Opportunities of Trade in Services between the EU and Ukraine: the Case of Telecommunications Services under the GATS and the Association Agreement

This working paper studies the legal and regulatory conditions for trade in services between the European Union (EU) and Ukraine on the example of tele-communications services that are important carrier services for various business activities in the cross-border trade. The paper outlines the general frame-work for trade in services under the GATS as expressed in the commitments undertaken by Ukraine and examines the detailed provisions of the EU-Ukraine Association Agreement on trade liberalisation and regulatory approximation that is a WTO-extra agreement. It also provides an overview of the relevant Ukrainian legal and regulatory rules in order to assess the starting point for regulatory approximation. The paper intends to highlight internal contradictions of the Association Agreement representing a balancing act be-tween the liberalisation obligations under the WTO agreements and requirements of integration in the EU internal market. The paper argues that in short to middle term the Association Agreement does not offer much of value-added in comparison to the current GATS commitments in terms of services liberalisation. The juiciest "carrot" of the Association Agreement - the internal market treatment - is difficult to reach due to unclear and complicated rules on regulatory approximation

Study on the NRA independence Final Report

Independence is a complex and multi-dimensional concept. It refers to the capacity of national regulatory authorities (NRAs) to resist pressure, in other words, to act without interference or influence from politics (both in government and outside it) and autonomously from other stakeholders such as regulated entities. Independence of the NRA comprises what is embodied in the framing of its legal system (de jure) and in the practices of the NRA and relevant stakeholders (de facto). The independence of NRAs is not an end in itself. Rather, it is a means of ensuring the effective functioning of authority in pursuing relevant policy objectives, e.g. market supervision, impartial decision-making and the creation of a level playing field. NRA independence can be understood through different dimensions, reflecting different areas of NRA’s activities. The report focuses on three broad categories: operational, financial and personnel. The dimension of systemic independence has been added in order to reveal the foundation of NRA independence. Accountability and monitoring have also been included, enabling verification of actions taken by NRAs. Finally, a dimension relevant to future challenges for NRA independence has been analysed

Point-of-care testing and treatment of sexually transmitted and genital infections during pregnancy in Papua New Guinea (WANTAIM trial): protocol for an economic evaluation alongside a cluster-randomised trial

Introduction: Left untreated, sexually transmitted and genital infections (henceforth STIs) in pregnancy can lead to serious adverse outcomes for mother and child. Papua New Guinea (PNG) has among the highest prevalence of curable STIs including syphilis, chlamydia, gonorrhoea, trichomoniasis and bacterial vaginosis, and high neonatal mortality rates. Diagnosis and treatment of these STIs in PNG rely on syndromic management. Advances in STI diagnostics through point-of-care (PoC) testing using GeneXpert technology hold promise for resource-constrained countries such as PNG. This paper describes the planned economic evaluation of a cluster-randomised cross-over trial comparing antenatal PoC testing and immediate treatment of curable STIs with standard antenatal care in two provinces in PNG. Methods and analysis: Cost-effectiveness of the PoC intervention compared with standard antenatal care will be assessed prospectively over the trial period (2017–2021) from societal and provider perspectives. Incremental cost-effectiveness ratios will be calculated for the primary health outcome, a composite measure of the proportion of either preterm birth and/or low birth weight; for life years saved; for disability-adjusted life years averted; and for non-health benefits (financial risk protection and improved health equity). Scenario analyses will be conducted to identify scale-up options, and budget impact analysis will be undertaken to understand short-term financial impacts of intervention adoption on the national budget. Deterministic and probabilistic sensitivity analysis will be conducted to account for uncertainty in key model inputs. Ethics and dissemination: This study has ethical approval from the Institutional Review Board of the PNG Institute of Medical Research; the Medical Research Advisory Committee of the PNG National Department of Health; the Human Research Ethics Committee of the University of New South Wales; and the Research Ethics Committee of the London School of Hygiene and Tropical Medicine. Findings will be disseminated through national stakeholder meetings, conferences, peer-reviewed publications and policy briefs

Investigating health service availability and readiness for antenatal testing and treatment for HIV and syphilis in Papua New Guinea

Background Papua New Guinea (PNG) has one of the highest burdens of HIV and syphilis in pregnancy in the Asia-Pacific region. Timely and effective diagnosis can alleviate the burden of HIV and syphilis and improve maternal and newborn health. Supply-side factors related to implementation and scale up remain problematic, yet few studies have considered their impact on antenatal testing and treatment for HIV and syphilis. This study explores health service availability and readiness for antenatal HIV and/or syphilis testing and treatment in PNG. Methods Using data from two sources, we demonstrate health service availability and readiness. Service availability is measured at a province level as the average of three indicators: infrastructure, workforce, and antenatal clinic utilization. The readiness score comprises 28 equally weighted indicators across four domains; and is estimated for 73 health facilities. Bivariate and multivariate robust linear regressions explore associations between health facility readiness and the proportion of antenatal clinic attendees tested and treated for HIV and/or syphilis. Results Most provinces had fewer than one health facility per 10 000 population. On average, health worker density was 11 health workers per 10 000 population per province, and approximately 22% of pregnant women attended four or more antenatal clinics. Most health facilities had a composite readiness score between 51% and 75%, with urban health facilities faring better than rural ones. The multivariate regression analysis, when controlling for managing authority, catchment population, the number of clinicians employed, health facility type and residence (urban/rural) indicated a weak positive relationship between health facility readiness and the proportion of antenatal clinic attendees tested and treated for HIV and/or syphilis. Conclusion This study adds to the limited evidence base for the Asia-Pacific region. There is a need to improve antenatal testing and treatment coverage for HIV and syphilis and reduce healthcare inequalities faced by rural and urban communities. Shortages of skilled health workers, tests, and medicines impede the provision of quality antenatal care. Improving service availability and health facility readiness are key to ensuring the effective provision of antenatal care interventions

Das Assoziierungsabkommen mit der EU: Welcher Anteil am Binnenmarkt für die Ukraine?

Am 1. Januar 2016 ist das Assoziierungsabkommen zwischen der EU und der Ukraine, inklusive des umstrittenen Kapitels IV zur »tiefen und umfassenden Handelszone«, in Kraft getreten. Damit werden die Verpflichtungen der Ukraine rechtskräftig, Reformen zur Liberalisierung des Handels und zur Rechtsangleichung mit dem Rechtsbesitzstand der EU auf den Weg zu bringen. Eine Beteiligung am europäischen Binnenmarkt wird vorerst nur in einem sehr geringen Maße gewährleistet und schrittweise, bedingt durch die Fortschritte der Reformen erweitert. Eine vollständige Beteiligung am Binnenmarkt sieht das Assoziierungsabkommen jedoch nicht vor