Gives an overview of the decentralization process in Kenya which has experienced little change since independence with the exception of Local Authority's (LA) responsibilities and resources which have been recentralized. The Kenya Local Government Reform Program (KLGRP) tried to correct this by increasing the LAs' financial resources, fostering citizens' participation in community life, and improving reliability of budgetary and accounting information. A new constitution was adopted in 2010 which reforms national institutions and intends to change the system of territorialized public institutions, but leaves issues of operation and financing of the new system unresolved. Currently, LA's freedom in regard to expenditure and revenue is extremely limited, but many of them do not comply with those rules. Principal elements of local taxation are the single business permit, property rates, contribution in lieu of rates (CILOR), and agricultural taxes. Even if the Local Government Act amendments bring changes for the current LAs, the new constitution maintains a centralizing tone.
Outlines decentralization in Senegal beginning with independence and later with the transfer of powers to the regions, communes, and rural communities (collectively known as CTs) through legislation that defines the missions and competences of the CTs, their organization, functioning, and oversight. The budget, prepared annually by the CT's elected executive, includes a classification of expenditures and revenues by type; however, there is confusion between the two classification systems and in the investment expenditure column. Most of the responsibilities transferred to the CTs concern education and health and though the law does not always require them to perform these responsibilities, it mandates the budget to include expenditures for them. Local resources include taxes, levies, property income, and user charges and fees; but tax revenues are always late and incomplete, and the identification of the tax base suffers from inaccuracies causing substantial abatements. Many intergovernmental transfers take place, but their total amount is modest compared with other local resources.
Offers an overview of the decentralization process in Burkina Faso beginning in 1991 with reforms to introduce a pluralist local democracy and improve local development in the face of bankruptcy. The territorial organization includes a decentralized level of regional and local government units and a deconcentrated level of administrative units that recognize the influential component of the customary power structure. Analysis of the decentralized budget, comprised of current and capital sections, shows controversy over ambiguity in the text of laws relating to the constraint of budget balance because provisions are liable to diverse interpretations. Ten areas of competence were transferred to the territorial collectives (CTs) using the principle of progressiveness signifying that the transfer of powers to local governments be carried out gradually. Statistical data on CT expenditures and revenues are abundant, but poorly organized and show that the ratios between capital expenditures and current expenditures are high, and revenues are inconsistent with resources.
Provides an overview of the framework for an analytical method created to provide country studies of Burkina Faso, Ghana, Kenya, and Senegal to address the historical and institutional design of decentralization as outlined in each country's national constitution or legislation through the use of an institutional study and a field study. The six steps in this process assess: (1) the institutional approach to decentralization, its design, and any gaps between the institutional norm and the reality on the ground; (2) the decentralized budget which provides a benchmark for comparing the financing systems of the countries studied; (3) the assignment of responsibilities across levels of government; (4) the revenue structures and systems and financial autonomy of local authorities; (5) the financial transfers through intergovernmental grants to support local governments; and (6) statistical data which can be used to measure the decentralization of responsibilities and resources.
The literature on federalism often evokes an association between redemocratization and decentralization, in which the consolidation of democracy is associated with a strengthening of federalism and a trend towards administrative, political and fiscal decentralization (Souza, 1999). The fact that this is driven by the need to provide resources and supply better-quality public services, makes analysis of the distribution of social spending highly relevant. Accordingly, the aim of this chapter is to analyze the trend of social spending in Latin America. Several Latin American countries have been pursuing an intensive process of fiscal decentralization over the last two decades; and, at the same time, almost the entire region has made changes to its social policies. These two processes reflect, first, the desire to generate allocation efficiency gains, which have an impact on expanding the decision-making, fiscal, and financial autonomy of local governments; and, second, the desire to strengthen democracy. The latter has had repercussions on social policy actions and services, generating broader coverage and higher monetary benefits, together with improved access, expansion of coverage, and the decentralization of jurisdictions and resources for service provision. In some countries, decentralization was seen as a way to resolve institutional problems caused by a loss of resources and the ability of federal governments to finance social policies and restructure service provision, while at the same time adapting to the growing importance of local areas in federative resource sharing and autonomous governance.
Kai-Min Chung, Edward Lui, Mohammad Mahmoody, Rafael Pass
Goldreich and Oren (JoCâ94) show that only trivial languages have 2-message zero-knowledge arguments. In this note we consider weaker, super-polynomial-time simulation (SPS), notions of zero-knowledge. We present barriers to using black-box reductions for demonstrating soundness of 2-message protocols with efficient prover strategies satisfying SPS zero-knowledge. More precisely, we show that assuming the existence of poly(T (n))-hard one-way functions, the following holds: ⢠For sub-exponential (or smaller) T (¡), polynomial-time black-box reductions cannot be used to prove soundness of 2-message T (¡)-simulatable arguments based on any polynomialtime intractability assumption. This matches known 2-message quasi-polynomial-time simulatable arguments using a quasi-polynomial-time reduction (Passâ03), and 2-message exponential-time simulatable proofs using a polynomial-time reduction (Dwork-Naorâ00, Passâ03). ⢠poly(T (¡))-time black-box reductions cannot be used to prove soundness of 2-message strong T (¡)-simulatable (efficient prover) arguments based on any poly(T (¡))-time intractability assumption; strong T (¡)-simulatability means that the output of the simulator is indistinguishable also for poly(T (¡))-size circuits. This matches known 3-message strong quasi-polynomial-time simulatable proofs (Blumâ86, Canetti et al â 00).
We propose an electronic payment protocol for typical customer-merchant relations which does not require a trusted (signed) payment descriptor to be sent from the merchant to the customer. Instead, the destination "account" number for the payment is solely created on the customer side. This eliminates the need for any encrypted or authenticated communication in the protocol and is secure even if the merchant's online infrastructure is compromised. Moreover, the payment transaction itself serves as a timestamped receipt for the customer. It proves what has been paid for and who received the funds, again without relying on any merchant signatures. In particular, funds and receipt are exchanged in a single atomic action. The asymmetric nature of the customer-merchant relation is crucial. The protocol is specifically designed with bitcoin in mind as the underlying payment system. Thereby, it has the useful benefit that all transactions are public. However, the only essential requirement on the payment system is that "accounts" are arbitrary user-created keypairs of a cryptosystem whose keypairs enjoy a homomorphic property. All ElGamal-type cryptosystems have this feature. For use with bitcoin we propose the design of a deterministic bitcoin wallet whose addresses can be indexed by clear text strings.
Governments have traditionally censored drug-related information, both in traditional media and, in recent years, in online media. We explore Internet content regulation from a drug-policy perspective by describing the likely impacts of censoring drug websites and the parallel growth in hidden Internet services. Australia proposes a compulsory Internet filtering regime that would block websites that âdepict, express or otherwise deal with matters of⌠drug misuse or addictionâ and/or âpromote, incite or instruct in matters of crimeâ. In this article, we present findings from a mixed-methods study of online drug discussion. Our research found that websites dealing with drugs, that would likely be blocked by the filter, in fact contributed positively to harm reduction. Such sites helped people access more comprehensive and relevant information than was available elsewhere. Blocking these websites would likely drive drug discussion underground at a time when corporate-controlled âwalled gardensâ (e.g. Facebook) and proprietary operating systems on mobile devices may also limit open drug discussion. At the same time, hidden Internet services, such as Silk Road, have emerged that are not affected by Internet filtering. The inability for any government to regulate Tor websites and the crypto-currency Bitcoin poses a unique challenge to drug prohibition policies.
Sander Greenland and Charles Poole1 accept that P values are here to stay but recognize that some of their most common interpretations have problems. The casual view of the P value as posterior probability of the truth of the null hypothesis is false and not even close to valid under any reasonable model, yet this misunderstanding persists even in high-stakes settings (as discussed, for example, by Greenland in 2011).2 The formal view of the P value as a probability conditional on the null is mathematically correct but typically irrelevant to research goals (hence, the popularity of alternativeâif wrongâinterpretations). A Bayesian interpretation based on a spike-and-slab model makes little sense in applied contexts in epidemiology, political science, and other fields in which true effects are typically nonzero and bounded (thus violating both the âspikeâ and the âslabâ parts of the model). I find Greenland and Pooleâs1 perspective to be valuable: it is important to go beyond criticism and to understand what information is actually contained in a P value. These authors discuss some connections between P values and Bayesian posterior probabilities. I am not so optimistic about the practical value of these connections. Conditional on the continuing omnipresence of P values in applications, however, these are important results that should be generally understood. Greenland and Poole1 make two points. First, they describe how P values approximate posterior probabilities under prior distributions that contain little information relative to the data: This misuse [of P values] may be lessened by recognizing correct Bayesian interpretations. For example, under weak priors, 95% confidence intervals approximate 95% posterior probability intervals, one-sided P values approximate directional posterior probabilities, and point estimates approximate posterior medians. I used to think this way, too (see many examples in our books), but in recent years have moved to the position that I do not trust such direct posterior probabilities. Unfortunately, I think we cannot avoid informative priors if we wish to make reasonable unconditional probability statements. To put it another way, I agree with the mathematical truth of the quotation above, but I think it can mislead in practice because of serious problems with apparently noninformative or weak priors. Second, the main proposal made by Greenland and Poole is to interpret P values as bounds on posterior probabilities: [U]nder certain conditions, a one-sided P value for a prior median provides an approximate lower bound on the posterior probability that the point estimate is on the wrong side of that median. This is fine, but when sample sizes are moderate or small (as is common in epidemiology and social science), posterior probabilities will depend strongly on the prior distribution. Although I do not see much direct value in a lower bound, I am intrigued by Greenland and Pooleâs1 point that âif one uses an informative prior to derive the posterior probability of the point estimate being in the wrong direction, P0/2 provides a reference point indicating how much the prior information influenced that posterior probability.â This connection could be useful to researchers working in an environment in which P values are central to communication of statistical results. In presenting my view of the limitations of Greenland and Pooleâs1 points, I am leaning heavily on their own work, in particular on their emphasis that, in real problems, prior information is always available and is often strong enough to have an appreciable impact on inferences. Before explaining my position, I will briefly summarize how I view classical P values and my experiences. For more background, I recommend the discussion by Krantz3 of null hypothesis testing in psychology research. WHAT IS A P VALUE IN PRACTICE? The P value is a measure of discrepancy of the fit of a model or ânull hypothesisâ H to data y. Mathematically, it is defined as Pr(T(yrep)>T(y)|H), where yrep represents a hypothetical replication under the null hypothesis and T is a test statistic (ie, a summary of the data, perhaps tailored to be sensitive to departures of interest from the model). In a model with free parameters (a âcomposite null hypothesisâ), the P value can depend on these parameters, and there are various ways to get around this, by plugging in point estimates, averaging over a posterior distribution, or adjusting for the estimation process. I do not go into these complexities further, bringing them up here only to make the point that the construction of P values is not always a simple or direct process. (Even something as simple as the classical chi-square test has complexities to be discovered; see the article by Perkins et al4). In theory, the P value is a continuous measure of evidence, but in practice it is typically trichotomized approximately into strong evidence, weak evidence, and no evidence (these can also be labeled highly significant, marginally significant, and not statistically significant at conventional levels), with cutoffs roughly at P = 0.01 and 0.10. One big practical problem with P values is that they cannot easily be compared. The difference between a highly significant P value and a clearly nonsignificant P value is itself not necessarily statistically significant. (Here, I am using âsignificantâ to refer to the 5% level that is standard in statistical practice in much of biostatistics, epidemiology, social science, and many other areas of application.) Consider a simple example of two independent experiments with estimates (standard error) of 25 (10) and 10 (10). The first experiment is highly statistically significant (two and a half standard errors away from zero, corresponding to a normal-theory P value of about 0.01) while the second is not significant at all. Most disturbingly here, the difference is 15 (14), which is not close to significant. The naive (and common) approach of summarizing an experiment by a P value and then contrasting results based on significance levels, fails here, in implicitly giving the imprimatur of statistical significance on a comparison that could easily be explained by chance alone. As discussed by Gelman and Stern,5 this is not simply the well-known problem of arbitrary thresholds, the idea that a sharp cutoff at a 5% level, for example, misleadingly separates the P = 0.051 cases from P = 0.049. This is a more serious problem: even an apparently huge difference between clearly significant and clearly nonsignificant is not itself statistically significant. In short, the P value is itself a statistic and can be a noisy measure of evidence. This is a problem not just with P values but with any mathematically equivalent procedure, such as summarizing results by whether the 95% confidence interval includes zero. GOOD, MEDIOCRE, AND BAD P VALUES For all their problems, P values sometimes âworkâ to convey an important aspect of the relation of data to model. Other times, a P value sends a reasonable message but does not add anything beyond a simple confidence interval. In yet other situations, a P value can actively mislead. Before going on, I will give examples of each of these three scenarios. A P Value that Worked Several years ago, I was contacted by a person who suspected fraud in a local election.6 Partial counts had been released throughout the voting process and he thought the proportions for the various candidates looked suspiciously stable, as if they had been rigged to aim for a particular result. Excited to possibly be at the center of an explosive news story, I took a look at the data right away. After some preliminary graphsâwhich indeed showed stability of the vote proportions as they evolved during election dayâI set up a hypothesis test comparing the variation in the data to what would be expected from independent binomial sampling. When applied to the entire data set (27 candidates running for six offices), the result was not statistically significant: there was no less (and, in fact, no more) variance than would be expected by chance alone. In addition, an analysis of the 27 separate chi-square statistics revealed no particular patterns. I was left to conclude that the election results were consistent with random voting (even though, in reality, voting was certainly not randomâfor example, married couples are likely to vote at the same time, and the sorts of people who vote in the middle of the day will differ from those who cast their ballots in the early morning or evening). I regretfully told my correspondent that he had no case. In this example, we cannot interpret a nonsignificant result as a claim that the null hypothesis was true or even as a claimed probability of its truth. Rather, nonsignificance revealed the data to be compatible with the null hypothesis; thus, my correspondent could not argue that the data indicated fraud. A P Value that Was Reasonable but Unnecessary It is common for a research project to culminate in the estimation of one or two parameters, with publication turning on a P value being less than a conventional level of significance. For example, in our study of the effects of redistricting in state legislatures (Gelman and King),7 the key parameters were interactions in regression models for partisan bias and electoral responsiveness. Although we did not actually report P values, we could have: what made our article complete was that our findings of interest were more than two standard errors from zero, thus reaching the P < 0.05 level. Had our significance level been much greater (eg, estimates that were four or more standard errors from zero), we would doubtless have broken up our analysis (eg, studying Democrats and Republicans separately) to broaden the set of claims that we could confidently assert. Conversely, had our regressions not reached statistical significance at the conventional level, we would have performed some sort of pooling or constraining of our model to arrive at some weaker assertion that reached the 5% level. (Just to be clear: we are not saying that we would have performed data dredging, fishing for significance; rather, we accept that sample size dictates how much we can learn with confidence; when data are weaker, it can be possible to find reliable patterns by averaging.) In any case, my point is that in this example it would have been just fine to summarize our results in this example via P values even though we did not happen to use that formulation. A Misleading P Value Finally, in many scenarios P values can distract or even mislead, either a nonsignificant result wrongly interpreted as a confidence statement in support of the null hypothesis or a significant P value that is taken as proof of an effect. A notorious example of the latter is the recent article by Bem,8 which reported statistically significant results from several experiments on extrasensory perception (ESP). At brief glance, it seems impressive to see multiple independent findings that are statistically significant (and combining the P values using classical rules would yield an even stronger result), but with enough effort it is possible to find statistical significance anywhere (see the report by Simmons et al9). The focus on P values seems to have both weakened that study (by encouraging the researcher to present only some of his data so as to draw attention away from nonsignificant results) and to have led reviewers to inappropriately view a low P value (indicating a misfit of the null hypothesis to data) as strong evidence in favor of a specific alternative hypothesis (ESP) rather than other, perhaps more scientifically plausible, alternatives such as measurement error and selection bias. PRIORS, POSTERIORS, AND P VALUES Now that I have established my credentials as a pragmatist who finds P values useful in some settings but not others, I want to discuss Greenland and Pooleâs proposal to either interpret one-sided P values as probability statements under uniform priors (an idea they trace back to Gossett)10 or else to use one-sided P values as bounds on posterior probabilities (a result they trace back to Casella and Berger).11 The general problem I have with noninformatively derived Bayesian probabilities is that they tend to be too strong. At first, this may sound paradoxical, that a noninformative or weakly informative prior yields posteriors that are too forcefulâand let me deepen the paradox by stating that a stronger, more informative prior will tend to yield weaker, more plausible posterior statements. How can it be that adding prior information weakens the posterior? It has to do with the sort of probability statements we are often interested in making. Here is an example from Gelman and Weakliem.12 A sociologist examining a publicly available survey discovered a pattern relating attractiveness of parents to the sexes of their children. He found that 56% of the children of the most attractive parents were girls, when compared with 48% of the children of the other parents, and the difference was statistically significant at P < 0.02. The assessments of attractiveness had been performed many years before these people had children, so the researcher felt he had support for a claim of an underlying biological connection between attractiveness and sex ratio. The original analysis by Kanazawa13 had multiple-comparisons issues, and after performing a regression analysis rather than selecting the most significant comparison, we get a P value closer to 0.2 rather than the stated 0.02. For the purposes of our present discussion, though, in which we are evaluating the connection between P values and posterior probabilities, it will not matter much which number we use. We shall go with P = 0.2 because it seems like a more reasonable analysis given the data. Let θ be the true (population) difference in sex ratios of attractive and less attractive parents. Then the data under discussion (with a two-sided P value of 0.2), combined with a uniform prior on θ, yield a 90% posterior probability that θ is positive. Do I believe this? No. Do I even consider this a reasonable data summary? No again. We can derive these âNoâ responses in three different ways: first, by looking directly at the evidence; second, by considering the prior; and third, by considering the implications for statistical practice if this sort of probability statement were computed routinely. First, a claimed 90% probability that θ > 0 seems too strong. Given that the P value (adjusted for multiple comparisons) was only 0.2âthat is, a result that strong would occur a full 20% of the time just by chance alone, even with no true differenceâit seems absurd to assign a 90% belief to the conclusion. I am not prepared to offer 9-to-1 odds on the basis of a pattern someone happened to see that could plausibly have occurred by chance alone, nor for that matter would I offer 99-to-1 odds based on the original claim of the 2% significance level. Second, the prior uniform distribution on θ seems much too weak. There is a large literature on sex ratios, with factors such as ethnicity, maternal age, and season of birth corresponding to difference in probability of girl birth of <0.5 percentage points. It is a priori implausible that sex-ratio differences corresponding to attractiveness are larger than for these other factors. Assigning an informative prior centered on zero shrinks the posterior toward zero, and the resulting posterior probability that θ > 0 moves to a more plausible value in the range of 60%, corresponding to the idea that the result is suggestive but not close to convincing. Third, consider what would happen if we routinely interpreted one-sided P values as posterior probabilities. In that case, an experimental result that is 1 standard error from zeroâthat is, exactly what one might expect from chance aloneâwould imply an 83% posterior probability that the true effect in the population has the same direction as the observed pattern in the data at hand. It does not make sense to me to claim 83% certaintyâ5-to-1 oddsâbased on data that not only could occur by chance alone but in fact represent an expected level of discrepancy. This system-level analysis accords with my criticism of the flat prior: as Greenland and Poole1 note in their article, the effects being studied in epidemiology are typically range from â1 to 1 on the logit scale; hence, analyses assuming broader priors will systematically overstate the probabilities of very large effects and will overstate the probability that an estimate from a small sample will agree in sign with the corresponding population quantity. Rather than relying on noninformative priors, I prefer the suggestion of Greenland and Poole1 to bound posterior probabilities using real prior information. I would prefer to perform my Bayesian inferences directly without using P values as in intermediate step, but given the ubiquity of P values in much applied work, I can see that it can be helpful for researchers to understand their connection to posterior probabilities under informative priors. SUMMARY Like many Bayesians, I have often represented classical confidence intervals as posterior probability intervals and interpreted one-sided P values as the posterior probability of a positive effect. These are valid conditional on the assumed noninformative prior but typically do not make sense as unconditional probability statements. As Sander Greenland has discussed in much of his work over the years, epidemiologists and applied scientists in general have knowledge of the sizes of plausible effects and biases. I believe that a direct interpretation of P values as posterior probabilities can be a useful startâif we recognize that such summaries systematically overestimate the strength of claims from any particular dataset. In this way, I am in agreement with Greenland and Pooleâs interpretation of the one-sided P value as a lower bound of a posterior probability, although I am less convinced of the practical utility of this bound, given that the closeness of the bound depends on a combination of sample size and prior distribution. The default conclusion from a noninformative prior analysis will almost invariably put too much probability on extreme values. A vague prior distribution assigns much of its probability on values that are never going to be plausible, and this disturbs the posterior probabilities more than we tend to expectâsomething that we probably do not think about enough in our routine applications of standard statistical methods. Greenland and Poole1 perform a valuable service by opening up these calculations and placing them in an applied context.
Cette thèse cherche Ă savoir si la mĂŠthode dĂŠcentralisĂŠe, officiellement mise en avant dans la gestion des crises de la dette souveraine depuis leur origine, est non seulement rĂŠalisable, mais ĂŠgalement efficace en termes de rĂŠpartition ĂŠquitable du fardeau de la dette. Nous dĂŠfinissons en effet un processus de restructuration efficace comme une procĂŠdure de courte durĂŠe (infĂŠrieure Ă un an) et qui respecte les besoins des deux parties prenantes au contrat. Si du cĂ´tĂŠ des crĂŠanciers, la dĂŠcote ne doit pas ĂŞtre abusive, du cĂ´tĂŠ du dĂŠbiteur, la dette doit redevenir soutenable, au sens Ă la fois ĂŠconomique et social du terme. Le terrain d'analyse des processus de renĂŠgociation de la dette se concentre exclusivement sur les ĂŠconomies d'AmĂŠrique Latine, dans la mesure oĂš elles reprĂŠsentent les dĂŠbiteurs ayant enregistrĂŠ le plus grand nombre de dĂŠfauts au cours de l'histoire. Ă travers une mĂŠthode pluridisciplinaire, nous dĂŠfendons finalement la thèse selon laquelle l'ĂŠchec des diffĂŠrents processus de restructuration est directement subordonnĂŠ Ă l'iniquitĂŠ du partage du fardeau de la dette, laquelle fait suite Ă un dĂŠsĂŠquilibre des pouvoirs de nĂŠgociation inhĂŠrente au cadre de gestion dĂŠcentralisĂŠe. Notre posture macroĂŠconomique et notre dĂŠmarche inductive induisent un cadre d'analyse socio-ĂŠconomique, lequel fait appel Ă un approfondissement historique, en termes d'ĂŠconomie politique, mais ĂŠgalement Ă une ĂŠtude basĂŠe sur la psychologie sociale. La thèse est structurĂŠe autour de deux parties, elles-mĂŞmes subdivisĂŠes en deux chapitres. La première partie s'attache Ă comprendre les origines et les modalitĂŠs de prĂŠvention et de gestion des crises, ainsi que leurs ĂŠchecs. Elle conjugue de fait l'observation empirique et les soubassements thĂŠoriques de la dĂŠcentralisation. De fait, le premier chapitre fait ĂŠtat, au vu de la double responsabilitĂŠ Ă l'Ĺuvre dans le dĂŠclenchement et l'enlisement dans la crise, de l'ĂŠchec de la mĂŠthode dĂŠcentralisĂŠe sur le long terme. En effet, non seulement la dĂŠcentralisation apparaĂŽt inapplicable, puisqu'une tierce partie est systĂŠmatiquement contrainte d'intervenir, mais elle ne permet pas non de plus de rĂŠpartir ĂŠquitablement les coĂťts de la crise. Le second chapitre cherche consĂŠcutivement Ă comprendre pourquoi ce processus de restructuration est nĂŠanmoins maintenu. L'ĂŠconomie politique de la dĂŠcentralisation montre alors que le choix entre la rĂŠgulation et le ÂŤ laissez-faire Âť ne tient pas tant Ă des critères d'efficacitĂŠ ĂŠconomique qu'Ă des considĂŠrations idĂŠologiques et politiques. La deuxième partie de cette thèse propose symĂŠtriquement des pistes de rĂŠflexion afin de pallier les principaux ĂŠcueils relevĂŠs lors des diffĂŠrents ĂŠpisodes de dĂŠfaut et de restructuration. Ainsi, si le troisième chapitre rĂŠpond au second, le quatrième fait ĂŠcho au premier. En effet, le troisième chapitre montre que la dĂŠcentralisation ne peut aboutir en raison non seulement de ses ĂŠcueils techniques, mais surtout de la nature des deux parties au contrat. L'immunitĂŠ souveraine ayant ĂŠtĂŠ relativisĂŠe dans les deux premiers chapitres, il s'agit ici d'analyser le fonctionnement des marchĂŠs selon une mĂŠthode alternative au concept d'efficience. C'est la raison pour laquelle nous faisons appel aux prĂŠceptes de Keynes (1936) et de son analyse en termes psychosociaux, que nous approfondissons au travers du courant de la finance comportementale. Une telle ĂŠtude rĂŠvèle ainsi l'incapacitĂŠ des crĂŠanciers Ă s'organiser de bonne foi, laquelle reprĂŠsente pourtant la condition sine qua non de la rĂŠalisation et de l'efficacitĂŠ de la mĂŠthode dĂŠcentralisĂŠe. Par consĂŠquent, le dernier chapitre de ce travail conclue sur la nĂŠcessitĂŠ d'un revirement en faveur d'une approche plus centralisĂŠe, laquelle inclut une tierce partie neutre, compĂŠtente et institutionnalisĂŠe.
In the months following his death on 20 August, Ethiopia's Prime Minister Meles Zenawi has been eulogized and demonized in equal measure. But his policies, and the transformational paradigm on which they were based, have rarely been elucidated. While alive, Meles was equally indifferent to praise and blame. To those who acclaimed Ethiopia's remarkable economic growth, he would ask, do they understand that his policies completely contradicted the neo-liberal Washington Consensus? To those who condemned his measures against the political opposition and civil society organizations, he demanded to know how they would define democracy and seek a feasible path to it, in a political economy dominated by patronage and rent seeking? Meles did not hide his views, but neither did he ever fully present his theory of the âdemocratic developmental stateâ to an international audience. Over nearly 25 years, I was fortunate to be able to discuss political economy with him regularly, including critiquing his incomplete and unpublished master's dissertation. During this time, his thinking evolved, but his basic principles and sensibilities remained constant. World leaders have lauded Meles' economic achievements without acknowledging their theoretical basis. Human rights organizations have decried his political record as though he were a routine despot with no agenda other than hanging on to power. Reviewing his writings on the developmental state, this essay shows the unity of his theory and practice. Meles had the quiet certitude of someone who had been tested â and seen his people tested â to the limit. Along with his comrades in arms in the leadership of the Tigray People's Liberation Front (TPLF), he had looked into the abyss of collective destruction, and his career was coloured by the knowledge that Ethiopia could still go over that precipice. Many times during sixteen years of armed struggle in the mountains of northern Ethiopia against the then-military regime led by Colonel Mengistu Haile Mariam, Meles had close personal brushes with death. In 1988, he and other central committee members avoided a likely-fatal aerial bombing by just twenty minutes after their hideout was betrayed by a spy and Ethiopian fighter-bombers targeted it. Later that year, he was taken gravely ill with malaria and was evacuated to hospital in Khartoum â one of the very few times he left the field during the entire armed struggle. As Meles crossed the border back into Ethiopia, I met him for the first time, and we began the first of our seminars on political economy. As dusk fell, still recuperating in his pyjamas, Comrade Meles climbed aboard a creaky Soviet Zil truck, captured from the Ethiopian army. All travel was at night, to avoid the MiGs, and we bumped our way along rocky tracks, first through the forested lowlands, camping out during daylight hours under trees next to a dry riverbed. Such was the itinerant life of the TPLF leadership. The next night our truck rumbled up a road cut through the mountainside by the guerrillas, with hairpins so tight that our truck had to make three-point turns. We spent the next day in caves at the TPLF's temporary headquarters in a mountain called Dejena, and the next nightfall I watched as an apparently uninhabited hillside gave forth a battalion of men, a dozen trucks and a tank, all of them completely obscured by camouflage until that moment. The TPLF had turned concealment into science. The discomfort of the journey was less memorable than the travelling discussion group of Comrade Meles, Comrade Seyoum (head of TPLF foreign relations and later Ethiopia's longest-serving Foreign Minister), a dozen fighters, a representative from a European agricultural assistance agency, and myself. I learned quickly that the most necessary attribute of a guerrilla fighter is functioning without sleep. Meles was a voracious consumer of information and analysis, and a tireless questioner. We discussed perestroika in the USSR, theories of people's liberation warfare, the imperfections of grain markets, and, above all, peasant survival strategies during drought. At one point we met a hunter on the track and Meles spent an hour discussing with him the importance of conserving endangered species. Meles was a convinced Marxist-Leninist, pragmatic but certain that the way of life of the Ethiopian peasants had to change or die. Having just completed my doctoral dissertation on famine survival strategies in Sudan, I tried to convince him that rural people were best served by diversified livelihoods, and that pastoral nomadism was an effective adaptation to the vagaries of life in a drought-prone ecosystem. He did his best to convince me that traditional livelihoods were doomed to stagnation and that Ethiopian peasants had to specialize in farming, trade, or livestock rearing. The abiding impression left by Meles and the TPLF leadership was that their theory and practice were deeply rooted in the realities of Ethiopia, and that they would succeed or fail on their terms and no others. The TPLF had convinced the people, and that was all that mattered. They did not measure their record or their policies against external standards; on the contrary, they evaluated outside precepts against their own experience and logic. It was a refreshing, even inspiring, dose of intellectual self-reliance. Meles was unflinchingly optimistic about the prospects for the armed struggle and assured me that the Tigrayan guerrillas, until a few months previously confined to the hills and the borderlands with Sudan, would penetrate as far south as Shewa, the Amhara heartland just a hundred miles from the capital Addis Ababa, within a year. I did not take his promise seriously (neither did any other non-Ethiopian). But he was correct, and within two and a half years, the TPLF â now a member of the Ethiopian People's Revolutionary Democratic Front (EPRDF) coalition â achieved the remarkable feat of capturing the capital city. The EPRDF took Addis Ababa on 28 May 1991, amid international predictions that Ethiopia would go the way of Somalia, where guerrillas had overrun Mogadishu just four months earlier. On 31 May, government salaries and pensions were due. They were paid on time. Police were back on the street within days. During the next 21 years, Meles often looked as though he was camping out in the palace. He moved into his predecessor's semi-subterranean bunker home in the sprawling grounds of the old palace of the Emperor Menelik, and took over Mengistu's spacious but damp modernist executive office. The artwork scarcely changed over the next two decades, the carpets just once. Meles was not interested in the trappings of power, only in what could be done with it. From the outset, what needed to be done was to conquer poverty. From his early days in the field through to his last years as an international statesman, Meles was absolutely consistent in this aim. Ethiopia's overriding national challenge was to end poverty, and in turn this needed a comprehensive, theoretically rigorous practice of development. Marxism-Leninism was, for him, not a dogma but a rigorous method for assembling evidence and argument, to be bent to the realities of armed struggle and development. When the TPLF first administered âliberatedâ territories in the 1970s, it took a conventional leftist line, tried to regulate trade and moneylending, and failed. The Front responded by adjusting its policies to encourage the local petit bourgeoisie in the villages and small towns it controlled. When the great famine of 1984â5 struck, the TPLF took the strategic decision to make feeding the peasantry its priority, even at the expense of losing ground to the enemy. Meles was primus inter pares in the EPRDF's collective leadership and chief economic theoretician. In an episode made famous by Joseph Stiglitz,1 Meles objected to the IMF position that international assistance was too unpredictable to be incorporated into national budget planning purposes, with the absurd consequence that national spending on infrastructure, health, and education could not be increased in line with foreign aid flows. Meles produced arguments and data and forced the Bretton Woods Institutions to rethink. Meles inverted Kissinger's dictum that holding office consumes intellectual capital rather than creating it. He was always learning, reading, debating, and writing, and while he never abandoned the fundamental principles forged in the field, his views evolved greatly. After 1991, he studied for a degree in Business Administration at the Open University (graduating first in his class) and subsequently a Masters in Economics at Erasmus University, Rotterdam, under the supervision of the former Minister of Development Cooperation, Jan Pronk. He never finished his thesis due to the outbreak of war with Eritrea in 1998, but the draft manuscript, âAfrican Development: Dead Ends and New Beginningsâ, was the justification and blueprint for a âdemocratic developmental stateâ. Excerpts are available online with the intriguing disclaimer: âThe author is the Prime Minister of Ethiopia. The views expressed are personal and do not necessarily reflect the official position of the Government.â2 Some of his analysis is also contained in a chapter in a recent collection edited by Akbar Noman and others.3 The war with Eritrea not only interrupted Meles' studies but provoked the most bitter dissension within the EPRDF. Meles was accused of having been soft on Eritrea and blind to Eritrean preparations for war, and subsequently for stopping the war once Ethiopia had expelled the invader from occupied territory. The internal party debate then took an ideological turn that seems to outsiders to be oddly anachronistic, replete with references to Bonapartism and the âKulak lineâ. Meles clearly stated that there should be no confusion that the EPRDF's mission was to build a capitalist state. He further stated that rent seeking and patronage within the ruling party posed the key dangers to this objective, and they needed to be thoroughly stamped out. Meles' adversaries accused him of selling his revolutionary soul to imperialism and serving Eritrea at the expense of Ethiopia. Meles won by the skin of his teeth â just two votes in the Central Committee of the TPLF. His rivals then walked out and Meles seized the moment to consolidate his power. The next decade was to be his chance both to hone and to implement his theory of âdemocratic developmentalismâ. One may disagree with Meles' thesis or argue that he failed to implement it properly. But without question it represents a serious attempt to develop, and apply, an authentically African philosophy of the goals and strategies of development. He explained the background to me. âFor the first ten years after we took over,â he said, âwe were bewildered by the changes. The New World Order was very visible and especially so in this part of the world. The prospect of an independent line appeared very bleak. So we fought a rearguard action not to privatize too much.â4 Meles was doubly constrained: internally the EPRDF was regressing, rehearsing its rhetoric but practising what Meles came to dub pervasive âsocially wasteful rent seeking.â5 But after emerging from the fractious debates of 2000â1, Meles had the upper hand, at the same time as international thinking shifted away from the neo-liberal demand for a non-interventionist ânight-watchmanâ state towards recognizing the need for a capable state to lead development. Meles agreed with the neo-liberals that the âpredatory stateâ of Africa's first post-colonial decades was one dead end, but argued that allowing the market to rule was a second dead end. âYou cannot change a rent-seeking political economy just by reducing the size and role of the state. The neo-liberal paradigm does not allow for technological capacity accumulation, which lies at the heart of development. For that, an activist state is needed, that will allocate state rents in a productive manner.â6 South Korea and Taiwan were Meles' favourite examples of developmental states that succeeded by subverting neo-liberal dogma. China's rise provided something else: by challenging American dominance it made space for alternatives. In his thesis he wrote, âthere has to be more political space for experimentation in development policy than has been the case so far in Africa ⌠The international community has a role in creating such a space by tolerating development paradigms that are different from the orthodoxy preached by it. Africans have to demand and create such a spaceâ (p. 39). Meles' starting point was that Ethiopia (and indeed Africa as a whole) lacked comparative advantage in any productive field. He laid out his case in one discussion we held.7 âAfrican workers produce textiles at nine times the price of the Chinese.â Similarly, African foodstuffs could not compete in international markets. âIn these circumstances, the best way to make money is through rent: natural resource rent, aid rent, policy rent. So the private sector will be rent-seeking not value creating, it will go for the easy way and make money through rent.â8 In reaction to this, Ethiopia postponed private land ownership and kept state control of the financial sector and telecoms. The argument continued, âIf the state guides the private sector, there is a possibility of shifting to value creation â it needs state action to lead the private sector from its preference (rent seeking) to its long-term interest (value creation). So the state needs autonomy.â9 The government should choose when and how to partner with the private sector (an example was developing Ethiopia's leather industry) and should invest in education and research. Meles clearly identified the challenge of development as primarily a political one: it is necessary to master the technicalities of economics, but essential not to let them become a dogma that masters you. It is the politics of the state that unlocks development. The âdevelopmental stateâ should, he argued, be obsessed with value creation, making accelerated and broad-based growth a matter of national survival. If Ethiopia could sustain its growth levels â which have been running at close to 10 percent per annum for most of the last decade â it could achieve middle-income status and escape from its trap. To succeed in this, a third element was needed, namely the hegemony of developmental discourse, in the Gramscian sense that it is an internalized set of assumptions, not an imposed order. Meles liked to give the example of corrupt customs officials in Taiwan, who exacted bribes worth 12 percent of the value of imports of consumer goods, while not demanding bribes on imported capital goods, illustrating how value creation had been internalized in this way â so that even the thieves followed the norm. African countries might have the trappings of human rights and democracy, but, he said, âthere is no sustainable democracy in a society characterized by pervasive rent seeking. We need value creation to be dominant for there to be a foundation of democracy, for politics to be more than a zero sum game, a competition to control state rents.â Worse, he added, âI am convinced that we will cease to exist as a nation unless we grow fast and share our growth.â10 Thus far, I found Meles' case compelling, though I questioned if it were possible to create a common mindset of value creation in a country as vast and diverse as Ethiopia, in such a short period. Was there not a danger that a theory, however sophisticated, would degenerate into a set of dogmas parroted by party cadres who scarcely understood the meaning of âpervasive rent seekingâ but who knew the rewards of loyally following the party line? Meles' response was that the EPRDF had indeed neglected political education and party organization for years, which explained the 2000â1 internal crisis and the poor performance in the 2005 elections, including being out in the he argued, a of leaders was he was the party at all and, above all, his policies were had the recent economic growth and the in and â and this, he said, would the country in the next in Meles' paradigm was a theory of He if a developmental state was to be about growth, it would have to build the capital that is for its It would have to out patronage and rent seeking. are the very same that create the for politics that is from (p. Meles condemned as and that, in a poor developing political and would become patronage rather than the for a political and sustainable development. He a in which for which one could best the state. states could in Meles argued, provided that they the hegemony of value creation, were from the private sector, stamped out rent seeking and and policy for to developmental state could be but in Africa's diverse was a Ethiopia's and Meles his preference was to have two of which for developmental but in their the would be a dominant party or dominant such as or in In the Ethiopian he wrote, peasant is the of a developmental His this them the chance of for alternatives. Meles' to democracy and human rights was all of a with his He said, developmental has done its it will its own to be by a or he argued, what meaning did civil and political rights have in a of or political Development and a state were for human and Ethiopia needed to these or this is a serious argument that serious In early I Meles he had been so about his He that he should not Ethiopia's by a personal intellectual agenda that would be to from his and he that his which had been just a few years were common and that as the time for him to office at the elections, he to his dissertation and 25 years Meles was indifferent to and argument that failed to his own and was that would their own and that would him when I Meles what he would his he was in those who his government as or and only the question of was in It would be he said, that question could be Meles also that the intellectual of the theoretical of his and that analysis to what he called the African state, characterized by a political was just of Meles' writings are in the to that Meles was a that his unpublished to out the less of his intellectual
Hana Brixi, Yan Mu, Beatrice Targa, David Hipgrave
China's current health system reform (HSR) is striving to resolve deep inequities in health outcomes. Achieving this goal is difficult not only because of continuously increasing income disparities in China but also because of weaknesses in healthcare financing and delivery at the local level. We explore to what extent sub-national governments, which are largely responsible for health financing in China, are addressing health inequities. We describe the recent trend in health inequalities in China, and analyse government expenditure on health in the context of China's decentralization and intergovernmental model to assess whether national, provincial and sub-provincial public resource allocations and local government accountability relationships are aligned with this goal. Our analysis reveals that government expenditure on health at sub-national levels, which accounts for âź90% of total government expenditure on health, is increasingly regressive across provinces, and across prefectures within provinces. Increasing inequity in public expenditure at sub-national levels indicates that resources and responsibilities at sub-national levels in China are not well aligned with national priorities. China's HSR would benefit from complementary measures to improve the governance and financing of public service delivery. We discuss the existing weaknesses in local governance and suggest possible approaches to better align the responsibilities and capacity of sub-national governments with national policies, standards, laws and regulations, therefore ensuring local-level implementation and enforcement. Drawing on China's institutional framework and ongoing reform pilots, we present possible approaches to: (1) consolidate key health financing responsibilities at the provincial level and strengthen the accountability of provincial governments, (2) define targets for expenditure on primary health care, outputs and outcomes for each province and (3) use independent sources to monitor and evaluate policy implementation and service delivery and to strengthen sub-national government performance management.
Fiscal decentralization is an important influence factor on the autonomy of local government. To the extent in which a local government benefits from amounts and transfers from the central government, it depends on it and has a reduced capacity to make decisions about the services they provide to citizens, local autonomy being limited. Even if the legal framework for decentralization was created in Romania, we still can not talk about a high degree of financial autonomy of local governments. Further, significant amounts from the state budget are transferred to local budgets to cover local expenses. Moreover, despite consistent efforts to implement the decentralization process, there is a series of imbalances, especially in smaller territorial administrative units that are clearly disadvantaged both in terms of financial capacity to finance themselves through local taxes and duties, and especially in terms of the low absorption capacity of European funds. In general, in Romania, the degree of financial autonomy differs nationally from the city level and from the village level.
After evaluating decentralization policy in the Lee Myung-bak administration's, this paper tried to suggest and propose some policy initiatives and directions on this policy to the upcoming administration of Park Geun-hye, the president-elect by reviewing her policy commitments and positions to decentralization during her presidential campaign. Being based on this research purpose and method, this article presented some policy guidelines and initiatives to the Park's government as follows; constitutional amendment for promoting decentralization to local governments, strengthen and rebuilding of pushing system of the decentralization policy, strengthen legislative autonomy, maintenance of special local administrative agencies, institution of autonomous police system, improvement autonomous education municipality, strengthen the position and role of local council, practices of political decentralization, and an innovative securing local autonomous finance.
Whether 15 million on antiretroviral therapy (ART) by 2015 is a realistic target or just a dream is posing the question in the wrong way. The real question is: how can we turn our dream of having 15 million HIV-infected people receiving adequate antiretroviral therapy in 2015 into reality? This issue of Current Opinion in HIV and AIDS, although far from comprehensive, provides building blocks to attain that goal, points out particular opportunities, but also identifies some of the obstacles that need to be overcome. The first article by Duncombe et al. (pp. 4â11) sets the stage by summarizing the WHO/UNAIDS Treatment 2.0 strategy. No need to duplicate or add to that here, because the article provides a thorough update on where we stand. One element needs to be highlighted, however: contributions of international donors have been stagnating over the past years, and although there is a continued increase in domestic funding, most African countries are far from reaching the Abuja Declaration targets for spending on healthcare. Sure, efficiencies in healthcare delivery can be improved [1], and the striking levels of fungibility or crowding out [2] may be tackled by innovative ways of donor financing [3]. But if there is too little money overall to provide decent healthcare, targets cannot be met. The second article by Vittoria and Vella (pp. 12â18) provides a very nice overview of the evolution of WHO HIV treatment guidelines, adapting to changing insights and possibilities throughout the years in an ever more timely manner. It also points at future trends, which take into account the beneficial effects early treatment can have on the health of individuals, HIV transmission, the incidence of tuberculosis and models of care delivery. If we do not succeed in simplifying models of care delivery, by decentralization and task-shifting a.o., we will be unable to reach the 15 million by 2015 target. The third article, by Hamers et al. (pp. 19â26) and the fourth article, by Sohn et al. (pp. 27â33) focus on transmitted HIV drug resistance in Africa and Asia, respectively, and point to an emerging and in some countries, like Uganda, already sizable problem. The Hamers article also presents data on the high rate of drug resistance mutations in those failing first-line therapy. It is clear that surveillance of both transmitted and secondary HIV drug resistance and measures to minimize the risk of their emergence (such as preventing drug stock-outs and increasing adherence) should be an integral component of the continuing ART scale-up. The 15 million target stands for 15 million people on effective, not failing, highly active antiretroviral therapy. Hill (pp. 34â40), in the fifth article, identifies three main problems with the current ART standard of care for many people in resource-poor settings: a large proportion of those on treatment are still taking stavudine-containing ART; there is limited diagnostic support â access to plasma viral load and drug resistance testing is still rare, which leads to late diagnosis of therapy failure and accumulation of drug resistance mutations; access to second-line treatment is limited. Thus, current practice often does not meet the standards deemed necessary by Hill to achieve âUniversal Accessâ: a simple system of treatment, using a sequence of low-cost, coformulated antiretrovirals with strong efficacy profiles, nonoverlapping resistance profiles, and safety issues which are manageable with minimal medical expertise. He argues that only a relatively small subset of antiretrovirals may be needed for first-line, second-line and potentially third-line treatment in large-scale treatment access programs, and has several creative ideas about how this could be achieved in the most cost-effective manner, with a focus on ongoing research to use lower dosages of drugs (âdose-optimizationâ) which are cheap to manufacture. One can argue whether stavudine should have been included in this list, but, overall, simplifying therapeutic algorithms and lowering the dose and thus the cost of individual drugs are essential ingredients of a more effective scale-up. The sixth article (pp. 41â49), by the âfathersâ of Treatment as Prevention (TasP), advocates passionately for expansion of combination HIV prevention with an emphasis on the merits of expanding treatment: there is increasing evidence of health benefits of earlier treatment, a sharp reduction in incidence of tuberculosis in HIV-infected individuals, and with viral suppression through effective ART the risk of passing on the virus from a person living with HIV to a negative partners is close to zero. The authors remind us about the early skepticism regarding the feasibility and advisability of delivering ART in resource-poor settings, and how these skeptics have been proven wrong. Yes, we should never ever be discouraged by âthe nattering nabobs of negativismâ (to use a phrase from the recently deceased William Safire). But we can also not be naĂŻve and ignore the potential risks. The path to âTest and Treatâ will be paved by identifying â and managing â the potential risks; long-term side effects, and development of significant drug resistance, for example, because of breeches in adherence in particular of people living with HIV who have never been sick and as such have not felt themselves the dramatic benefits of treatment and full reconstitution of ill-health. The question should be less whether or not to treat earlier. But much rather about the âhowâ and what needs to be in place to minimize, track and manage the potential risks. Let us move intelligently, and while proceeding, watch carefully for possible negative effects to take corrective action, and take the emerging results and lessons of ongoing TasP demonstration projects into account. The seventh article, by Hankins and Dybul (pp. 50â58), is a thorough review of the evidence for pre-exposure prophylaxis (PrEP), with either local (e.g. vaginal microbicides) or systemic (e.g. oral) use of antiretrovirals. Based on the positive results of several clinical trials, oral PrEP with Truvada [tenofovir disoproxil fumarate/emtricitabine (TTDF/FTC)] has now been approved by the United States Food and Drug Administration (FDA) to reduce risk of sexually acquired HIV infection in high-risk adults. Public health experts are struggling with how to translate scientific findings from PrEP effectiveness trials into real-world implementation. For several reasons PrEP cannot be seen in isolation from treatment, and thus deserves a place in this issue of Current Opinion in HIV and AIDS. First: the same drugs (TDF and FTC) that are used for PrEP are a mainstay of ART regimens (for this purpose lamivudine is considered similar to FTC), which is not an ideal situation considering the risk of HIV drug-resistance development. Second, both human and financial resources for the treatment scale-up are already limited; are we now going to spend resources on these relatively expensive drugs for prevention, while, in addition to the effect of HIV treatment on HIV transmission, other HIV prevention modalities are available (male and female condoms, male circumcision)? Hankins and Dybul carefully review the prerequisites for, challenges to and dilemma's of a PrEP rollout. They also briefly review exciting products in the pipeline, including long-acting agents. The cascade of HIV care, which has the ultimate aim to achieve and undetectable plasma viral load â for the benefit of the individual and to prevent onward transmission â goes way beyond âTest and Treatâ. It also involves linking people to care after a positive HIV test, retaining them in care, getting them to initiate ART (if they want so), and getting them to adhere to the treatment regimen. All assuming that the care given is adequate, and that the antiretrovirals are present every time and of good quality. In the eighth article of this issue, with the catchy title âPatching a Leaky Pipeâ, Kilmarx and Mutasa-Apollo (pp. 59â64) review the recent literature on these multiple Achillesâ heels of the treatment scale-up. Fixing just one or two is not enough: they can all work as âchain terminatorsâ. Carefully examining the gaps at each step of the cascade, country by country and community by community, will be among the most useful approaches for planers and decision makers to improve scale-up and quality of care â essential elements to reaching and keeping the 15 million on ART. Article number nine, by Samuel Oti (pp. 65â69), who has the privilege to work at the unique African Population and Health Research Centre in Nairobi, is a compassionate and well reasoned plea for a coordinated response to HIV and noncommunicable diseases (NCDs). It is amazing that the advantages of this are not yet evident to everyone. How can we defend testing every adult for HIV and not take a blood pressure measurement at the same time. Hypertension is the biggest risk factor for premature death in the world [4] and its treatment is relatively straightforward and affordable. To secure continued funding for HIV it is essential to show that this money adds value beyond HIV and helps to build viable and sustainable health systems. Last but not least, article number 10 in this issue, by ât Hoen and Passarelli (pp. 70â74), looks at the role of intellectual property rights in HIV treatment access. It is hard to understand for us, why thus far only one research-based pharmaceutical company (Gilead) has had the courage and common sense to contribute to the Medicines Patent Pool. What are the others afraid of and what do they want to accomplish? However, we are living in a rapidly changing world and access to medicines is a complex issue beyond licensing agreements. With significant economic growth in the developing world the old concepts of rich and poor countries are increasingly invalid. Already today, the significant majority of all people living with HIV is living in middle and high-income countries, up from less than one-third, 10 years ago. And this trend is to continue. We need new approaches to access and equity, differential pricing approaches that address poverty within a given country, more systematic approaches to price negotiations that protect the smaller and less powerful states in their attempts to negotiate access to life-saving medicines, and the full use of TRIPS flexibilities including compulsory licensing if we are to reach the 15 million, and beyond. All in all, although some pieces, like healthcare financing, are missing, this issue of Current Opinion in HIV and AIDS presents a relevant mix of articles about opportunities of and challenges to a continued antiretroviral therapy scale-up. It has been a privilege to have served as its editors. J.M.A.L. and B.S. Acknowledgements None. Conflicts of interest J.M.A.L. institution has been receiving educational grants from the following pharmaceutical companies: Abbott, Boehringer Ingelheim, Bristol Meyers Squibb (BMS), Crucell, Gilead, ViiV, Johnson and Johnson, Merck, Mylan, and Roche. I have received honoraria for speaking engagements or consulting from Bristol Meyers Squibb, Gilead, Roche and Tibotec (Johnson and Johnson). B.S. has no conflicts of interest.
New Public Management (NPM) is considered as a global paradigm emerging in response to economic, institutional, political, and ideological changes.Many attempts to define the New Public Management have been made and there are several definitions of this notion, referring to the implementation of management ideas from business and private sector into the public services.Over the past few years, Romania has been facing a great challenge as it has to enhance its public management for achieving the European standards and values of transparency, predictability, accountability, adaptability and efficiency. The necessity of a modern administration at European standards exists both at the level of the citizen, and at the level of institutions delivering public services.According to the provisions of its last stand-by arrangement with IMF, Romania placed emphasis on restoring medium- and long-term sustainability and paved the way for future growth. Structural reforms were a large component of the program, including tax administration, pensions, public wages and employment, and social benefits, improving public sector efficiency, as well as enhancing the business environment. Since 2009 a public financial management structure was introduced for multi-year budgeting while limiting intra-year budget revisions. Fiscal rules were introduced on spending, public debt and primary deficit, and a framework for managing guarantees and other contingent liabilities was approved. Local public finance law was amended to bolster fiscal discipline and limit risks from local governments.Thus, presently, the legal framework envisages the use of new instruments and structures to support local administration authorities to increase their administrative capacity in order to perform in accordance with their new authority and thereby increases the quality of the already decentralized public services.The Common Assessment Framework (CAF) ' the total quality management tool was introduced in Romania, public institutions acknowledging the need for change and improvement, the importance of people'(tm)s involvement within the organization'(tm)s self-assessment process, the importance of measuring the results, objectives prioritization, the need to assume responsibility for the identified improvement actions, as well as the need to share knowledge and experience.Most of the Romanian public institutions apply the diagnosis obtained through CAF implementation as a solid ground to develop and implement their Multi-annual Modernizing Strategies, thus assuring the sustainability of the results accomplished so far.Concluding, we consider that the changes incurred and the significant transformation of Romanian public services include important elements of NPM.
In the past thirty years, a series of plans have been developed by successive Brazilian governments in a continuing effort to maximize the nation's resources for economic and social growth. This planning history has been quantitatively rich but qualitatively poor. The disjunction has stimulated Professor Mello e Souza to address himself to the problem of national planning and to offer some criticisms of Brazilian planning experience. Though political instability has obviously been a factor promoting discontinuity, his criticisms are aimed at the attitudes and strategic concepts which have sought to link planning to national goals and administration. He criticizes the fascination with techniques and plans to the exclusion of proper diagnosis of the socio-political reality, developing instruments to coordinate and carry out objectives, and creating an administrative structure centralized enough to make national decisions and decentralized enough to perform on the basis of those decisions. Thus, fixed, quantified objectives abound while the problem of functioning mechanisms for the coordinated, rational use of resources has been left unattended. Although his interest and criticism are focused on the process and experience of national planning, he recognized variation in the level and results of Brazilian planning. National plans have failed due to faulty conception of the function of planning. Sectorial plans, save in the sector of the petroleum industry under government responsibility, ha e not succeeded in overcoming the problems of formulation and execution thereby repeating old technical errors. Planning for the private sector has a somewhat brighter history due to the use of Grupos Executivos which has enabled the planning process to transcend the formalism and tradition-bound attitudes of the regular bureaucracy. Regional planning offers two relatively successful experiences, Sudene and the strategy of the regionally oriented autarchy. Thus, planning history in Brazil is not entirely black but a certain shade of grey. The major part of the article, however, is devoted to a descriptive analysis of the national planning experience. The plans included in this analysis are: The Works and Equipment Plan (POE); The Health, Food, Transportation and Energy Plan (Salte); The Program of Goals; The Trienal Plan of Economic and Social Development; and the Plan of Governmental Economic Action (Paeg). Using these five plans for his historical experience the author sets out a series of errors of formulation and execution by which he analyzes that experience. With respect to formulation, he speaks of a lack of elaboration of programs and projects, of coordination among diverse goals, and of provision of qualified staff and techniques. He mentions the absence of the definition of resources necessary to the financing of the plan and the inadequate quantification of sectorial and national goals due to the lack of reliable statistical information. Finally, he notes the failure to coordinate the annual budget with the multi-year plans. He sees the problems of execution as beginning in the absence of coordination between the various sectors of the public administration, the failure to develop an operative system of decentralization, the absence of any system of financial and fiscal control over execution, the difficulties imposed by the system of public accounting, and the absence of an adequate program of allocation for the liberation of resources. He ends by pointing to the failure to develop and use an integrated system of political economic tools in a mode compatible with the objective of the plans. The body of the article analyzes national planning experience in Brazil using these lists of errors as rough model of criticism. Several conclusions emerge from this analysis with regard to planning in Brazil and in developing countries, in general. Plans have generally been of little avail in Brazil because of the lack of a continuous, bureaucratized (in the Weberian sense) planning organization set in an instrumentally suitable administrative structure and based on thorough diagnoses of socio-economic conditions and problems. Plans have become the justification for planning. Planning has come to be conceived as a rational method of orienting the process of decisions through the establishment of a precise and quantified relation between means and ends. But this conception has led to a planning history rimmed with frustration, and failure, because of its rigidity in the face of flexible and changing reality. Rather, he suggests a conception of planning which understands it "as a rational process of formulating decisions about the policy, economy, and society whose only demand is that of managing the instrumentarium in a harmonious and integrated form in order to reach explicit, but not quantified ends". He calls this "planning without plans": the establishment of broad-scale tendencies through diagnosis whose implementation is carried out through an adjustable, coherent instrumentarium of political-economic tools. Administration according to a plan of multiple, integrated goals is a sound procedure if the nation's administrative machinery contains the technical development needed to control the multiple variables linked to any situation of socio-economic change. Brazil does not possess this level of refinement and any strategy of planning relevant to its problems must recognize this. The reforms which have been attempted fail to make this recognition as is true of the conception of planning informing the Brazilian experience. Therefore, unworkable plans, ill-diagnosed with little or no supportive instrumentarium or flexibility have been Brazil's legacy. This legacy seems likely to continue until the conception of planning comes to live in the reality of Brazil.
Alexander TobĂłn, Mauricio LĂłpez GonzĂĄlez, Jenifer GonzĂĄlez
Fiscal decentralization process in Colombia has led to significant achievements in the financial management of municipalities, which can be followed using some main indicators. This article presents the fiscal performance of the municipality of Medellin through aggregated fiscal indicators and the estimation of two econometric models of sensitivity for investment expenditure and tax income. It is concluded that, although the municipality presents a healthy fiscal state, there is evidence for fiscal laziness and relaxation phenomena between 1998 and 2009 that can be justified by the increasing dependency of non-tax revenues. Š 2012 Universidad ICESI. Publicado por Elsevier Espana. All rights reserved. Financas e gestao publica local na Colombia: no caso das Financas no municipio de Medellin
Xiao Qiang Guo, Li Hong Li, Cui Ling Luo, Yi Shuo Shi
The Bit Commitment (BC) is an important basic agreement in cryptography . The concept was first proposed by the winner of the Turing Award in 1995 ManuelBlum. Bit commitment scheme can be used to build up zero knowledge proof, verified secret sharing, throwing coins etc agreement.Simultaneously and Oblivious Transfer together constitute the basis of secure multi-party computations. Both of them are hotspots in the field of information security. We investigated unconditional secure Quantum Bit Commitment (QBC) existence. And we constructed a new bit commitment model â double prover bit commitment. The Quantum Bit Commitment Protocol can be resistant to errors caused by noise.
Fan and Lv (2012) have convincingly argued that China's public debt, including borrowings by local governments, is relatively small and manageable. They have also correctly pointed out that over the last 10 years, while debt owed by local governments has surged, the government's contingent liabilities, which take into account the need to use public funds to bail out state-owned banks with large nonperforming loans, have declined sharply. I have little disagreement with Fan and Lv's conclusions, and my comments, which cover four major issues, are meant to clarify some details. My first comment relates to centralization versus decentralization. Fan and Lv argue that China has a centralized fiscal system (de jure) based on the facts that top local officials are appointed by the central authority, tax revenues largely accrue to the central government, and the central government monopolizes the right to issue debt to the public. However, some economists have argued that China has a decentralized system (de facto) based on the facts that local government expenditures are very large relative to the central government expenditure, formula-based equalization transfers are relatively small, revenues from land sales make up a large share of total local government revenues, and borrowing by local government âfinancing platformsâ helps to fund infrastructure projects. Even if we accept that China has a centralized fiscal system, based on the case of Japan, which has a centralized fiscal system but is running one of the largest budget deficits in the world, I still have some doubts about whether centralization necessarily means fiscal prudence (small budget deficits and public debt) as argued by Fan and Lv. There is also a debate over whether decentralization favors economic growth. On the pro side, fiscal decentralization promotes competition among local governments, and it acts as a major force of economic development in China. On the con side, fiscal decentralization fragments the national market, encourages local protectionism, induces duplicated investment, and, hence, negatively affects economic growth. Second, I would put more emphasis on land prices and pension liabilities as major determinants of fiscal balances and, thus, the size of the public debt. A fall in land prices affects the fiscal position of local governments in the following two ways. On the one hand, it leads to a decline in their revenue, since proceeds from land sales are a major source of revenue for local governments. On the other hand, some local government financing platforms involved in property development (if not speculation) using funds borrowed from banks may have difficulty servicing those loans. Pension liabilities relating to urban workers under the previous pension regime, the so-called legacy costs, are estimated to range from 82% to 130% of 2008 gross domestic product (GDP), depending on assumptions made (World Bank and Development Research Center of the State Council of the People's Republic of China, 2012). Ultimately, this obligation will have to be paid down through fiscal resources and should be counted as part of the government's contingent liabilities. Third, I think more attention should be paid to the future trends of revenues and expenditures when discussing fiscal sustainability. On the revenue side, growth in fiscal revenues is expected to slow down as the pace of China's economic growth declines due to demographic changes and to the diminishing advantage of backwardness as China approaches the stage of an advanced economy. On the expenditure side, there is a pressing need to further increase spending on education, health, social protection, and environmental protection. Part of these incremental expenditures could be met through a reallocation of spending away from infrastructure investment. Finally, I agree with the view expressed by the World Bank and Development Research Center of the State Council of the People's Republic of China (2012) that enhancing fiscal sustainability in China calls for raising revenues by further reforms in the following six directions: (i) higher taxes or prices on energy, water, natural resources, and pollution; (ii) raising state-owned enterprise dividend payments to the general budget; (iii) further mobilizing personal income taxes, which make up only 1% of China's GDP compared with an average of about 6% in high-income countries; (iv) enhancing the taxation of motor vehicles and pricing of parking and congestion; (v) enhancing property taxes; and (vi) auctioning public resources such as bandwidth user rights, franchises for public utilities, and exploitation rights for natural resources. These measures should improve not only fiscal sustainability but also improve equity and efficiency for the Chinese economy as a whole.
In recent years, our clean coal technology made some breakthrough by means of introduction, digestion, and innovation. But compared with the developed countries, the use of clean coal technology in our country is not common for the unsound policies and standards, the lack of market mechanism, insufficient capital investment, decentralize of trade management and so on. We can effectively promote the development of clean coal technology, promote our country's energy consumption to transform extensive to intensive consumption and gradually realize a coordinated development between the energy, economy and environment by completing the relevant policies, laws and regulations of technology, finance, taxation, environmental protection, perfecting the independent innovations and technology admittance mechanism, increasing financial investment, encouraging private investment and setting up specialized standard managing and setting body of clean coal technology.
In this essay, Foucault's concept âof other spacesâ â or, heterotopia â is used to examine the Occupy Wall Street (OWS) movement in the context of systemic crisis. Neoliberalism is marked by innovations that amplify and accelerate contradictions, unfolding the false utopia of finance capitalism. Information and communication technologies (ICTs) helped hyper-financialize the economy, enrich banksters and extend inequalities. Conversely, high-tech developments allow for decentralized decision-making and more direct democracy, paralleling the ethics of OWS. New ICTs compress TimeSpace, opening doors for empathic connections, generating conditions for elevation of collective superstructural consciousness. This paper explores how these conditions create â and are recreated by â heterotopic spaces. Drawing on Foucault's method of heterotopology we throw light on the potential of OWS to prefigure another world, analyzing endeavors to promote cooperative autonomy, and raise consciousness in and through mediated environments, always contested, ever in flux, and inevitably over-(but never pre-)determined.