This report calls for the creation of a new international development architecture (NIDA) for least-developed countries (LDCs) that will reverse their marginalisation in the global economy and help them catch up, while supporting a pattern of accelerated economic growth and diversification that will improve the general health and well-being of all their people. It argues that these objectives can be achieved if there is a paradigm shift that supports new, more inclusive development paths in LDCs and outlines alternative policy scenarios to accelerate growth and reduce poverty. The NIDA will consist of formal and informal institutions, rules and norms, including incentives, standards and processes, which would shape international economic relations in a way that is conducive to sustained and inclusive development. It will be supported by reforms of the global economic regimes that directly affect development and poverty reduction in LDCs, as well as the design of a new generation of special international support mechanisms (ISMs) for LDCs aimed at addressing their specific structural constraints and vulnerabilities. Increasing South-South cooperation could also play an important role.
Health equity in economic and trade policies
In recent years, there have been increasing concerns about macroeconomic policy constraints interfering with the ability of many African governments to increase health sector spending and getting access to urgently needed funds for HIV/AIDS human resource development. The International Financial Institutions (IFIs) and, in particular, the IMF have been accused of undermining health care systems in many developing countries through conditionalities that favour budgetary ceilings as a panacea for macroeconomic stability. The economic policies sometimes affect overall spending, resulting in caps on the health sector, salary and recruitment of health workers and the acceptance of large amounts of financial assistance. AFRODAD has conducted a two country study aimed at looking at the links between macroeconomic frameworks provided by the International Financial Institutions (IFIs) and the social spending, and in particular, the fight against HIV/AIDS in Ghana and Malawi. This study reviewed the major channels through which fiscal and monetary policies impact on public expenditure frameworks and how this, in turn, affects the ability of the countries under study to design and implement public programmes concerning those living with and affected by HIV/AIDS and assessing the debt positions of the case studies to see how the HIV/AIDS has impacted on their financial portfolios and planning abilities or vice-versa.
Have traditional restrictive macroeconomic policies and budget ceilings limited some governments from giving HIV and AIDS the attention it deserves? This paper analyses the links between macroeconomic frameworks provided by the International Financial Institutions (IFIs) and HIV/AIDS social spending in Ghana and Malawi. Authors stress the need for a fundamental shift in the design and execution of the macroeconomic framework and propose policy recommendations.
Have traditional restrictive macroeconomic policies and budget ceilings limited some governments from giving HIV/AIDS the attention it deserves? This paper analyses the links between macroeconomic frameworks provided by the International Financial Institutions (IFIs) and HIV social spending in Ghana and Malawi. It reviews major channels through which fiscal and monetary policies impact on public expenditure frameworks and how this, in turn, affects the ability of the countries to design and implement public programmes for those living with and affected by AIDS. Authors stress the need for a fundamental shift in the design and execution of the macroeconomic framework.
In order to ensure their population's regular access to essential medicines, many countries are faced with the policy question of whether to import or manufacture drugs locally. For domestic manufacturing to be viable and cost-effective, the local industry must be able to compete with international suppliers of medicines. This paper considers the 'make-or-buy' dilemma by using Tanzania as a case study. Key informant interviews, event-driven observation, and purposive sampling of documents were used to evaluate the case study. The case study focused on Tanzania's imitation technology transfer agreement to locally manufacture a first-line ARV (3TC + d4T + NVP), reverse engineering the ARV. The study finds that Tanzania is limited by weak political support for the use of Trade-Related Aspects of Intellectual Property Rights (TRIPS) flexibilities, limited production capacity for ARVs and limited competitiveness in both domestic and regional markets. The Ministry of Health and Social Welfare encourages the use of flexibilities while others push for increased IP protection. Insufficient production capacity and lack of access to externally -financed tenders make it difficult to obtain economies of scale and provide competitive prices. Within the "make-or-buy" context, it was determined that there are significant limitations in domestic manufacturing for developing countries. The case study highlights the difficulty governments face to make use of economies of scale and produce low-cost medicines, attract technology transfer, and utilize the flexibilities of the WTO Agreement on TRIPS. The results demonstrate the importance of evaluating barriers to the use of TRIPS flexibilities and long-term planning across sectors in future technology transfer and manufacturing initiatives.
The author reports on 2013 loans taken without parliament approval in Mozambique totaling $2 billion. External funders suspended credit to Mozambique because of the loans, and the national currency fell by 70% in 2016. Restructuring the loans means imposed austerity on a population already living in extreme austerity and eventually repaying the creditors from revenues derived from Mozambique’s natural gas deposits that come on the market in 2023. The author presents information on the case, the funders and the implications for other African countries.
Contemporary famines are either deliberately created or allowed to happen. This new book collection argues for a conceptual shift in famine analysis: from understanding famines as failures of food availability or access, to understanding famines as failures of response. New concepts introduced in this collection include ‘famine intensity and magnitude scales’, ‘pre-modern, modern, and post-modern’ famines, ‘hidden famines’, and ‘priority regimes’. Case studies include famines that have occurred since the 1980s in Ethiopia, Sudan, Malawi, Madagascar, Iraq and North Korea, and a ‘near-famine’ in Bosnia.
The authors argue that an insular, authoritarian wave has been on the rise that is playing on people's fears and insecurities, undermining democratic institutions that are vital to maintaining the ties of accountability between the elected and the public: and multilateral infrastructures. Global health is argued to rely on an outward-looking, internationalist stance, since the threats that are faced know no borders. So how can global health advance in an era of retreat? Politics drive policies and the public drives the political. All sectors must thus, it is argued, be politically active in order to affect the development and implementation of public policies, including academia and the knowledge it brings. To successfully advance financial and political capital investments in global health, arguments must be framed by how they improve the security and prosperity of citizens and the nation. Investing in global health and multinational actions is a path to address these threats that know no borders.
The concept of ‘green growth’ implies that a wide range of developmental objectives, such as job creation, economic prosperity and poverty alleviation, can be easily reconciled with environmental sustainability. The authors of this study, however, argue that rather than being win-win, green growth is similar to most types of policy reforms that advocate the acceptance of short-term adjustment costs in the expectation of long-term gains. In particular, green growth policies often encourage developing countries to redesign their national strategies in ways that might be inconsistent with natural comparative advantages and past investments. In turn, there are often sizeable anti-reform coalitions whose interests may conflict with a green growth agenda. The authors illustrate this argument using case studies of Malawi, Mozambique, and South Africa, which are engaged in development strategies that involve inorganic fertilisers, biofuels production, and coal-based energy, respectively. Each of these countries is pursuing an environmentally suboptimal strategy but nonetheless addressing critical development needs, including food security, fuel and electricity. The study’s results show that adopting a green growth approach would not only be economically costly but also generate substantial domestic resistance, especially amongst the poor.
Kenya has been hailed as a successful sub-Saharan African country in attracting private investment for renewable energy. However, this paper observes that energy poverty remains very high, with connectivity rates lower than the average for sub-Saharan Africa and poor quality of supply for those connected. Several constraints persist to achieve universal access to clean and affordable electricity: high system costs, including a deficient transmission and distribution infrastructure; low rural demand and inadequate planning to meet it; and local opposition to large renewable infrastructure. This article considers the political economy of these constraints, explaining how they arose, which policies can address them and which actors back or oppose these policies. The overarching message is that a prominent state role is required to fund the network components of the electricity system and to reach the less profitable segments of society, namely the rural poor. However, the authors find that this clashes with a dominant private sector-led narrative in the international development community.