The Potential Demand for and Strategic Use of an HIV-1 Vaccine in Southern India

The Potential Demand for and Strategic Use of an HIV-1 Vaccine in Southern India

Author: Shreelata Rao-Seshadri

Publisher: World Bank Publications

Published: 2003

Total Pages: 32

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Even a modestly effective HIV-1 vaccine would be highly useful in India and could avoid millions of deaths. How should such a vaccine be introduced? Based on evidence of adoption of other vaccines in India, current levels of spending on them and coverage of prevention programs targeting both high- and low-risk groups, Seshadri, Subramaniyam, and Jha assess the potential demand for and strategic use of an HIV-1 vaccine in the four southern Indian states of Andhra Pradesh, Karnataka, Maharashtra, and Tamil Nadu. The authors also discuss potential strategies for delivery of the vaccine, prioritization for vaccination, and the political economy of such a vaccine in India. Assuming a vaccine cost of $10 a dose and including estimated delivery costs, the total cost of vaccinating 21.6 million adolescents 11-14 years of age and 1 percent of adults would be Rs. 12.25 billion (US$ 245 million). To maintain the vaccination rate in the 11-14 year old cohort, an additional 6.77 million in that age range would have to be vaccinated each year, at a vaccine cost of Rs. 3.39 billion (US$ 67.5 million). An HIV-1 vaccine will greatly reduce HIV/AIDS in India, but it will not be a panacea. There will be a continued need for effective prevention programs to guard against behavior reversals or an imperfect vaccine. Key inputs for prevention, immunization, and treatment programs such as identification of various groups that could be immunized (vulnerable groups or general populations), strengthened surveillance, capacity building, operations research, and evaluation at local levels will continue to require intensive support. This paper--a product of Public Services, Development Research Group--is part of the research project on The Economics of an HIV/AIDS Vaccine in Developing Countries: Potential Impact, Cost-Effectiveness, and Willingness to Pay," sponsored by the European Commission and the Development Research Group of the World Bank. The project was launched in response to recommendations of the World Bank's AIDS Vaccine Task Force.


Intertemporal Excess Burden, Bequest Motives, and the Budget Deficit

Intertemporal Excess Burden, Bequest Motives, and the Budget Deficit

Author: Derek Hung Chiat Chen

Publisher: World Bank Publications

Published: 2003

Total Pages: 84

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The author aims to empirically determine the significant factors that affect the levels of budget deficits of central governments across time and across countries. He empirically tests two prominent theories of budget deficits-the Barro (1979) tax-smoothing approach, and the still-untested theory of negative bequest motives advocated by Cukierman and Meltzer (1989). The author uses econometric techniques including fixed-effects (both country and time) panel regressions spanning 87 countries over the period 1975 to 1992, and the Griliches treatment of missing data. The author finds relatively stronger statistical support for the tax-smoothing approach among developing countries but not in industrial countries. The existence of empirical evidence supporting the theory of negative bequest motives is indeterminate. The author also conducted post-regression analyses to assess the proportion of observed differences in budget deficits the factors were actually able to explain. These reveal that both theories are generally weak in accounting for inter-temporal changes in budget deficit shares for both industrial and developing countries. The theories performed significantly better in accounting for cross-section differences. The author has many contributions to the literature. First, he analyzes the question of what determines the size of central government budget deficits using cross-country time series data leading into the 1990s. Second, he provides empirical tests of the still-untested Cukierman-Meltzer (1989) negative bequest motive theory of budget deficits. By using the panel data, the author attempts to determine the factors that influence not only the inter-temporal differences in budget deficits but also those factors that lead to cross-country differences. Last but not least, he provides some preliminary evidence that poverty reduction is necessary for long-term government budget deficit reduction.


Can Fiscal Rules Help Reduce Macroeconomic Volatility in the Latin America and Caribbean Region?

Can Fiscal Rules Help Reduce Macroeconomic Volatility in the Latin America and Caribbean Region?

Author: Guillermo Perry

Publisher: World Bank Publications

Published: 2003

Total Pages: 28

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The debate on fiscal policy in Europe centers on how to let automatic stabilizers work while achieving fiscal consolidation. There is significant agreement on the importance of using fiscal policy as a counter-cyclical instrument, as monetary policy can no longer play this role. In contrast, most of the discussion on fiscal policy in Latin America and the Carribean region (LAC) deals just on solvency issues, largely ignoring the effects of the economic cycle. This is surprising as LAC economies are much more volatile than their European counterparts and have been generally applying pro-cyclical fiscal policies that exacerbate volatility. Some analysts and policymakers appear to think that counter-cyclical fiscal policies are a luxury that only industrial countries can indulge in or, at least, that LAC countries (with the exception of Chile) that have successfully put in place a counter-cyclical fiscal policy need to deal first with pressing adjustment and solvency issues before they attempt to reduce the highly pro-cyclical character of their fiscal policies. The author argues that this is a major mistake because the costs of pro-cyclical fiscal policies in LAC are huge in growth and welfare terms, especially for the poor, and because pro-cyclical policies and rules tend to develop a deficit bias, thus ending up being nonsustainable and noncredible. Perry illustrates both propositions. He then examines the causes of the pro-cyclicality of fiscal policies in LAC and discusses how well-designed fiscal rules may help to deal with the political economy and credibility factors behind pro-cyclicality. He also examines conflicts between flexibility and credibility in rules, showing how a good design can both facilitate the operation of automatic stabilizers while at the same time supporting solvency goals and enhancing credibility. Perry evaluates the experience with different fiscal rules and institutions in LAC to see the extent they have helped or can help to achieve the twin goals of avoiding deficit and pro-cyclical biases.


The Gender Impact of Pension Reform

The Gender Impact of Pension Reform

Author: Estelle James

Publisher: World Bank Publications

Published: 2003

Total Pages: 81

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Pension systems may have a different impact on gender because women are less likely than men to work in formal labor markets and earn lower wages when they do. Recent multipillar pension reforms tighten the link between payroll contributions and benefits, leading critics to argue that they will hurt women. In contrast, supporters of these reforms argue that it will help women by the removal of distortions that favored men and the better targeted redistributions in the new systems. To test these conflicting claims and to analyze more generally the gender effect of alternative pension systems, James, Edwards, and Wong examine the differential impact of the new and old systems in three Latin American countries--Argentina, Chile, and Mexico. Based on household survey data, they simulate the wage and employment histories of representative men and women, the pensions they are likely to generate under the new and old rules, and the relative gains or losses of men and women because of the reform. The authors find that women do accumulate private annuities that are only 30-40 percent those of men in the new systems. But this effect is mitigated by sharp targeting of the new public pillars toward low earners, many of whom are women, and by restrictions on payouts from the private pillars, particularly joint annuity requirements. As a result of these transfers, total lifetime retirement benefits for women reach 60-80 percent those of men, and for "full career" women they equal or exceed benefits of men. Also as a result, women are the biggest gainers from the pension reform. For women who receive these transfers, female/male ratios of lifetime benefits in the new systems exceed those in the old systems in all three countries. Private intra-household transfers from husband to wife in the form of joint annuities play the largest role. This paper is a product of the Gender Division, Poverty Reduction and Economic Management Network.


Trade Reform in Vietnam

Trade Reform in Vietnam

Author: Philippe Auffret

Publisher: World Bank Publications

Published: 2003

Total Pages: 24

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In 1986 Vietnam initiated a transition from a centrally planned economy to a market-oriented economy where the government would keep playing a leading role. These renovation (doi moi) policies were successful at generating economic growth and reducing poverty. In the ten-year socioeconomic strategy endorsed by the Ninth Party Congress in April 2001, the authorities further articulated their development objectives in terms of economic growth and poverty reduction. To reach these objectives, the government indicated that its structural reform priorities were to change Vietnam's trade and financial policies, liberalize the climate for private investment, increase the efficiency of public enterprises, and improve governance. The author argues that the pace of implementation of trade reform-which has been impressive so far-is raising new challenges. On one side, fast liberalization of trade reform may soon conflict with the slow pace of implementation of other reforms, including restructuring of state-owned enterprises and state-owned commercial banks. On the other side, Vietnam would greatly benefit from fast implementation of trade reform and particularly fast accession to the World Trade Organization (WTO), especially after China's recent WTO accession. Auffret concludes that implementation of trade reform will be a testing ground to reveal the extent of Vietnam's commitment to a market-oriented economy.


Are You Satisfied?

Are You Satisfied?

Author: Uwe Deichmann

Publisher: World Bank Publications

Published: 2003

Total Pages: 40

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Citizen feedback is considered an effective means for improving the performance of public utilities. But how well does such information reflect the actual quality of service delivery? Do so-called scorecards or report cards measure public service delivery accurately, or do personal and community characteristics have a significant impact on residents' assessment of service quality? Deichmann and Lall investigate these questions using newly available household survey data on access to and satisfaction with selected public services in two Indian cities-Bangalore and Jaipur. They develop a framework where actual levels of services received, as well as expectations about service performance, influence a household's satisfaction with service delivery. The authors find that satisfaction increases with improvements in the household's own service status, a finding that supports the use of scorecard initiatives. But the results also suggest that a household's satisfaction is influenced by how service quality compares with that of its neighbors or peers and by household level characteristics such as welfare and tenure status. This implies that responses in satisfaction surveys are at least in part determined by factors that are unrelated to the service performance experienced by the household.


Export Profiles of Small Landlocked Countries

Export Profiles of Small Landlocked Countries

Author: Alexander J. Yeats

Publisher: World Bank Publications

Published: 2003

Total Pages: 60

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World Bank demographic and country characteristic statistics identify 16 small landlocked countries that are similar to Lesotho. Ng and Yeats attempt to determine what useful policy information can be derived from the recent trade performance of these "comparators." Among questions they pose are whether the trade profiles of the comparators suggest potentially promising export ventures for Lesotho, do they indicate directions for a geographic diversification of trade, or do they suggest products in which Lesotho might acquire a comparative advantage. The authors also use U.S. partner country statistics to evaluate Lesotho's export performance in this major market. The U.S. data indicate Lesotho lost competitive export shares for about three-quarters of its major clothing products during the late 1990s. The data show these losses were primarily to the North America Free Trade Agreement (NAFTA) countries in the Caribbean. Lesotho was competing on basically equal terms and did not fare well. But it is generally held that the most efficient clothing exporters are in the Far East and not Latin America. Lesotho's difficulties in competing with the latter have worrisome implications for its ability to compete with East Asian exporters when the Multifiber Arrangement is phased out. The comparative advantage profiles of the landlocked comparator countries suggest Lesotho's options for a greatly needed export diversification may be wider than is assumed. One or more of the comparator countries developed a comparative advantage in 110 four-digit SITC (non-clothing) manufactures which are generally labor-intensive in production. Many of these goods should also be suitable for production and export by Lesotho. International production sharing often involves the importation and further assembly of components in developing countries. This activity can significantly broaden the range of new products in which a country can diversify. Statistics show many landlocked comparator countries have moved into component assembly operations, and it appears this activity could contribute to Lesotho's export diversification and industrialization. But the quality problems associated with Lesotho's trade statistics makes it impossible to determine the extent to which local production sharing is occurring. A special effort is needed to tabulate reliable statistics on Lesotho's current involvement in this activity. Finally, the authors attempt to determine how the commercial policy environment in Lesotho compares with that in other countries. Policymakers previously had difficulty in addressing this issue, but several recent efforts to compile comprehensive cross-country indices of the quality of governance and commercial policies now provide relevant information. These statistics suggest domestic commercial policies make Lesotho relatively less attractive to foreign investment than many other developing countries. Less than 20 percent of all Latin American countries have a domestic commercial environment judged to be inferior to that in Lesotho, while the corresponding share for East Asia is under 30 percent. Overall, almost 70 percent of all developing countries appear to pursue commercial policies that make them as, or more, attractive to foreign investment than Lesotho. This paper--a product of Trade, Development Research Group--was prepared for the background study of Lesotho Diagnostic Trade Integration Study in summer 2002.