How did the Asian countries avoid the debt crisis?

Economic stability, sound macroeconomic policies, and appropriate microeconomic incentives hold down a country's external debt burden. Most of the Asian countries pursued prudent macroeconomic policies, paid attention to price stability, and minimized price distortions. These countries avoided the overvalued exchange rates and uncompetitive interest rates that caused massive capital flight from Latin American and some African countries. The author contrasts Asian country debt crisis behavior with that of 12 highly indebted Latin American and African countries.Banks&Banking Reform,Achieving Shared Growth,Economic Theory&Research,Environmental Economics&Policies,Macroeconomic Management

Institutions of Restraint: The Missing Element in Pakistan’s Governance

Governance and Institutions are not ends in themselves but it is well known by now that good governance and effectively functioning institutions are required, along with sensible policies and well designed public investment, to improve resource allocation and comparative advantage, enhance productivity, facilitate more efficient markets and distribute the benefits of growth more equitably in any economy. How do Governance and Institutions interact? Governance refers to the manner in which power is exercised in the management of a country’s economic and social resources. Good governance requires checks and balances in a country’s institutional infrastructure, such that politicians and bureaucrats have the flexibility to pursue the common good, while restraining arbitrary action and corruption. The state’s monopoly on coercion, coupled with access to information not available to the general public, creates opportunities for public officials to promote their own interests, or those of friends or allies, at the expense of general interest. The probabilities for rent seeking and corruption are considerable. A variety of institutional mechanisms can provide the checks and balances that will lead to good governance and reduced corruption. To be enduring and credible, these mechanisms need to be anchored in core state institutions. Power can be divided horizontally among judiciary, the legislative and the executive, and vertically between central, provincial and local authorities. Beyond the institutions within the state structure, voice and participation from civil society e.g. vigilant NGOs and watchdog bodies, independent but impartial media, user participation surveys, public dissemination of governance benchmarks—can exert external pressures for better government performance and reduced corruption.

The macroeconomics of adjustment in sub-Saharan African countries : results and lessons

Despite the satisfactory performance of several intensely adjusting sub-Saharan African countries - and successful results in agriculture and food production - the overall results of adjustment achieved in Africa have so far been modest. Adjustment has not yet succeeded in raising the rate of growth enough to make major inroads in reducing poverty. Sub-Saharan Africa's economic recovery is still fragile. Currency depreciation and inflationary pressures have not yet been fully subdued in several countries because of persistence of underlying expansionary fiscal and monetary policies. Many sub-Saharan countries still rely exclusively on external grants and concessional financing to close their fiscal gaps. Per capita consumption remains stagnant, and private investment has not yet revived. Unemployment rates are still high, particularly in urban areas, and poverty is on the rise. When there is civil strife, adjustment, of course, has not worked. There is a general consensus that consistent and unfetted implementation of adjustment policies and attainment of macroeconomic stability do improve the outlook for growth in Africa. But the record of implementation is mixed and uneven. Adjustment is necessary even if it is bound to work slowly. But for it to work at all depends on the strong commitment by leaders of these countries to sustain reform policies in the face of adverse and harsh external circumstances and domestic political pressures. What is less clear, and thus invokes controversy, is the speed, timing, and sequencing of adjustment programs. As each reform has a different impact on the various segments of the population - creating winners and losers - mediating among these conflicting claims is highly political. There are no technocratic solutions or quick fixes to provide satisfactory solutions. No amount of external assistance can help in this process. Consensus-building, open communications, consultations, and debate - and reaching compromises - will bring about the durable results. But in practice, this path has proved difficult. It is equally clear that adjustment policies, even when they are put in place after reaching internal consensus, will not lift African countries out of poverty. The agenda of policy reforms should be considered as part of the broader long-term development strategy of each country. This strategy should aim not only at changes in policies, but also at improving investment in human resources and physical infrastructure, accelerating opportunities for private sector development, enhancing the quality of governance, strengthening institutional capacity, and - most importantly - maintaining national solidarity and social cohesion.Environmental Economics&Policies,Achieving Shared Growth,Economic Theory&Research,Inequality,Poverty Assessment

Trade, aid, and investment in sub-Saharan Africa

Trade, aid, and investment are more inextricably linked in sub-Saharan Africa than anywhere else in the world, contends the author, whose survey of sub-Saharan Africa's prospects for trade, aid, and investment lead to the following broad conclusions. Developing an outward orientation, improving competitiveness, and recapturing its lost share in world markets offers a higher potential payoff than any other strategy for growth and sustainable development in sub-Saharan countries. If the region had maintained internal competitiveness and retained its 1970 share of world exports, successfully defending against new entrants, its 1990 level of exports would have been at least $50 billion higher than actual earnings - assuming that the composition of sub-Saharan exports would have changed to reflect changes in world trade. If the region continued to rely on exports of commodity products alone, the relative gains would have been much smaller. In the last decade, sub-Saharan Africa has become increasingly dependent on external resource flows for investment, imports, and development. But there is little chance of sustained high levels of aid because of budget constraints in the OECD countries, competing demands from new claimants, and the new conditionalities imposed by bilateral donors (for democratization, reduced military spending, and improved human rights). Most African countries must mobilize domestic resources and increase domestic savings rates by reducing public sector dissavings, the financial losses of public enterprises, and other nonproductive spending. Certain low-middle-income African countries can attract a significant amount of foreign direct investment, but most resource-poor countries - especially in the Sahel and the Horn of Africa - will continue to depend on foreign aid. There must be a more durable solution to Africa's debt problem. Only half of the debt service due can be paid, suggesting the urgent need to reduce the debt stock and thus debt servicing obligations, in alignment with debt servicing capacity. Many current proposals under discussion, if implemented, can bring considerable relief. Several sub-Saharan countries can attractsignificant investment because of their location, low labor costs, natural resource endowments, and the size of their domestic market. But productive investment levels in most African countries have remained depressed, and even where economic policy reform has been implemented, the investor response - both domestic and foreign - has been poor. Uncertainty, fears of policy reversals, lack of credibility and continuity, the contagion effect, and more attractive opportunities elsewhere reinforce such structural weaknesses in sub-Saharan Africa as poor infrastructure, inefficient services, and a weak human resource base to deprive Africa of new investment.Trade Policy,Achieving Shared Growth,Economic Theory&Research,Environmental Economics&Policies,TF054105-DONOR FUNDED OPERATION ADMINISTRATION FEE INCOME AND EXPENSE ACCOUNT

Future financing needs of the highly indebted countries

Under base scenario assumptions, the authors estimate that the Baker 17 countries will require about $18 to$ 20 billion of net new disbursements annually to reverse recent investment trends and bring about modest growth in per capita incomes. The most significant shortfall is in commercial bank lending. Without an adequate burden sharing arrangement, it is unlikely that official creditors would be prepared to assume a disproportionately large exposure risk in these countries. Husain and Mitra conclude that with sound adjustment policies in the debtor countries, a combination of concerted new lending, debt reduction, reflows of flight capital, and intermittant accumulation of interest arrears will be the principal means of financing.Economic Theory&Research,Banks&Banking Reform,Financial Intermediation,Environmental Economics&Policies,Strategic Debt Management

Capital flows to South Asian and ASEAN countries : trends, determinants, and policy implications

The authors compare the experiences of selected Asian countries in attracting different forms of external financing and examine how that financing has contributed to growth. They carry out the analysis for two subgroups - South Asian and ASEAN countries - with distinctly different dominant forms of capital flows. After reviewing recent trends in financial flows to individual countries, they perform a statistical analysis of the effects of foreign capital flows on the macroeconomic performance of developing countries in the region. They find that foreign direct investment has been a more significant positive factor than other types of resource flows in shaping the economic growth of ASEAN countries. Substantial increases in ODA flows are unlikely, and so is the resumption of significant bank lending, so policy makers in South Asia should pursue policies and nondistortionary incentive systems conducive to the infusion of foreign direct investment flows. The main findings are consistent with the Bank's emphasis on an increasingly important role for the private sector - and direct investment flows - in development. A focus on foreign direct investment is appropriate, given current constraints on external financing, particularly through traditional bank credits.Economic Theory&Research,Banks&Banking Reform,International Terrorism&Counterterrorism,Environmental Economics&Policies,Financial Intermediation

Why do some economies adjust more successfully than others? lessons from seven African countries

The sustained application of adjustment policies is explicable in terms of two variables - domestic ownership and capacity. These findings carry important implications for the future policies of African governments and their external partners. There is an urgent need for the African governments to go beyond their limited and small groups of technocratic advisers and civil servants to consult, educate, and inform the representatives of the civil society and opinion-makers in the design and implementation of adjustment policies and institutional restructuring. A strong, committed, and visionary leadership that places these policy reforms in the context of the country's long-term development can bond and cement diverse and divergent viewpoints and nurture a shared visionfor the future. For the international financial institutions and external donors who are supporting African governments, the narrow, short-term, and conditionality-driven enforcement and compliance of agreements needs to be replaced by a medium- to long-term framework of macro, sectoral policy, and investment and institutional changes developed and owned by government - keeping short-term capacity as given constraints, but taking measures to develop this capacity within the long-term framework. This framework can then be translated into time-bound, specific action programs on various agreed-on changes between the donors and the African governments. Both the African governments and their external partners have to rethink the measures that will build, save, use, and enhance the capacity of African governments, private sectors, nongovernmental organizations, professional groups, universities, and research institutes. The adversarial relationship between the government and the private sector will have to be transformed into a symbiotic and constructive partnership aimed at achieving the long-term developmental goals. The effectiveness of the present practices of delivering the technical assistance by external donors has been sufficiently questioned, and a new way of delivering this assistance employing capacity building and utilization as the overreaching objective needs to be developed. The transferability of institutions or policies from one setting to another has always proved difficult, but adapting successful practices that have worked elsewhere should be encouraged.Environmental Economics&Policies,Economic Theory&Research,Achieving Shared Growth,ICT Policy and Strategies,Educational Sciences

Computer Simulation and the Practice of Oral Medicine and Radiology

The practice of Oral Medicine and Radiology has long been considered an art form. Collecting and collimating the enormous amount of information each patient brings has always tested the best of our abilities as diagnosticians. However, as the tide of smartphones, cheaper data access, and automation rises, it threatens to wash away all that we have held sacrosanct about conventional clinical practices. In this tussle between what is traditional and what is tantalizing, it is time to question, as diagnosticians, how much can we accede to the invasion of algorithms. How does computer simulation affect the practice of diagnosis in the field of Oral Medicine and Radiology

Stakeholders' views and opinions on existing guidelines on “How to Choose Mental Health Apps”

BackgroundMental health Applications (Mhealth Apps) can change how healthcare is delivered. However, very little is known about the efficacy of Mhealth Apps. Currently, only minimum guidance is available in Assessment and Evaluation Tools (AETs). Therefore, this project aims to understand AET developers' perspectives and end users' experiences and opinions on “how to choose a Mhealth App”.ObjectiveThe primary objectives were: (1) obtaining stakeholder's opinions and experiences of development and use of AETs for Mhealth Apps, their weaknesses and strengths, and barriers in their implementation of Mhealth Apps; (2) the experiences of App users, their analyzation and, obstacles in the use of apps; and (3) to quantify themes related to choosing a Mhealth App.MethodsThis qualitative study, used a sampling method to recruit six stakeholders (one App developer, two AET developers, an individual with lived experience of mental health illness, and two physicians) who were interviewed using a topic guide. These were examined by researchers (CT, WK, & FN) using thematic content analysis. Additionally, an anonymous online survey of 107 individuals was conducted.FindingsOur analyses revealed six main themes: (a) needs and opportunities; (b) views on Mhealth apps; (c) views & opinions on AETs; (d) implementation barriers; (e) system of evaluation and; (f) future directions. The first key concept was, all stakeholders agreed that Apps could significantly impact mental health and that end-users were unaware of mental health AETs and Apps. Secondly, due to commercial interests, end-users reliability of App evaluations requires clear conflict-free guidelines. Thirdly, AETs should be evaluated and developed through a rigorous methodology. Finally, stakeholders shared insights into future developments for AETs and Mhealth Apps. Additionally, online survey respondents chose a “health professional” as their preferred source of guidance in selecting a Mhealth app (84%) and best suited to develop guidelines (70%).ConclusionThe interviews and survey highlight the need for Mhealth Apps to be regulated and the importance of health professionals' engagement in the implementation process. Similarly, without well-defined roles for App evaluations within the health care system, it is unlikely that AETs will have wider spread use and impact without risk