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Bill Savedoff is a senior fellow at the Center for Global Development where he works on issues of aid effectiveness and health policy. His current research focuses on the use of performance payments in aid programs and problems posed by corruption. At the Center, Savedoff played a leading role in the Evaluation Gap Initiative and co-authored Cash on Delivery Aid with Nancy Birdsall. Before joining the Center, Savedoff prepared, coordinated, and advised development projects in Latin America, Africa and Asia for the Inter-American Development Bank and the World Health Organization. As a Senior Partner at Social Insight, Savedoff worked for clients including the National Institutes of Health, Transparency International, and the World Bank. He has published books and articles on labor markets, health, education, water, and housing including “What Should a Country Spend on Health?,” Governing Mandatory Health Insurance, and Diagnosis Corruption.
There are 20 pages covering the Addis Ababa Action Agenda. And while they are inevitably bubble-wrapped in diplo-speak and hat-tipping, there is a solid package of proposals nestled within. They cover domestic public finance, private finance, international public finance, trade, debt, technology, data and systemic issues. Amongst many other things, the Agenda calls for more tax and better tax (less regressive, more focused on pollution and tobacco). And it is long and specific on base erosion, tax evasion and competition and tax cooperation. It calls for financial inclusion and cheaper remittances. The draft discusses blended finance and a larger role for market-based instruments to support infrastructure rollout, as well as a new measure of “Total Official Support for Sustainable Development.” It calls for Multilateral Development Bank reform including new graduation criteria and scaling up. And it suggests a global compact to guarantee a universal package of basic social services and a second compact covering infrastructure. Finally, the draft has a good section on technology including the need for public finance and flexibility on intellectual property rights.
The single most cost-effective way to save lives in developing countries is in the hands of developing countries themselves: raising tobacco taxes. In fact, raising tobacco taxes is better than cost-effective. It saves lives while increasing revenues and saving poor households money when their members quit smoking.
“Is learning the only result worth financing in education?” That was the question posed to me at a recent World Bank debate about results-based financing in education. The question is germane because the World Bank has a large program of results-based financing in health and a new modality of Program for Results lending operations, and it is negotiating a new trust fund for performance programs in education.
Health aid pays for life-saving medicines, products, and services in the poorest countries in the world. Funding for such uses needs to be smooth and uninterrupted. But when fraud is detected, funds are subject to sudden stops and starts—the result of a sequence of events set off by the scandal cycle in health aid. We examine this idea in a new CGD policy paper.
A billion premature deaths this century—that’s the estimated toll of smoking. As 80% of the world’s smokers live in low- to middle-income countries, that’s a huge problem for the developing world. So what’s the solution? You’ve
Cmd+Click or tap to follow the link">heard before from CGD senior fellow Bill Savedoff that increasing tobacco taxes can actually help turn people away from nicotine; on this week’s podcast, you’ll hear another idea.
In the paper, we show that health spending in most countries is very likely to increase – and for some very good reasons. Most countries are experiencing rising incomes, people are living longer, and medical care technologies continue to expand. In other words, much of that money is buying more health. It is also likely, but hardly inevitable, that most of that increased spending will be channeled through taxes or insurance premiums rather than out-of-pocket. If countries work for that to happen, health spending will be less burdensome to the sick and the poor.
As mentioned in our last post, aid agencies are experimenting with programs that incorporate the main features of COD Aid: paying for outputs and outcomes, giving the recipient greater discretion to spend as they see fit, independent verification, and transparency. Once these results-based programs are up and running, they face a critical test when the first results are reported. In particular, most programs create expectations by setting annual targets and are then judged relative to those targets rather than to their baseline. And this means that even successful programs will be viewed as failures (a point also made in an earlier blog). By refusing to set targets, a results-based program can avoid this pitfall. How is it that targets can create such a problem?
I’ve been reading news of corruption scandals in Brazil with a great deal of sadness. I lived in Brazil during its return to democracy and experienced first-hand the hope and optimism that came with that transition. In a recent policy paper, I argue that decisions about funding projects in other countries should depend more on the results achieved by those countries than by formal actions meant to control corruption.
In a recent trip to the center of the world, I found myself confronting the big development questions in a low-income country with reasonably propitious circumstances. Papua New Guinea (PNG) is larger, richer, and growing faster than I had thought. It will go to the polls this very month to elect a new government. It is also facing all the dilemmas faced by most low-income countries since the 1950s—political fragmentation, resource curses, income inequality, and poor health. Have we learned anything to help it meet those challenges?
“3ie has made my job much easier.” This is what we heard last month from a high-ranking government official in Africa, referring to the International Initiative for Impact Evaluation (3ie), and it made us very proud. Creating 3ie was the outcome of the Evaluation Gap Working Group that we led along with Nancy Birdsall to address the limited number of rigorous impact evaluation of public policies in developing countries. As CGD celebrates its 15th year, it is worth considering what made that working group so successful, the obstacles we confronted, and the work that still remains to be done.