations Educational, Scientific, and Cultural Organization (UNESCO) world heritage sites and numerous wildlife parks, beach resorts, coral reefs, and spectacular scenic mountain views.
  • Publication
    Breaking Into New Markets
    (World Bank, 2009) Newfarmer, Richard; Walkenhorst, Peter
    This book takes a fresh look at export diversification. It concludes that much of the recent literature, though novel, has focused excessively on simply adding new products to export portfolios. One branch of these studies centers on the 'discovery' of exports, and it argues that the threat of entry (imitation) leads to an underinvestment in bringing new products to the global market. Another analytical branch focuses on changing the contents of an export portfolio to mirror the exports of countries with higher incomes on the grounds that these lead to higher productivity. Both strands implicitly point to the need for careful yet active government policies. While such policies are important, this book argues for a more comprehensive view of diversification and hence a more comprehensive trade policy strategy-one that takes into account improving the quality of existing exports, breaking into new geographic markets, and increasing services exports. This publication has been tailored to policy makers, their staffs, and the international development community at large. It is a collection of short articles that summarize major issues and policies on particular topics. Many of the chapters are digests of more formal studies but are presented here with a minimum of underlying econometric and theoretical detail of less interest to policy makers. As the World Bank increases its efforts on 'aid for trade,' Staff are working with countries to help diversify their exports. Along with other development partners, the Bank is providing enhanced assistance to improve competitiveness, facilitate trade, improve trade-related services, and exploit regional and multilateral initiatives to open markets for developing countries. This book makes a substantial contribution to the efforts of developing countries to use the global economy to spur growth and reduce poverty.
  • Publication
    Attacking Inequality in the Health Sector : A Synthesis of Evidence and Tools
    (World Bank, 2009) Yazbeck, Abdo S.
    The overwhelming evidence of inequalities in health outcomes and in the use of health services calculated and disseminated by the World Bank and other development agencies in the last 10 years has energized global efforts to address the needs of the poor and socially vulnerable. These efforts have led to a renewed interest at the global and national levels in both understanding the causes of health sector inequalities and developing policies to tackle them. It is time to synthesize the new knowledge being generated from research and experimentation on addressing inequality. The main purpose of this book is to make available the accumulated knowledge of successful policy and analytical tools in this fight to reverse the vicious circle of income-poverty and ill health. The book presents both a practical set of analytical tools for understanding the causes of inequality in the use of health services and a menu of proven pro-poor policy actions. It is based on the evaluation of 14 successful policy changes in low- and middle-income countries in Africa, Asia, and Latin America, and a review of the published literature on inequality in the health sector.
  • Publication
    Economic Implications of Chronic Illness and Disability : In Eastern Europe and the Former Soviet Union
    (Washington, DC : World Bank, 2008) Mete, Cem
    This report aims to fill in the knowledge gap in this field by analyzing cross-country data on basic indicators, and by carrying out more detailed empirical analysis on causal relationships of interest, including the impact of disability on employment, wages, poverty, and children's school enrollments-focusing on four transition countries with household survey data sets that allow more elaborate econometric analyses. This report argues that it is timely to bring the economic costs of disability to the forefront of development policy because of the large impact poor health status and disabilities have on employment, poverty, children's schooling, and time spent in caring for disabled individuals, especially by adult females (which in turn inhibits higher female labor force participation prospectus). In recent years, there has been some recognition of the need to discuss disability issues in strategy documents such as poverty reduction strategy papers (PRSPs) and country assistance strategies (CASs). But in the absence of basic empirical evidence on the living conditions and behavior of disabled individuals, it is a challenge to formulate concrete steps to tackle this particular economic development problem.
  • Publication
    Governing Mandatory Health Insurance : Learning from Experience
    (Washington, DC : World Bank, 2008) Savedoff, William D.; Gottret, Pablo
    This book provides guidance to countries that want to reform or establish mandatory health insurance (MHI) by specifically addressing governance. It elucidates the role played by the social, political, and historical context in conditioning how MHI systems are governed and, in turn, how governance structures influence the health insurance systems' performance. The book describes the forms of governance that are associated with success, in particular, the regulatory institutions required to guide the system toward its social goals; the oversight mechanisms that monitor and correct the system; and the internal management of the health insurance institutions themselves. It highlights five governance dimensions: coherent decision making structures, stakeholder participation, transparency and information, supervision and regulation, and consistency and stability that influence the coverage, financial protection, and efficiency of MHI entities, and show how these operate in particular countries. Detailed analysis of governance arrangements in four countries: Chile, Costa Rica, Estonia, and the Netherlands, provide nuanced lessons for establishing health insurance systems that can truly serve the social goals of improved health, reduced financial insecurity, and greater equity.
  • Publication
    Hospital Performance in Brazil : The Search for Excellence
    (Washington, DC : World Bank, 2008) La Forgia, Gerard M.; Couttolenc, Bernard F.
    This book combines a comprehensive overview of the Brazilian hospital sector with in-depth analyses of the key elements of interest in promoting and ensuring excellence in hospital performance. It does so in an accessible manner and within the organizational and financial context of Brazil. Thus, the book can offer specific recommendations that go to the heart of the problem, as well as suggest what kinds of approaches work in that context. The recommendations themselves are based on what works in Brazil while drawing on international experiences relevant to the Brazilian context to broaden the policy options. But the authors go a step further by providing recommendations on implementation, specifically highlighting the need to strengthen governance arrangements, improve accountability, and sharpen resource management.
  • Publication
    Ending Poverty in South Asia : Ideas That Work
    (Washington, DC: World Bank, 2007) Narayan, Deepa
    The case studies in this book were developed as part of a year-long learning process initiated by the World Bank in 2003-4 to examine large scale poverty reduction programs in a wide range of developing countries around the world. This volume presents 12 of the case studies from South Asia. . The last two decades saw substantial change in the countries of South Asia. All countries of the subcontinent experienced more rapid growth than in the earlier decades and also saw a definite reduction in the incidence of poverty, resulting in the improvement of the lives of hundreds of millions of poor people. One common element was the adoption of broad based economic reforms involving rethinking of earlier approaches to development. The reforms in South Asia were notable in that they were homegrown, gradual, and accompanied by continual redesign and fine tuning. Individuals can make a difference in fighting poverty when ways are found to institutionalize creative ideas and apply them on a scale extending beyond pilot projects. This book recounts 12 such cases from a range of countries and sectors in the South Asia region, with a focus on how these programmes scaled up and on the potential for applying lessons in other settings. These case studies do not offer a blueprint or model for poverty reduction; there is no single model. Nor do they cover every issue that is important. But they suggest the range of ideas that can be successful and the underlying principles that cut across these diverse initiatives. All the programmes tap the imagination and ingenuity of the South Asian people- in government offices, in civil society organizations, in the private sector, and in the villages and urban neighborhoods. All seek to empower poor people to access the economic opportunities and basic services so necessary to human dignity. The lessons are complex, and applying them will undoubtedly require redesign and fine-tuning to fit the initiatives to the local context. What is important, however, is that the experience of the last two decades has shown that reforms and scaling-up innovations can work in South Asia-and if these examples can be strengthened and expanded in the coming decades, the dreams of a subcontinent free of poverty may be realized.
  • Publication
    Breaking the Barriers to Higher Economic Growth : Better Governance and Deeper Reforms in the Middle East and North Africa
    (Washington, DC: World Bank, 2007) Nabli, Mustapha Kamel
    Contents of the report are as follows: Long-term economic development: challenges and prospects for the Arab countries by Mustapha K. Nabli. Reform complementarities and economic growth in the Middle East and North Africa by Mustapha Kamel Nabli, and Marie-Ange Veganzones-Varoudakis. After Argentina: was MENA right to be cautious? By Mustapha K. Nabli. Restarting Arab economic reform by Mustapha K. Nabli. Democracy for better governance and higher economic growth in the MENA region? By Mustapha K. Nabli, and Carlos Silva-Jauregui. The political economy of industrial policy in the Middle East and North Africa by Mustapha K. Nabli, Jennifer Keller, Claudia Nassif, and Carlos Silva-Jauregui. The macroeconomics of labor market outcomes in MENA by Jennifer Keller, and Mustapha K. Nabli. Challenges and opportunities for the 21st century by Mustapha Nabli. Labor market reforms, growth, and unemployment in labor-exporting countries in the Middle East and North Africa by Pierre-Richard Agenor, Mustapha K. Nabli, Tarik Yousef, and Henning Tarp Jensen. Economic reforms and people mobility for a more effective EU-MED partnership by Ishac Diwan, Mustapha Nabli, Adama Coulibaly, and Sara Johansson de Silva. Cruise control, shock absorbers, and traffic lights by Mustapha K. Nabli. Trade, foreign direct investment, and development in the Middle East and North Africa by Farrukh Iqbal, and Mustapha Kamel Nabli. Making trade work for jobs by Dipak Dasgupta, Mustapha Kamel Nabli, Christopher Pissarides, and Aristomene Varoudakis. Exchange rate management within the Middle East and North Africa region by Mustapha Nabli, Jennifer Keller, and Marie-Ange Véganzones. How does exchange rate policy affect manufactured exports in MENA countries? By Mustapha Kamel Nabli, and Marie-Ange Veganzones-Varoudakis. Public infrastructure and private investment in the Middle East and North Africa by Pierre-Richard Agenor, Mustapha K. Nabli, and Tarik M. Yousef. Governance, institutions, and private investment by Ahmet Faruk Aysan, Mustapha Kamel Nabli, and Marie-Ange Veganzones-Varoudakis.
  • Publication
    An Opportunity for a Different Peru : Prosperous, Equitable, and Governable
    (Washington, DC : World Bank, 2007) Guigale, Marcelo M.; Fretes-Cibils, Vincente; Newman, John L.
    This book argues that Peru faces an unprecedented opportunity to become the next success story in Latin America. In the coming five years, policy making could put the country on a development path similar to the one that, say, Chile, Costa Rica, or Spain have followed over the last two decades. This book includes 32 sector-specific chapters and 2 historical perspectives that precede them. The beginning chapter, a synthesis, builds a comprehensive reform agenda that highlights possible sequencing and priorities. It is organized in five sections-the main messages, the three strategic challenges in Peru's development, and a path for action over the next five years.