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  • Reply to: China’s 2015 tobacco tax adjustment: a step in the right direction   1 month 2 days ago
    Thank you for a very useful update on tobacco tax in China. In Hong Kong we are also asking for a significant 100% tax increase in the 2017 budget (tobacco tax is currently 67% of retail price).
    Even more, we are asking for long-term planning, such as they now have in Australia, with a 12.5% annual tax increase committed in advance (see refs below), and also New Zealand.
    This avoids a huge waste of annual effort in lobbying for an increase in every annual budget.
    Also, the WHO target of a 30% relative reduction in smoking prevalence by 2025 will not be reached unless tobacco tax in Hong Kong is substantially raised.
    Australian references:
    Esp 13.2 & 13.3

  • Reply to: One Health: let’s not have pandemics get in the way   2 months 5 days ago
    Dear Mr Burland, I agree that the One Health agenda is crucial to the World Bank’s goals of eliminating extreme poverty and boosting shared prosperity.  Recognizing the interconnectedness of human and animal health will be extremely important as we work with partners to take on global health challenges. Thank you very much for your comment.
  • Reply to: One Health: let’s not have pandemics get in the way   2 months 5 days ago

    I am very positively surprised that the World Bank is concerned about preventing disease among poor rural populations, especially. 2.2 billion illnes cases every year, because domesticated animals are ill. This is simply shocking. I read that the World Bank loans and grants for projects in health that are being carried out now amounts to $10 billion.

    west Africa REDISS Program is only $300 million though. How much out of the $9.7 billion is for similar One Health projects in other countries? Or is it all for healthcare costs for ill people (not for preventing illness) ? And investments in (subsidized) health workers and facilities? How much is World Bank support to country capacity for coordination for One Health?

    With crossed fingers that World Bank will act as the "honest broker" between veterinary sector and the powerful medical-pharma-industry complex. World Bank can give much strong help to One Health!

    Poverty elimination will stay unreachable without ONE HEALTH.

    If not this, what is the World Bank plan in poorest countries? $9.7 billion is too much to waste on curative programs and infrastrucute and high overhead/talkshop costs in healthcare. Is it to prevent disease? Or is it for the usual low-return (or likely completely wasteful ) investments in health sector, which benefit mainly the medical workers (elite)?

    Again, I just love this article, despite questions about whether the World Bank "walks the talk."

    Thank you very much.

  • Reply to: Bridging the humanitarian-development divide in the health sector   2 months 6 days ago
    Thank you for sharing the Sierra Leone experience. While it is difficult to comment on decisions for providing support to individual projects – which are highly contextual and depend on factors such as budget, opportunity costs, technical quality of the proposal, and many more – overall, the World Bank believes that RBF mechanisms can be a useful tool to improve access to, and utilization of, quality health services. Thus, in over 30 countries, the World Bank supports this work coupled with evaluative mechanisms to ensure that we are constantly learning from experience and improving our approach.
    More to the point, we believe that RBF can be particularly powerful in fragile contexts where central control may already be weak, with high level of facility autonomy coupled with weak capacity of the government to provide services in remote and/or affected areas, allowing us to ensure resources flow to front line workers where they are most needed. The programmatic approach to strengthening health service delivery resilience in fragile, conflict, and violence settings that I cite in the blog includes two such RBF pilots: in South Sudan and in the Autonomous Region in Muslim Mindanao (ARMM).
    I hope that the positive results you cite from the Sierra Leone pilot may lead the government to consider this approach more broadly in the health sector.
  • Reply to: Bridging the humanitarian-development divide in the health sector   2 months 1 week ago

    Happy to learn that now, a year after the Ebola crisis, the World bank will invest in analytic work to strengthen health service delivery in fragile countries. During the peak of the Ebola outbreak in Sierra Leone, the Dutch agency Cordaid unfortunately did not manage to convince the World Bank to invest in an improved Performance Based Financing, PBF/RBF model in order to revive the paralysed health system. Fortunately Cordaid found the funds itself and introduced the PBF-PLUS pilot in one full District, 105 health facilities. With an increased investment from USD 0.5 (PBF-Light) to USD 2 (PBF-Plus) per capita per year, the average performance based income of the 105 health facilities went up from USD 165 to USD 960 per month. Within 3 months time this caused remarkable results like increased and revitalised motivation of healthcare staff and renewed confidence by the public in the health system. As a result of the many trainings and strong and regular monthly verification and coaching, validated evidence showed, amongst others, an increase of 20% facility quality scores; Over 100% increase of OPD consultations; 45% increase of fully immunized children; 45% increase of 4 ANC visits, etc. The full report was shared with the World Bank and is available at Cordaid upon request.