Key issues in trade facilitation : summary of World Bank/European Union workshops in Dhaka and Shanghai in 2004

Trade facilitation is the ability of countries to deliver goods and services on time at the lowest possible cost. It has emerged as an important issue in unilateral, bilateral, and multilateral trade liberalization. Most countries have embarked on heroic reforms aimed at reducing transaction costs of trade. Thus, among the four new Singapore issues, there was least resistance from World Trade Organization (WTO) member countries to include trade facilitation in the Doha Round discussions. However, all countries are not equally placed in initiating reforms in the complex areas of customs procedures, transport and port logistics, harmonization of standards, and simplification of procedures. Trade facilitation reforms require a large volume of technical assistance for national capacity building. To facilitate what these reforms entail and what can be learned from cross-country experiences, the EU and the World Bank organized two workshops in Dhaka (South Asian countries) and Shanghai (East Asian countries) in 2004. Jointly they succeeded in bringing together renowned experts from multilateral organizations, selected bilateral donor community, the private sector, ex civil servants, and scholars. The participants were largely drawn from the relevant government departments and chambers of commerce and industry. This paper summarizes the main presentations in the workshops. It also indicates the areas that need more focus in future events. The paper should serve as a reference document for national policymakers and for future seminars and workshops on trade facilitation. It has also linked the presentations to the ongoing research work on trade facilitation.Common Carriers Industry,Transport and Trade Logistics,Environmental Economics&Policies,Economic Theory&Research,Trade Policy

The data chase : what's out there on trade costs and nontariff barriers ?

Trade costs and nontariff barriers are at the forefront of discussions on competitiveness and expanding trade opportunities for developing countries. This paper provides a summary overview of data and indicators relevant to these issues and has been informed by work underway at the World Bank on trade facilitation over the past several years to catalogue data sets and indicators. Although there has been progress in expanding data sets and developing policy-relevant indicators on trade costs and barriers, much more is needed. In order to assess progress toward achieving the Millennium Development Goals, evaluating the impact of development projects, and whether meeting Aid for Trade goals will be met, for example, a dedicated and expansive new effort to collect and assess data is needed. This paper attempts to highlight gaps in data on trade costs and provides insight into the type of new data that might be developed in the future.Transport Economics Policy&Planning,Economic Theory&Research,Trade Law,Free Trade,Trade Policy

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used