Addressing the Challenge of HIV/AIDS: Macroeconomic, Fiscal and Institutional Issues - Working Paper 58

Maureen Lewis

After decades of neglect the HIV/AIDS epidemic has rightly become one of the highest priorities on the global agenda. Funding pledges from the donors have doubled resource commitments between 2002 and 2004 to over $6 billion. That surge in funding belies the volatile nature of contributions to HIV/AIDS initiatives at the country level. The paper analyzes the impacts of abrupt HIV/AIDS funding on macroeconomic stability, fiscal health and the development of health institutions.

Connecting the Poor to Economic Growth: Eight Key Questions

Sarah Lucas and Peter Timmer

It has long been understood that economic growth is the essential foundation for poverty reduction. The key to income growth is the expansion of jobs that pay sustainable remunerative wages, and the two keys areas of production in this vein have almost always been agriculture and labor-intensive manufactured exports. Rising average incomes, both personal and national, are a necessary ingredient for improved livelihoods, but they do not guarantee broad-based poverty reduction. Economic history shows that countries, and communities within countries, with similar growth rates can have very different degrees of success in connecting growth to the poor and translating it into sustained poverty reduction.

Making Markets for Vaccines - Ideas to Action (Brief)


New medicines are usually financed by a mixture of public funding by governments, philanthropic giving, and investment by private firms. Private investment is especially important in paying for and managing the later stages of clinical trials, regulatory approval, and investment in manufacturing capacity. But for diseases that mainly affect people in developing countries, the prospective sales market is tiny—and not sufficient to justify commercially the large scale investment that is needed to develop new products.

An advance market commitment to accelerate the development of vaccines for diseases concentrated in developing countries, donors could make a binding commitment to pay for a desired vaccine if and when it is developed. This advance market commitment would mean firms could invest in finding a vaccine with the confidence that if they succeed there would be a market for the product.

Making Markets for Vaccines: Ideas to Action

Advance Market Commitment Working Group

Making Markets for Vaccines: Ideas to Action presents the proposal from theory to practice, by showing how a commitment can be consistent with ordinary legal and budgetary principles. A draft contract term sheet is included, highlighting the key elements of a credible guarantee.

Autonomous Recovery and International Intervention in Comparative Perspective - Working Paper 57

Jeremy Weinstein

There is growing recognition that significant threats to collective security emerge not only from competition among great powers, but also from the disorder, violence, and oppression wrought by governments (or occurring in the absence of effective governance) across the developing world. Scholars have responded by proposing new models of intervention—including neo-trusteeship and shared sovereignty—that respond to these failures of governance. But these calls for intervention rest on two underlying assumptions that have escaped serious consideration: the idea the countries cannot recover from conflict on their own and the argument that intervention is the best strategy for state-building. In this article, I define and describe a process of autonomous recovery in which states achieve a lasting peace, a systematic reduction in violence, and post-war political and economic development in the absence of international intervention.

Gold for Debt: What's New and What Next?

John Williamson

This new CGD Note by Center for Global Development President Nancy Birdsall and Institute for International Economics Senior Fellow John Williamson argues that sale of a portion of IMF gold makes sense as a way to create a more transparent institution and use a global resource for debt relief for the world’s poorest countries.

Big Sugar and the Political Economy of US Agricultural Policy


Sugar is a prototypical case of a policy that favors the few at the expense of the many. Thanks to a government policy that supports prices by sharply restricting imports, a small number of American sugar cane and beet growers are enriched at the expense of US consumers and of more efficient foreign growers, most of whom are in poorer developing countries.

Resolving Nigeria’s Debt Through a Discounted Buyback


Nigeria has $33 billion in external debt. The government has been trying unsuccessfully for years to cut a deal with creditors to reduce its external obligations but to date has only managed to gain non-concessional restructuring. The major creditors also have good reasons for wanting to seek a resolution, yet agreement has been elusive. Fortunately, there is a brief window of opportunity in 2005 to find a compromise that can meet the needs of both sides. This note briefly outlines a proposal for striking such a deal through a discounted debt buyback.

Overcoming Stagnation in Aid-Dependent Countries


In this book, Nicolas van de Walle identifies 26 countries that are extremely poor and grew little if at all in the 1990s. His sample excludes North Korea and countries where civil war explains some of their failure to grow (Afghanistan, Sierra Leone, Sudan, Tajikistan and others). The 26 countries have limited infrastructure and human capital and the small size of their markets deter private savings and investment. Aid was meant to help overcome these problems, and these countries received a lot. Yet they have failed to grow. What is wrong? Is foreign aid a solution or part of the problem? What changes might make aid more effective? Given these countries require the financial and technical resources of the West, why haven’t aid programs made a difference?

Overcoming Stagnation in Aid-Dependent Countries - Brief


Traditional economic theory predicts that capital mobility and international trade will push the world's national economies to one income level. As poorer nations race ahead, richer ones should slow down. Eventually, theory says, national economies would reach equilibrium. The reality of the last few decades, however, defies this notion; most of the poorest economies continue to lag far behind. For 50 years, foreign aid has been the main way the international community has promoted economic development. Yet it has not proven to be a silver bullet.

No Child Left Behind-Anywhere


"No Child Left Behind" could move from a national program to a global mission if several current policies and initiatives converge: the Education for All Fast Track Initiative, the U.S. Millennium Challenge Account, and the renewed declarations of the Bush administration, supported by U.S. public opinion.

Double Standards on IDA and Debt: The Case for Reclassifying Nigeria

Todd Moss and Scott Standley

Although nearly all poor countries are classified by the World Bank as IDA-only, Nigeria stands out as a notable exception. Indeed, Africa’s most populous country is the poorest country in the world that is not classified as IDA-only. Under the World Bank’s own criteria, however, Nigeria has a strong case for reclassification. IDA-only status would have two potential benefits for Nigeria. First, it would expand Nigeria’s access to IDA resources and make the country eligible for grants. Second, it would strengthen Nigeria’s case for debt reduction. With a renewed economic reform effort getting under way and the emerging use of debt reduction as a tool for assisting economic and political transitions, the UK, the US, and other official creditors should support such a move as part of a broader strategy for encouraging progress in one of Africa’s most important countries.

A Better Globalization: Legitimacy, Governance, and Reform

Kemal Dervis and Ceren Özer

A Better Globalization: Legitimacy, Governance, and Reform by Kemal Dervis is a reformist manifesto that argues that gradual institutional change can produce beneficial results if it is driven by an ambitious long-term vision and by a determination to continually widen the limits of the possible.

On the Road to Universal Primary Education


Education is an end in itself, a human right, and a vital part of the capacity of individuals to lead lives they value. It gives people in developing countries the skills they need to improve their own lives and to help transform their societies. Women and men with better education earn more throughout their lives and participate more fully in the civic and political lives of their communities and countries. Particularly for women, education confers the skills and behaviors that lead to healthier lives. Education that reaches women, the poor, and marginalized ethnic groups not only benefits them directly; it contributes to a more equitable and just society.

Business Environment and Comparative Advantage in Africa: Evidence from the Investment Climate Data - Working Paper 56


This paper ties together the macroeconomic and microeconomic evidence on the competitiveness of African manufacturing sectors. The conceptual framework is based on the newer theories that see the evolution of comparative advantage as influenced by the business climate—a key public good—and by external economies between clusters of firms entering in related sectors. Macroeconomic data from purchasing power parity (PPP), though imprecisely measured, estimates confirms that Africa is high-cost relative to its levels of income and productivity. This finding is compared with firm-level evidence from surveys undertaken for Investment Climate Assessments in 2000-2004.

Primary Health Care in Practice: Is It Effective? - Working Paper 55

Maureen Lewis , Gunnar Eskeland and Ximena Traa-Valerezo

Primary health care is accepted as the model for delivering basic health care to low income populations in developing countries. Using El Salvador as a case study, the paper draws on three data sets and a qualitative survey to assess health care access and utilization across public and private sector options (including NGOs).