The fiscal dimension of HIV/AIDS in Botswana, South Africa, Swaziland, and Uganda

HIV/AIDS imposes enormous economic, social, health, and human costs and will continue to do so for the foreseeable future. The challenge is particularly acute in Sub-Saharan Africa, home to two-thirds (22.5 million) of the people living with HIV/AIDS globally, and where HIV/AIDS has become the leading cause of premature death. But now, after decades of misery and frustration with the disease, there are signs of hope. HIV prevalence rates in Africa are stabilizing. This book sheds light on these concerns by analyzing the fiscal implications of HIV/AIDS in Southern Africa, the epicenter of the epidemic. It uses the toolbox of public finance to assess the sustainability of HIV/AIDS programs.

Importantly, it highlights the long-term nature of the fiscal commitments implied by HIV/AIDS programs, and explicitly discusses the link between HIV infections and the resulting commitments of fiscal resources. The analysis shows that, absent adjustments to policies, treatment is not sustainable. But it also shows that, by accompanying treatment with prevention, and making existing programs more cost-effective, these countries can manage both treatment and fiscal sustainability. Even in countries where HIV/AIDS-related spending is high or increasing (as past infections translate into an increasing demand for treatment), the fiscal space absorbed by the costs of HIV/AIDS-related services will decline if progress in containing and rolling back the number of new infections can be sustained. The purpose of this study is to refine the analysis of the fiscal burden of HIV/AIDS on national governments and assess the fiscal risks associated with scaling-up national HIV/AIDS responses.

The study complements and contributes to the agenda on identifying and creating fiscal space for HIV/AIDS and other development expenditures. The findings from this study, and the analytical tools developed in it, could help governments in defining policy objectives, improving fiscal planning, and conducting their dialogue with donor agencies.

World Bank.Author:  Lule, Elizabeth ; Haacker, Markus.Document Date:  2011/01/01.Document Type:Publication.Report Number:65658.Volume No: 1 of 1

The fiscal dimension of HIV/AIDS in Botswana, South Africa, Swaziland, and Ugandan

Botswana's infrastructure: a continental perspective

Infrastructure made a net contribution of just over two percentage points to Botswana's improved per capita growth performance in recent years. Raising the country’s infrastructure endowment to that of the region's middle-income countries could boost annual growth by about 1.2 percentage points. Botswana has made significant infrastructure progress in recent years, spanning the transport, water and sanitation, power, and mobile telephony sectors. But the country still faces a number of important infrastructure challenges.

The most pressing is in the power sector, where the country is economically and financially exposed to a lack of generation capacity and insufficient power supply, leaving the economy vulnerable to power price shocks and load shedding. Botswana's international transport connections and Internet connectivity also lag behind those of comparable countries. Botswana's overall resource envelope of $800 million per year surpasses its $785 million needs estimate.

Nevertheless, it loses $68 million a year to inefficiencies and faces a funding gap of $305 million per year, entirely in the power sector, traceable to the quality of spending decisions. Botswana will be in a good position to meet its infrastructure goals if it can reduce inefficiencies, increase public-sector receipts, and attract more public funding.

Author: Dominguez-Torres,Carolina;Briceno-Garmendia,Cecilia.Document Date:2011/11/01.Document Type:Policy Research Working Paper.Report Number:WPS5887. Volume No: 1 of 1

Botswana's infrastructure: a continental perspective

The Design of Fiscal Adjustment Strategies in Botswana, Lesotho, Namibia, and Swaziland

Botswana, Lesotho, Namibia, and Swaziland face the serious challenge of adjusting not only to lower Southern Africa Customs Union (SACU) transfers because of the global economic crisis, but also to a potential further decline over the medium term. This paper assesses options for the design of the needed fiscal consolidation. The choice among these options should be driven by (i) the impact on growth and (ii) the specificities of each country.

Overall, a focus on government consumption cuts appears to minimize the negative impact on growth, and would be appropriate given the relatively large size of the public sector in each country.

IMF.Author/Editor:Basdevant, Olivier;Benicio, Dalmacio;Mircheva,Borislava;Mongardini,Joannes;Verdier,Geneviève;Yang, Susan;Zanna,Luis-Felipe. Authorized for Distribution: November 01, 2011.Series: Working Paper No. 11/266
This Working Paper should not be reported as representing the views of the IMF.The views expressed in this Working Paper are those of the author(s) and do not necessarily represent those of the IMF or IMF policy. Working Papers describe research in progress by the author(s) and are published to elicit comments and to further debate

The Design of Fiscal Adjustment Strategies in Botswana, Lesotho, Namibia, and Swaziland