Debt Relief and Public Health Spending in Heavily Indebted Poor Countries (*)

By Gupta, Sanjeev; Clements, Benedict et al. | Bulletin of the World Health Organization, February 2002 | Go to article overview

Debt Relief and Public Health Spending in Heavily Indebted Poor Countries (*)


Gupta, Sanjeev, Clements, Benedict, Guin-Siu, Maria Teresa, Leruth, Luc, Bulletin of the World Health Organization


Resume

Allegement de la dette et depenses de sante publique dans les pays pauvres tres endettes

L'initiative en faveur des pays pauvres tres endettes (initiative PPTE, ou HIPCI en anglais), lancee en 1996, est le premier effort global de la communaute internationale en vue de reduire la dette exterieure des pays les plus pauvres du monde. Elle a pour objectif de generer des economies substantielles afin de couvrir les depenses publiques actuelles et pass,es de ces pays dans le domaine de la sante et de l'education. Neanmoins, bien qu'il y ait largement matiere augmenter les depenses de sante publique dans les PPTE, il ne serait peut-etre pas judicieux d'y affecter toutes les economies realisees dans le cadre de l'initiative. Toute strategie globale visant a combattre la pauvrete doit egalement viser a ameliorer l'efficacite des services de sante publique et a reattribuer des fonds aux programmes les plus utiles aux pauvres. Pour assurer que l'allegement de la dette permettra d'augmenter les depenses visant a reduire la pauvrete et a aider les pauvres, toutes les depenses de ce type, et non seulement celles qui sont financees par les ressources de l'initiative, devront etre suivies. II faut pour cela que les pays ameliorent tous les aspects de leur gestion des depenses publiques. A court terme, les pays pauvres tres endettes peuvent prendre quelques mesures pragmatiques fondees sur les systemes actuels de gestion des depenses publiques, mais a plus long terme ils devront adopter une approche plus globale de facon a renforcer leurs systemes de formulation, d'execution et de rapport budgetaires.

Resumen

Alivio de la deuda y gasto en salud publica en los paises pobres muy endeudados

La Iniciativa en favor de los paises pobres muy endeudados (HIPCI), lanzada en 1996, es el primer esfuerzo amplio emprendido por la comunidad internacional para reducir la deuda externa de los paises mils pobres del mundo. Su objetivo consiste en propiciar economias sustanciales en relacion con el gasto publico, presente y pasado, en salud y educacion en esos paises. Sin embargo, aunque existe un amplio margen para aumentar el gasto en salud publica en los paises pobres muy endeudados, tal vez no convenga dedicar a ese fin la totalidad de lo ahorrado gracias a los recursos de la HIPCI. Toda estrategia amplia orientada a combatir la pobreza deberia centrarse tambien en mejorar la eficiencia de los desembolsos en salud publica y reasignar los fondos a los programas mas ventajosos para los pobres. A fin de asegurar que el alivio de la deuda se traduzca en un aumento de las inversiones en mitigacion de la pobreza y beneficie a los pobres, es necesario seguir de cerca todo ese tipo de gastos, no solo de los costeados con recursos de la HIPCI. Para ello los paises deben mejorar todas las facetas de su gestion del gasto publico. A corto plazo, los paises pobres fuertemente endeudados pueden adoptar algunas medidas pragmaticas de seguimiento basadas en los sistemas vigentes de gestion del gasto publico, pero a mas largo plazo deberian adoptar un enfoque mas amplio para reforzar sus sistemas de formulacion y ejecucion del presupuesto y de preparacion de informes al respecto.

Introduction

The Heavily Indebted Poor Countries (HIPC) Initiative, launched in 1996, was the first comprehensive effort by the international community to reduce the external debt of the world's poorest countries. It went beyond earlier debt relief initiatives in that it covered also debt from multilateral creditors, e.g. the International Monetary Fund (IMF) and the World Bank, and placed debt relief within an overall framework of poverty reduction.

In 1999, the HIPC Initiative was enhanced to further strengthen the links between debt relief, poverty reduction, and social policies. The aim of the enhanced HIPC is to channel government resources, available as a consequence of debt relief, into poverty-reduction activities. …

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Debt Relief and Public Health Spending in Heavily Indebted Poor Countries (*)
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