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Mr. Giorgio Brosio, Mr. Ehtisham Ahmad, and Ms. Maria Gonzalez
This Working Paper should not be reported as representing the views of the IMF. The views expressed in this Working Paper are those of the author(s) and do not necessarily represent those of the IMF or IMF policy. Working Papers describe research in progress by the author(s) and are published to elicit comments and to further debate. A politically driven and ambitious decentralization program implemented by the authorities since the late 1990s has had mixed results in terms of enhancing service delivery. Paradoxically, concerns with the results of service delivery, partially driven by donors' requirements, have resulted in a deconcentrated system relying on conditional grants and unfunded mandates. This has reduced the incentives, responsibility, and ownership for local authorities to improve service delivery. Crucially, for functions where the local authorities have had full responsibility, better service quality has resulted than in those areas in which there are overlapping responsibilities between the center and the local authorities.
International Monetary Fund

Abstract

The past century has been marked by rapid advances in human welfare. People in most parts of the world are healthier and are living longer. While this trend is likely to continue, hopes are fading in some regions where progress slowed or stopped in the1990s, primarily as a result of the AIDS epidemic. This compilation of articles published over the past five years in the pages of F&D looks at the important links between health and economic progress. Articles range over a variety of topics, from the Millennium Development Goals and their health-related targets for 2015 to the economics of tobacco control. Several articles examine the impact of AIDS and the global reaction, while others look at debt and the intellectual property aspects of health care.

Mr. Markus Haacker

Abstract

This paper analyzes the macroeconomics of HIV/AIDS. The paper highlights that the mortality and morbidity associated with AIDS make it unlike most other types of sickness and disease. The paper describes the most common approaches used in accounting for growth in the context of an HIV/AIDS epidemic. The impact of HIV/AIDS on education and the accumulation of human capital is discussed. The paper also discusses the impact of HIV/AIDS on the public sector, and elaborates certain demographic events specific to the HIV/AIDS pandemic.

Mrs. Ritha S. Khemani, Mr. Sanjeev Gupta, Mr. Calvin A McDonald, Mr. Louis Dicks-Mireaux, and Marijn Verhoeven

Abstract

As part of its mandate, the IMF seeks to create the conditions necessary for sustained high-quality growth, which encompasses a broad range of elements. These include sound macroeconomic policies, growth-enhancing structural reforms, good governance, and such social policies as cost-effective social safety nets and targeted social expenditures. This paper reviews the IMF's policy advice in two key areas of social policy: social safety nets and public spending on education and health care. It was initiated as part of the work by the World Bank and IMF to strengthen the poverty focus of adjustment programs in low-income countries, in particular within the framework of the Initiative for Heavily Indebted Poor Countries (HIPCs).