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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.
“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.
In the world of international aid, performance payments are a hot topic. But when it comes to signing performance payment agreements, most funders have been reticent. One of the reasons is a fear of “Double Counting” – paying once for investments to achieve outcomes and a second time when the outcomes are delivered. This concern ignores the complexity of achieving development goals and the intangible assets invested by recipient countries. When funders do agree to performance agreements, they end up ignoring the burden on recipients of “Double Demanding” – disbursing when outcomes are achieved and then setting restrictions on the use of those funds. All this confusion gets in the way of designing effective aid programs.
I’m always a little anxious introducing a topic at a workshop without knowing if the presentations that follow will support or contradict my points. So it was with some trepidation that I spoke earlier this month at a SIDA workshop in Stockholm, associated with the Swedish International Development Cooperation Agency’s launch of “Results Based Financing Approaches (RBFA) — What Are They?”.
This Wednesday, you will be attending an event on tobacco taxes at the World Bank’s annual meetings, where President Jim Kim and Mayor Michael Bloomberg will be speaking. You will be attending this high-level discussion along with about 14 other Finance Ministers. While the meeting may look routine, it is actually one of the most important you will attend this week. You will be discussing how the Finance Ministry can save more lives than the Minister of Health—by raising tobacco taxes in a way that best discourages smoking.
The President’s Budget Request for FY 2015 proposes flat funding for international affairs but it contains priorities and policy reversals that have led at least one observer to describe it as edgy! And indeed, it is edgy on a number of fronts, including a proposal by the Millennium Challenge Corporation (MCC) to pilot Cash on Delivery Aid (COD Aid).
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.
The World Bank's Program-for-Results (PforR) financing instrument was approved in January 2012 to complement the two existing financing instruments of the Bank: the Policy Financing instrument (DPL), which focuses on discrete policy actions within the direct control of governments, and the Project Financing instrument (IL), the Bank's main instrument to finance investment projects. PforR has been developed to enable the Bank to support the performance of a government program using the government's own systems, and when the risks to achieving the program's objectives relate to the capacity of the systems to achieve better results.
Shortly after its approval, CGD hosted an event to discuss the potential advantages and risks of this new results-based approach, including the approach to social, environmental and fiduciary safequards. Nearly a year later, CGD will welcome back Joachim von Amsberg for an update on early experiences with PforR. Since the instrument's approval, a number of PforR operations have been prepared, with several in the early stages of implementation. Representatives from some of these operations will be in attendance. Initial commentary will be followed by open discussion.
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.
What should tomorrow’s aid agencies look like in a landscape where the global goal is to ensure sustainable development? In the past, the role of aid has mainly been to “finance” specific projects or services, with a strong sense of donor identity and marked projections of donor interests. A modern approach to development assistance, however, focuses on the catalytic role of institutions and their capacity to mobilize expertise and resources towards shared objectives.