Are Current Debt Relief Initiatives an Option for Scaling Up Health Financing in Beneficiary countries?/Les Initiatives Actuelles Pour Alleger la Dette De Certains Pays Fournissent-Elles Une Solution Pour Financer Plus Largement Leur Secteur De sante?/?Es Posible Aprovechar Las Actuales Iniciativas De Alivio De la Deuda Para Expandir la Financiacion Sanitaria En Los Paises Beneficiarios?

By Kaddar, M.; Furrer, E. | Bulletin of the World Health Organization, November 2008 | Go to article overview

Are Current Debt Relief Initiatives an Option for Scaling Up Health Financing in Beneficiary countries?/Les Initiatives Actuelles Pour Alleger la Dette De Certains Pays Fournissent-Elles Une Solution Pour Financer Plus Largement Leur Secteur De sante?/?Es Posible Aprovechar Las Actuales Iniciativas De Alivio De la Deuda Para Expandir la Financiacion Sanitaria En Los Paises Beneficiarios?


Kaddar, M., Furrer, E., Bulletin of the World Health Organization


Introduction

"The original focus of the Heavily Indebted Poor Countries (HIPC) Initiative was on removing the debt overhang and providing a permanent exit from rescheduling. Relief can also be used to free up resources for higher social spending aimed at poverty reduction to the extent that cash debt-service payments are reduced. These are now twin objectives." The World Bank and the International Monetary Fund (IMF), 1999.

Forty one of the poorest and most heavily indebted countries, of which 33 are located in sub-Saharan Africa, are currently eligible to benefit from debt reduction under the enhanced HIPC Initiative and from cancellation of multilateral debt under the more recent Multilateral Debt Relief Initiative (MDRI). Many hopes and promises were attached to the launch of these initiatives. For the first time, the provision of debt relief was explicitly linked with the goal of poverty reduction: budgetary resources no longer needed for debt servicing were meant to be used for scaling up expenditure conducive to poverty reduction. (1) Given the important role of health in the achievement of the Millennium Development Goals, and the fact that all eligible countries identify this sector as a priority in their Poverty Reduction Strategy papers (although to a variable extent), health was expected to benefit from significant additional resources.

More than one decade after the launch of the HIPC Initiative and two years after the implementation of MDRI, it has become evident that the situation is far more complicated. One dollar of debt relief does not necessarily translate into one additional dollar of expenditure on poverty (let alone specifically on health). The successful realization of the initiatives' objective with regard to increased expenditure on poverty, and our capability to assess this question, depend on various internal and external factors. Internally, a very decisive one seems to be the ability of officials in ministries such as health and education to actively advocate for these resources. All too often, the ministry of health lacks crucial information about the overall amounts of debt relief available on an annual basis and about the procedures in place to manage them (Box 1).

In this paper, we presenta classification of debt relief savings management systems and illustrate the different types with findings from our country case studies. The proposed classification is not new. It was introduced by the IMF and The World Bank (6) and has been used by other authors. (7) However, a thorough-comprehension of its meaning and implications is essential for health officials in beneficiary countries to increase their bargaining power and for a wider public not necessarily familiar with the economics of debt relief to readjust expectations of what debt relief can realistically achieve and of what can be measured. We also present the major external challenge, i.e. the question of additionality to other forms of foreign aid, which may prevent current debt relief initiatives from having the desired impact. Finally, we ask for improved transparency and information flow at the national and international levels and propose a broader research agenda to tackle this issue.

Box 1. WHO working group on the financial impact of debt relief
initiatives

In 2006, a working group at WHO decided to take a closer look at
current debt relief initiatives since various governments reported
that they use HIPC funds for scaling up priority health
interventions, notably their immunization programme.

Three main reasons fuelled and justified this enquiry:

(i) The necessity to provide additional (external and domestic)
resources to the health sector of many developing countries in
order to progress towards the Millennium Development Goals;

(ii) The potential magnitude of additional fiscal space provided as
a result of the combined effect of different debt relief
initiatives;

(iii) The lack of accurate information and analysis of the impact
of debt relief on social sector spending in general and on health
spending in particular, despite the wide publicity and importance
attached to the launch of the HIPC initiative and the MDRI. … 

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Are Current Debt Relief Initiatives an Option for Scaling Up Health Financing in Beneficiary countries?/Les Initiatives Actuelles Pour Alleger la Dette De Certains Pays Fournissent-Elles Une Solution Pour Financer Plus Largement Leur Secteur De sante?/?Es Posible Aprovechar Las Actuales Iniciativas De Alivio De la Deuda Para Expandir la Financiacion Sanitaria En Los Paises Beneficiarios?
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.