The SACU revenue that BLNS countries receive is declining substantially, putting pressure on government budgets and expenditures. By 2020, SACU revenues are projected to drop to 4.4% of GDP for Namibia and 2.8% for Botswana. Given the heavy reliance on SACU funds, particularly for health and HIV programs, this decline threatens to reduce funding for critical areas. In both the short and long run, policy options proposed include lobbying for increased donor aid, fiscal restraint, allowing higher deficits, restructuring budgets to rely less on volatile SACU revenues and improving domestic revenue collection.
Universal coverage of essential health services in sub Saharan Africa: projec...HFG Project
The first decade of the new millennium brought high-level advocacy to mobilize more funding for health coupled with unprecedented economic growth in some African countries. Given the region’s healthy economic outlook, will countries have adequate domestic resources for basic health services by 2020? USAID’s Health Finance and Governance project looked into sub-Saharan Africa’s health financing outlook by projecting domestic health spending per capita to 2020 and comparing it to an internationally-accepted target ($60 per capita) for universal coverage of a package of essential health services. The analysis modeled two assumptions: 1) domestic health spending continuing to increase in line with current economic growth and 2) countries moving aggressively towards fulfilling their Abuja commitment (15% of the government expenditure). Under the economic growth assumption alone, the projections indicate that a little over half of the countries will be spending over USD 60 per capita by 2020. In this presentation, Dr. Carlos Avila discussed the results of the analysis and reaffirmed the need for complementary actions to improve equity and efficiency in addition to resource mobilization.
The non-partisan Committee for a Responsible Federal Budget (CRFB) has compiled a brief background on the scope of our nation's fiscal challenges and the drivers of our debt and deficits, while outlining some of the types of solutions available to address the problems. This Powerpoint is meant to offer an objective, easily-accessible view of our country's fiscal situation as an educational tool meant to help foster open and honest discussion about these issues.
Universal coverage of essential health services in sub Saharan Africa: projec...HFG Project
The first decade of the new millennium brought high-level advocacy to mobilize more funding for health coupled with unprecedented economic growth in some African countries. Given the region’s healthy economic outlook, will countries have adequate domestic resources for basic health services by 2020? USAID’s Health Finance and Governance project looked into sub-Saharan Africa’s health financing outlook by projecting domestic health spending per capita to 2020 and comparing it to an internationally-accepted target ($60 per capita) for universal coverage of a package of essential health services. The analysis modeled two assumptions: 1) domestic health spending continuing to increase in line with current economic growth and 2) countries moving aggressively towards fulfilling their Abuja commitment (15% of the government expenditure). Under the economic growth assumption alone, the projections indicate that a little over half of the countries will be spending over USD 60 per capita by 2020. In this presentation, Dr. Carlos Avila discussed the results of the analysis and reaffirmed the need for complementary actions to improve equity and efficiency in addition to resource mobilization.
The non-partisan Committee for a Responsible Federal Budget (CRFB) has compiled a brief background on the scope of our nation's fiscal challenges and the drivers of our debt and deficits, while outlining some of the types of solutions available to address the problems. This Powerpoint is meant to offer an objective, easily-accessible view of our country's fiscal situation as an educational tool meant to help foster open and honest discussion about these issues.
Table of Contents
General Agreement on Tariffs and Trade 3
First Phase : 5
Second Phase : 5
Third Phase : 5
OBJECTIVES OF GATT : 5
OBJECTIVES OF GATT : 5
FUNDAMENTAL PRINCIPLES OF GATT : 5
OTHER FUNCTIONS OF GATT : 5
OTHER FUNCTIONS OF GATT : 5
Did GATT succeed? : 6
Slide 20: 6
Slide 21: 6
Slide 22: 6
Slide 23: 6
Slide 24: 6
Difference between GATT & WTO 7
Samuel Benin
POLICY SEMINAR
Virtual Event - The political economy of COVID-19: Impacts on agriculture and food policies
OCT 22, 2020 - 08:30 AM TO 10:00 AM EDT
The aim of the study was to investigate the effects of covid-19 on economic growth in SADC. Covid19 has been a challenge and still a challenge in many parts of the world across the globe. As a result of covid-19 many people from all walk of life lost their businesses, their belongings, their jobs, including friends and relatives due the deadly pandemic and Africa was no exemption from all these. As consequences of covid-19 particularly in SADC and beyond many people lost their lives, the unemployment rate has augmented and trading relationship between SADC countries has been limping since the pandemic occurred in March 2020. Therefore, the present study recommends a SADC mitigation covid -19 measure strategies that would enable SADC countries to improve on the spread of covid-19 and strengthen the trading relationship among SADC countries
Post covid ecnomic condition ways to recover from covid-19 pandemic recessionShimanta Easin
Current condition of world economy and Bangladesh in Covid-19 pandemic, Ways to recover from this pandemic destruction, Challenges faced by world and Bangladesh in Covid-19 pandemic
Prepared By:
Roksana Rahim Rumki
Roll: 1610
49th Batch JU
BGE 10th Batch
Jahangirnagar University
This Research Aims To Assess The Effect Of The Covid-19 Health Crisis On The Indebtedness Of
Family SMEs In Chad. The Sample Of This Study Consists Of 150 Managers Of Family SMEs. We Used A
Qualitative Method Complemented By A Quantitative Method Based On Linear Regression
The Sustainable Development Goals (SDGs) represent an ambitious global plan that aims to eliminate poverty in its multiple forms and dimensions by 2030 by calling for action, all countries, rich and poor, to promote prosperity while protecting the planet. This paper aims at eradicating poverty through unlocking investment opportunies by effective management and development of the abundance of Natural resoucres in South Sudan. The paper targets the Government and Private sector as important agents for a successful and sustainable transition to a middle income country, with reduced Poverty and improved livelihoods.
Table of Contents
General Agreement on Tariffs and Trade 3
First Phase : 5
Second Phase : 5
Third Phase : 5
OBJECTIVES OF GATT : 5
OBJECTIVES OF GATT : 5
FUNDAMENTAL PRINCIPLES OF GATT : 5
OTHER FUNCTIONS OF GATT : 5
OTHER FUNCTIONS OF GATT : 5
Did GATT succeed? : 6
Slide 20: 6
Slide 21: 6
Slide 22: 6
Slide 23: 6
Slide 24: 6
Difference between GATT & WTO 7
Samuel Benin
POLICY SEMINAR
Virtual Event - The political economy of COVID-19: Impacts on agriculture and food policies
OCT 22, 2020 - 08:30 AM TO 10:00 AM EDT
The aim of the study was to investigate the effects of covid-19 on economic growth in SADC. Covid19 has been a challenge and still a challenge in many parts of the world across the globe. As a result of covid-19 many people from all walk of life lost their businesses, their belongings, their jobs, including friends and relatives due the deadly pandemic and Africa was no exemption from all these. As consequences of covid-19 particularly in SADC and beyond many people lost their lives, the unemployment rate has augmented and trading relationship between SADC countries has been limping since the pandemic occurred in March 2020. Therefore, the present study recommends a SADC mitigation covid -19 measure strategies that would enable SADC countries to improve on the spread of covid-19 and strengthen the trading relationship among SADC countries
Post covid ecnomic condition ways to recover from covid-19 pandemic recessionShimanta Easin
Current condition of world economy and Bangladesh in Covid-19 pandemic, Ways to recover from this pandemic destruction, Challenges faced by world and Bangladesh in Covid-19 pandemic
Prepared By:
Roksana Rahim Rumki
Roll: 1610
49th Batch JU
BGE 10th Batch
Jahangirnagar University
This Research Aims To Assess The Effect Of The Covid-19 Health Crisis On The Indebtedness Of
Family SMEs In Chad. The Sample Of This Study Consists Of 150 Managers Of Family SMEs. We Used A
Qualitative Method Complemented By A Quantitative Method Based On Linear Regression
The Sustainable Development Goals (SDGs) represent an ambitious global plan that aims to eliminate poverty in its multiple forms and dimensions by 2030 by calling for action, all countries, rich and poor, to promote prosperity while protecting the planet. This paper aims at eradicating poverty through unlocking investment opportunies by effective management and development of the abundance of Natural resoucres in South Sudan. The paper targets the Government and Private sector as important agents for a successful and sustainable transition to a middle income country, with reduced Poverty and improved livelihoods.
KI a INESS v spolupráci s ďalšími partnermi organizovali medzinárodnú
konferenciu v rámci Free Market Road Show 2012 na tému Európa na ceste do
nevoľníctva?, ktorá sa konala dňa 27. apríla 2012 v Bratislave. Pozrite si
prezentáciu Daneila Mitchella. Viac informácií na
www.konzervativizmus.sk.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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Health Expenditure Implications of SACU's Revenue Volatility in BLNs Countries policy brief_final_june_30[1]
1. Health Expenditure Implications
of SACU’s Revenue Volatility in
BLNS Countries
ISSUE BRIEF JULY 2010
Executive Summary Namibia's and Botswana's shares will drop from
8.1 percent and 5.1 percent of GDP in 2005 to 4.4
percent and 2.8 percent of GDP, respectively in
T he Southern African Customs Union (SACU)
is the world’s oldest customs union.
Established as Customs Union Convention in
2020 (Figure 1).
1889, the union operated under different Figure 1: SACU Revenues as a share of
agreements, which were negotiated and GDP (%)
renegotiated with changing circumstances [1,2]. 30
Botswana
Presently, the union is being governed by the 25
Lesotho
2002 Agreement. Its members are Botswana, 20
Namibia
Lesotho, Namibia, Swaziland (BLNS countries) 15
Swaziland
and the Republic of South Africa. 10
5
SACU member states deposit their customs and 0
excise collections in a common revenue pool 1994 2002 2005 2020
(CRP), which they share using a formula that has Source: Flatters and Stern (2005)
evolved over the years. Under the 2002 revenue
sharing formula (RSF), the BLNS countries
Against the declining SACU revenues and the
together get nearly half of the collections although
heavy government reliance on income from the
their joint gross domestic product (GDP) is less
CRP, fiscal expenditures and hence public
than 10 percent of SACU's GDP. Not surprisingly,
programs in the BLNS countries will be adversely
income from the CRP constitutes a considerable
affected. A likely effect is that critical areas such
proportion of total government revenue (about
as health, education and agriculture, which are
half in Lesotho, more than two thirds in Swaziland
paramount for human development, may be
and nearly 40 percent in Namibia).
scaled down. This is an issue of major concern
given that SACU countries carry the world’s worst
SACU revenue is on the decline. Flatters and
HIV/AIDS epidemic. Any scaling down of
Stern [3] predict that Swaziland's SACU revenue
prevention, care and treatment programs will
as a share of its GDP will decline from 17.6
decelerate current initiatives and, in some cases,
percent in 2005 to 9.4 percent in 2020; Lesotho's
reverse advances made in combating the
share will go down to 12.6 percent of GDP in
scourge.
2020 from 21.5 percent of GDP in 2005; while
Health Economics and HIV/AIDS Research Division
University of KwaZulu-Natal, Westville Campus, J block, Level 4, University Rd, Durban, South Africa
Tel: +27 (0)31 260 2592 | Fax: +27 (0)31 260 2587 | heard@ukzn.ac.za | www.heard.org.za
2. To counter the problem, we suggest that, in the financial support for treatment in Lesotho,
short term, the BLNS countries should lobby for Namibia and Swaziland. The availability of
more donor support, exercise fiscal restraint and funding to treat people in need of antiretroviral
allow for relatively higher budget deficits. In the treatment (ART) in the near future however, is not
long run, the solution lies in restructuring their secure. PEPFAR's 2009-2014 plan shows a
fiscal frameworks to move away from reliance on slowdown in the rate of enrolling new patients [5]
SACU revenue, especially for recurrent and the Global Fund continues to face funding
expenditures. This will necessitate the adoption of gaps [6]. With major donors increasingly reluctant
an expenditure plan anchored on domestic to lock themselves into long-term funding for
revenue. The BLNS countries may also aim at AIDS, the financial responsibility falls onto these
efficient and effective use of public resources countries at a time when revenue injections from
SACU are declining.
The State of HIV/AIDS in BLNS Countries
Figure 2 SACU revenue and Govt
The state of HIV/AIDS in Southern Africa is contributions to HIV/AIDS prms
100 Share of SACU
alarming. Continued new infections, especially 80 revenue to total
amongst infants, national sero-prevalence rates 60 govt revenue
among pregnant women and aggregate numbers (%)
40
of people living with HIV/AIDS are all very high in 20 Share of govt
SACU member states. In Swaziland the United 0 contributions to
Nations Development Program warned that `if the domestic
HIV/AIDS
current trends are not reversed, the longer term prgms (%)
survival of Swaziland as a country will be
seriously threatened' [4]. Existing levels of poverty Sources: UNAIDS (2008) [7]; Flatters and Stern
(2005)
and poor access to health services compound the
impacts HIV/AIDS is having. The cost of care and
treatment for people living with HIV and AIDS as
well as support for those affected (such as the
Declining SACU Revenues
millions of AIDS orphans), applies pressure to
already tight budgets.
Receipts from the SACU CRP constitute a
Lesotho, Namibia and Swaziland presently significant proportion of total government revenue
shoulder a significant share of the financial in the BLNS countries. Governments of Lesotho
and Swaziland stand out as the most dependent
responsibility for HIV/AIDS given their
development indicators (see figure 2). If more on SACU revenue among the SACU member
people are to be enrolled onto ART programs, states, while Namibia's dependence, albeit slightly
funding may increasingly have to be from these lower, has been gradually increasing in recent
overstretched governments since donor years.
commitment is uncertain. The US President's
Available statistics, show that SACU income has
Emergency Plan for AIDS Relief (PEPFAR) and
been on the decline and is likely to continue going
the Global Fund for AIDS, Tuberculosis and
down. A number of factors explain the declining
Malaria (the Global Fund) provide the greatest
Health Economics and HIV/AIDS Research Division
Harold Ngalawa, Khaled Ahmed and Alan Whiteside
3. SACU revenue. These include the recent global (ii) Fiscal restraint aimed at realigning declining
recession, the impact of the recession on the government revenue with public expenditures:
South African economy and declining global trade This is both a short and long term solution. The
tariffs. The European Union (EU) Sovereign Debt BLNS countries can address the financing gap
Crisis and a slowdown of imports associated with between government revenue and required
the 2010 FIFA World cup infrastructure are expenditures on HIV/AIDS by exercising fiscal
additional factors that are expected to keep the restraint. This means cutting down on non-priority
CRP declining. expenditures and, in some instances, even
HIV/AIDS projects may have to be downsized.
This approach will ascertain that countries do not
unnecessarily accumulate public debt.
Policy Options
(iii) Increasing the fiscal deficit to avoid disrupting
BLNS countries are largely left on their own to public projects amid declining government
face the impending financial battle of falling SACU revenue: The BLNS countries can choose to
revenues. The strategic geopolitical links between maintain the present level of fiscal expenditures
southern African countries, that allowed high and let the running projects continue undisrupted.
SACU revenue recepits, are largely obsolete. The declining government revenue, however, will
Regional intervention, therefore, cannot be imply a corresponding increase in the budget
realistically expected. deficit. This may be an inevitable short to medium
term solution pending restructuring of the fiscal
We present six policy proposals, not mutually framework.
exclusive, to counter the problem, both in the
short run and in the long run. (iv) Restructuring the fiscal framework to move
away from relying on SACU revenue, especially
(i) Lobbying for increased aid to offset the for recurrent expenditures: This is a long term
declining SACU revenue: This is a short term solution. Taking this approach, the BLNS
solution. Everything else remaining the same, the governments may have to reconsider how they
BLNS countries are likely to face a widening gap utilise SACU revenue. A way forward is to move
between government revenue and required public away from using SACU revenue for recurrent
expenditures on HIV/AIDS, which can be filled by expenditures, in particular wages and salaries.
a corresponding increase in donor funding. Donor Instead, the revenue should be channelled to
funding for HIV/AIDS programs in BLNS countries finance investment projects such as infrastructure
vary from country to country. Lesotho and development.
Botswana, respectively, are the most and least
dependent on donors for their HIV/AIDS projects (v) Developing a long-term expenditure plan
among the BLNS countries. The funding gap will anchored on domestic revenue: It is imperative for
depend both on the dependency ratio of public to the BLNS countries to develop fiscal strategies
donor funding and on the extent to which the aimed at moving away from reliance on external
BLNS countries have relied on SACU revenue to sources of revenue. This entails enhancing efforts
finance government budgets. to improve domestic revenue collection. Larger
amounts of domestic revenue will provide a
Health Economics and HIV/AIDS Research Division
Harold Ngalawa, Khaled Ahmed and Alan Whiteside
4. cushion against any shock to the budget arising [2] Gibb, R. (2006). ‘The New Southern
from the volatility of SACU revenues. This is a African Customs Union Agreement: Dependence
long term plan intended to re-align public with Democracy,’ Journal of Southern African
expenditures with domestic revenues. Studies 32(3):583-603.
(vi) Efficient and effective use of public resources: [3] Flatters, F. and Stern, M. (2005).
This is a long term solution that involves ‘Implementing the SACU Revenue-Sharing
streamlining the public sector. This is to ensure Formula: Customs Revenues,’ Policy Brief
that government is involved only in services that Prepared for the South African National Treasury.
cannot be efficiently provided by the private
sector, that government adheres to public [4] UNDP and Government of Swaziland,
expenditure ceilings, and there is priority targeting (2006). ‘Country Program Action Plan (2002-
of public expenditures towards more urgent 2010),’ Action Plan for the Government of
productive projects. Swaziland.
[5] PEPFAR (2009). ‘The US President’s
Emergency Plan for HIV/AIDS: Five Year
Policy Recommendations Strategy.’ URL: http://www.pepfar.gov/
documents/organization/133035.pdf
In the short run, the BLNS countries should lobby
for an increase in donor support to cover the [6] MSF (2010). ‘No Time to Quit: HIV/AIDS
funding gap in critical areas such as HIV/AIDS. Treatment Gap Widening in Africa,’ Brussels:
Donor funding may have to be complemented Médecins Sans Frontières.
with fiscal restraint, cutting down expenditures in
non-priority areas. Realising that the expenditure [7] UNAIDS (2008). ‘Domestic and International
cuts need not be done in a manner that constricts AIDS Spending Data – Global Report 2008’. xls
the economy, relatively larger fiscal deficits may file. URL: http://www.unaids.org/
be inevitable. In the long run, the BLNS countries en/KnowledgeCentre/HIVData/Tracking/default.asp
should consider adopting an expenditure plan
anchored on domestic revenue. The fiscal Contacts
framework may have to be restructured, moving
Harold Ngalawa, School of Economics and
away from reliance on SACU revenue, especially
Finance, University of KwaZulu-Natal,
for recurrent expenditures. There is also need to
email: ngalawa@ukzn.ac.za
aim at efficient and effective use of public
resources. Khaled Ahmed, Health Economics and HIV/AIDS
Research Division, University of KwaZulu-Natal,
References email: ahmedk@ukzn.ac.za
[1] Ettinger, S. (1974). ‘The Economics of the Alan Whiteside, Health Economics and HIV/AIDS,
Research Division, University of KwaZulu-Natal,
Customs Union Between Botswana, Lesotho,
email: whitesid@ukzn.ac.za
Swaziland and South Africa,’ Unpublished PhD
Thesis, University of Michigan.
Health Economics and HIV/AIDS Research Division
Harold Ngalawa, Khaled Ahmed and Alan Whiteside