Zimbabwe has experienced a precipitous collapse in its economy over the past five years. The government blames its economic problems on external forces and drought. We assess these claims, but find that the economic crisis has cost the government far more in key budget resources than has the donor pullout. We show that low rainfall cannot account for the shock either. This leaves economic misrule as the only plausible cause of Zimbabwe’s economic regression, the decline in welfare, and unnecessary deaths of its children.
Addressing the Challenge of HIV/AIDS: Macroeconomic, Fiscal and Institutional Issues - Working Paper 58
After decades of neglect the HIV/AIDS epidemic has rightly become one of the highest priorities on the global agenda. Funding pledges from the donors have doubled resource commitments between 2002 and 2004 to over $6 billion. That surge in funding belies the volatile nature of contributions to HIV/AIDS initiatives at the country level. The paper analyzes the impacts of abrupt HIV/AIDS funding on macroeconomic stability, fiscal health and the development of health institutions.
New medicines are usually financed by a mixture of public funding by governments, philanthropic giving, and investment by private firms. Private investment is especially important in paying for and managing the later stages of clinical trials, regulatory approval, and investment in manufacturing capacity. But for diseases that mainly affect people in developing countries, the prospective sales market is tiny—and not sufficient to justify commercially the large scale investment that is needed to develop new products.
An advance market commitment to accelerate the development of vaccines for diseases concentrated in developing countries, donors could make a binding commitment to pay for a desired vaccine if and when it is developed. This advance market commitment would mean firms could invest in finding a vaccine with the confidence that if they succeed there would be a market for the product.
Making Markets for Vaccines: Ideas to Action presents the proposal from theory to practice, by showing how a commitment can be consistent with ordinary legal and budgetary principles. A draft contract term sheet is included, highlighting the key elements of a credible guarantee.