I got a bit confused by your entry on user fees and access to basic services. If user fees have been found to reduce access, why go along with them? The basic idea of user fees, if I am not mistaken, was actually to increase the incentives for users to hold service providers accountable. The decrease in access means the strategy is not working. I haven't read the paper you base your comments on, but it seems you argue for user fees as the only feasible strategy even though this strategy leads to a worse outcome for the poor than having free access. Why have user fees if they tax the poor AND decrease access to basic services? It seems you place more emphasis on a theoretical modelling of democratic accountability than on access to health and education.