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    XXIV Meeting of the Summit Implementation and Review Group

    October 25-26, 2001

    Washington, DC

    World Bank support to activities undertaken in the context of the

    Quebec Summit Follow up

1. Regional Activities

    Leaders of the Hemisphere gathered in Quebec City, Canada, in April 2001 and identified an ambitious agenda for the Region. The World Bank participated in the event and expressed its commitment to support, in the context of its specific mandate and through its lending activities in the region, requests generated in our client countries to implement the agreements reached in Quebec.

    Since April 2001, the World Bank has approved more than 25 projects worth US$ 3.5 billion in loans and credits to Latin America and the Caribbean Region. In terms of knowledge sharing and creation, the World Bank has supported its clients by producing more than 27 reports responding to specific demands from our clients to develop their knowledge on economic, social, environmental and health issues. In this context, the World Bank has centered the theme of its Flagship Report on the question if the way in which the LAC region integrates into the global market promises rapid growth and good jobs for the workers in the region. To discuss the finding of this report the World Bank is organizing a series of workshops in the region.

2. Specific Sector Issues:


    Over the past year, the World Bank has committed more resources to combating the spread of HIV/AIDS than ever before. This follows a pledge made by Wolfensohn last year that no country with a credible HIV/AIDS program in place would go without funding from the World Bank.

    Between 1996 and 2000, the Bank committed approximately US$493 million for new HIV/AIDS components and stand-alone projects in 39 countries. By the end of this fiscal year, the Bank will have committed an additional US$740 million for new HIV/AIDS prevention and care efforts, mostly in Sub-Saharan Africa.

    The World Bank, in collaboration with UNAIDS, the International Partnership Against AIDS in Africa, key bilateral donors, and leading NGOs, has launched the first phase of the Multi-country AIDS Program (MAP) for Africa, which over the past year has provided $500 million in new money to help ten African countries scale up effective prevention, care, and treatment. The MAP makes significant resources available to civil society organizations and communities, which have developed some of the world's most innovative HIV/AIDS interventions. It is expected that $500 million more will be made available next year to reach another 15 African countries.

    A similar effort is being carried out in the Caribbean in the context of the Quebec Summit Follow up where HIV/AIDS infections may have reached 12 percent in some urban areas, an infection rate comparable to some of the worst-affected countries in Sub-Saharan Africa. Next week, the Bank's Board will consider a 2

$155 million five-year program for the region. Although most Bank assistance

    focuses on prevention, some loans also support improvements in treatment for

    people living with HIV/AIDS. Under the impending Caribbean program,

    Barbados would become the first country to receive Bank assistance to finance the

    use of anti-retroviralsa cocktail of drugs that vastly reduces HIV levels in

    bloodallowing people to live healthier and longer lives. In addition to financial support, the Bank is helping developing countries to put

    HIV/AIDS prevention and treatment efforts in the forefront of their poverty

    reduction strategies. The Bank is also assisting poor countries which have

    benefited from debt relief under the World Bank Heavily Indebted Poor Countries

    Initiative (HIPC) to devote a share of their subsequent savings to prevention and

    care for people suffering from the disease.

    3. Connectivity:

    Global Gateway in Latin America and the Caribbean Region:

    Since the Quebec Summit the Bank has been working in close cooperation to

    consolidate partnerships with global development players to strengthen the global

    gateway in Latin America and the Caribbean Region (LAC). The World Bank

    participates in the working team ―Regional Alliances for Universal Access to

    Internet‖ with the objective of reducing the digital divide in the Region, including issues on regulation, software, connectivity and relevant contents.

Other organizations participating in this effort are the Interamerican Development

    Bank and the Organization of American States. A critical aspect to be

    emphasized is the coordination with organizations working on Telecenters

    (centers for public access to the internet, with development objectives).

    Telecenters are central to the success of efforts such as the Gateway, because they

    are the main channel by which poorer citizens/organizations have access to the


Global Distance Learning:

    Since the Quebec Summit in April 2001, there has been considerable progress

    in establishing Global Distance Learning networks (GDLN) in the Region.

    We are currently working with eight (8) LAC countries, with the expectation

    of four more being completed by the end of calendar year 01 (plus Spain).

    Expansion in FY02 will include Brazil (identification mission held in July),

    Mexico and potentially Argentina. Others may be added on demand.

    Over this period, twelve (12) Global Dialogs, seven (7) multi-session WBI

    courses and two (2) seminars have been offered, with a combined

    participation of approximately 2000 persons across a broad range of sectors,

    occupations and seniority.

    A workshop was held in Quito, Ecuador in June, bringing together

    representatives from our twelve partner sites. As well as allowing the partners 3

    to get to know each other, the workshop produced a detailed work program and tangible recommendations for GDLN polices, procedures and guidelines.

    Emphasis was placed on developing content partnerships and assisting the partner sites to articulate local needs. The latter, which will pilot in the Dominican Republic, will include discussions with donors/MDBs as well as potential clients (government, civil society, etc).

    GDLN policies and procedures are now in place and operating well. These include a financial mechanism, a legal framework and operational guidelines.

    The Global Distance Learning Network

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    NicaraguaNicaraguaCosta RicaCosta Rica





    Operational by Operational by ChileChileend FY01end FY01


    Priority FY02Priority FY02

4. Interagency Coordination

    The Bank is participating as an observer with OAS, PAHO, ECLAC and IDB in an interagency working-group to coordinate Summit Follow up activities. The group met twice already and has agreed to exchange information on events, seminars, studies, etc. relevant to the Summit follow up process. Currently, we are in the process of linking our respective www site with the OAS www site.

    In the context of this interagency coordination process we have also agreed to meet periodically with representatives from Civil Society Organizations (CSO) to


    discuss Summit Follow up. The first meeting took place in June, and a second

    meeting with 30 local CSO representatives and VC connections with La Paz,

    Bogotá and Quito took place in the World Bank to discuss a paper produced by

    the North-South Center entitled "Protest and Collaboration: CSO networks and

    the politics of Summitry and Free trade in the Americas".

    5. A sample of projects approved since the Quebec Summit:

     Argentina: World Bank Approves $400 Million to Support Reforms The World Bank approved a $400 million project to support Argentina's social

    programs, health insurance regulation, tax administration and improvements to

    the provinces' fiscal management. The Argentina Structural Adjustment Loan

    is part of the Bank's contribution to a multilateral initiative to back up Argentina's wide-ranging reform effort to launch a sustained economic recovery.

The loan will support the government's ambitious program to improve

    administration of federal social programs, including pensions, family allowance,

    and social assistance payments while also improving the tax collection system

    that finances these social expenditures at all levels of government. By providing

    this support, the Bank expects to help improve fiscal stability in federal,

    provincial and local governments, while also ensuring that the poor continue to

    have access to essential health, education and other social services.

This loan is part of the Bank's $2.4 billion program for Argentina for 2001 and

    2002 which, in turn, is part of a larger initiative by the international community,

    involving the International Monetary Fund and the Inter-American Development


The single currency U.S.-dollar, fixed-spread loan will be disbursed in two

    tranches of $200 million each, with the first tranche disbursed immediately, and

    the second upon completion of agreed reforms. The loan will be repaid in 15

    years, with three years of grace.

    Uruguay: World Bank Approves $18.5 Million to Eradicate Foot and Mouth


    The World Bank approved a $18.5 million-loan to Uruguay to support the Foot

    and Mouth Disease Emergency Recovery Project. The project is the first Bank


    emergency operation to help alleviate the economic impact of an outbreak, and will benefit 50,000 livestock farmers as well as the livestock sector in general. The Foot and Mouth Disease Emergency Recovery Project, to be implemented

    over a period of two years, will provide technical and financial support to the Government of Uruguay to help contain and mitigate the impact of the outbreak through:

    ? A comprehensive vaccination program for of all cattle in the country; ? Improved monitoring and surveillance capacity to prevent eventual future outbreaks. This will include the strengthening of the system to track animal movements and sales, and of sanitary barriers in key points in the interior and at the country's border passes;

    ? Identification of alternative markets for Uruguayan beef, and measures to promote the restoration of the country's presence in the premium beef market.

    The loan will also support training, education and awareness programs to increase the information about disease prevention to producers and the public in general, as well as the measures being adopted by Uruguay against the disease to the export markets.

    The $18.5 million, fixed-spread loan has a 15-year maturity including a 5-year grace period.

    Honduras: World Bank Supports Sustainable Tourism Project For The Caribbean Coast

    The World Bank approved a US$5 million, interest-free credit by the International Development Association (IDA) to promote sustainable tourism along Honduras's North Coast and offshore Bay Islands.

    The Sustainable Coastal Tourism Project will develop a national strategy for coastal tourism on Honduras' North Coast, based on the results of a national dialogue on sustainable tourism, that takes into account social and environmental concerns, such as land security and HIV/AIDS as well as conservation of the marine environment. The IDA credit will increase environmental planning resources to the Honduran Institute of Tourism and provide technical assistance for environmental assessment and tourism destination management to the coastal municipalities of: Omoa, Tela, La Ceiba and Trujillo, and to local government in the Bay Islands of Roatan and Utila. The credit will also finance technical assistance and training to the private sector and community organizations to engage in sustainable tourism development planning and introduce environmental certification for tourism enterprises.


    To stimulate small and medium enterprise tourism development, the credit will finance a entrepreneurship center to pilot programs aimed at engaging public and private partnerships. The entrepreneurship center will offer business plan development assistance and will award grants to individuals, communities and indigenous groups on a competitive basis.

    The North Coast of Honduras -extending along the mainland from Omoa to Trujillo and offshore to the Bay Islands- includes the southern tip of the Mesoamerican Barrier Reef System, the world's second longest coral barrier reef. The credit complements a US$11 million Global Environment Facility (GEF) grant to the Central American Commission on Environment and Development to promote the sustainable development and protection of the Mesoamerican Barrier Reef System. The World Bank approved implementation of the GEF Grant on May 22 of this year.

    The US$5 million IDA credit is on standard terms of 40 years maturity, including 10 years grace.

    Argentina: World Bank Encouraged By Argentina Measures, Approves $330 Million Loan For Reform In Santa Fe Province

    The World Bank approved a $330 million project supporting reforms in public finance, health, education and private sector development in the Argentine province of Santa Fe, and reaffirmed its overall strategy for lending to Argentina focused on structural reform, social protection and public sector management.

    The Santa Fe project, like recent Bank loans to the provinces of Catamarca and Córdoba, ensures that public services provided by provincial government are of high quality and delivered efficiently. In Santa Fe, these include services such as health care, public education, and social protection. For example, the loan will finance an income support program for 16,000 low-income families, provide prenatal care to poor pregnant women, and help the government direct spending on education towards schools in poor neighborhoods. By strengthening the quality of province's primary and secondary schools, and delivering health services to non-insured people, it will help increase school attendance and improve the health of poor and vulnerable people.


    Santa Fe, like other provinces, is responsible for about half of public spending and more than 80 percent of total health and education expenditures. This loan will enable Santa Fe's government to maintain a fiscal balance while supporting essential services during the continuing recession, and also undertaking fiscal and social sector reforms.

    The loan will also help stimulate economic development and growth in Santa Fe, Argentina's second-largest province, with an average per capita income about 15 percent below the national average. It will support a fiscal program consistent with the federal government's effort to strengthen public finances to help reduce country risk, which would lower interest rates. The loan will also support more directly small and medium-sized firms, which generate about 70 percent of jobs, by lowering their energy costs and easing their tax burdens.

    The single currency U.S.-dollar loan will be repaid in 15 years, including five years grace, at the World Bank's standard variable interest rate.

Costa Rica: World Bank to Support Health Sector Reform

    The World Bank has approved a $17 million project to support Costa Rica's initiative to provide high-quality health care services to all its citizens within the framework of a modernization program that strengthens government regulation and de-concentrates delivery of health services across the country.

The Health Sector Strengthening and Modernization Project consolidates a

    health sector modernization process launched in 1993, with support from an earlier World Bank-financed project. The new project will continue that support by financing measures to increase the capacity of government institutions to regulate health care providers to control quality, as well as purchase and distribute pharmaceuticals. It will also help to strengthen hospital management, increase ambulatory care, extend health services to low-income areas, and introduce a formula-based plan to ensure that hospitals and local health centers receive the staff and equipment they need to meet local demands for health care.

    Although Costa Rica's health system has a record of significant achievement, the government plans further improvements to guarantee that the quality of care provided is of comparable quality across the country. As the Caja Costarricense 8

    de Seguro Social (CCSS) purchases health care services from decentralized health units, and possibly others, it is critical that all health service providers have clear performance guidelines that are properly monitored. The CCSS also plans to upgrade its information systems to implement reforms in revenue collection, billing, purchasing, and allocation of expenditures.

    The project will benefit four million Costa Ricans whose health care services are managed by the CCSS and regulated by the Ministry of Health, by improving the quality and equity of these services, reducing wait times, and delivering easier access to needed pharmaceuticals.

    The fixed-spread loan on IBRD terms, to be disbursed over six years, matures in 15 years with seven years of grace.

Ecuador: World Bank Approves $25.2 Million for Rural Community

    Initiatives to Fight Poverty

     The World Bank approved a $25.2 million project to finance local initiatives to fight poverty in Ecuador's rural communities.

The loan for the Poverty Reduction and Local Rural Development Project

    (PROLOCAL), effective in September 2001 and to be disbursed over five years, will finance training in planning and project management for community leaders, non-governmental organizations, local juntas, grass-roots organizations and producers' associations. These groups will then develop community development projects which will receive initial financing from a fund, also financed by the PROLOCAL loan.

    The project will begin financing activities in two sub-regions of Ecuador and will gradually extend coverage to four other sub-regions. By June 2006, it is expected to have involved 150 local governments, supporting their planning efforts in collaboration with residents at the parish (parroquia) and township (cantón) level.

    Projects to be financed by the loan are expected to include small enterprises, environmental protection, small-scale farming, watershed and forest management, among others.

The loan is fixed-spread on IBRD terms with eight years of grace.


Bolivia : World Bank Approves $35 Million Credit to Reduce Infant

    Mortality The World Bank approved a $35 million, interest-free credit by the International Development Association (IDA) to reduce infant mortality in Bolivia

    particularly among the most disadvantaged communities.

    The adaptable program credit supports the second phase of the Health Sector

    Reform Program, carried out from 1999 to 2001. It will increase coverage and

    quality of public health services and related programs for the poor across the country, as part of a nationwide effort to protect children's health by strengthening local capacity to deliver public health programs.

    With the overall goal of reducing infant mortality to 48 per 1,000 in 2008 from 67 to 1,000 in 1998, the second phase of the project will expand health coverage to an additional 25 percent of the population or about two million people in the poorest regions of the country.

    The strengthening of the Basic Health Insurance program will benefit all children under five years and all mothers using public health services, by incorporating new vaccines, as well as prenatal and neonatal care. The National Program on Coverage Extension, partly financed by the IDA credit, will focus on people, including indigenous communities, living in under-served, mostly poor, rural areas, as well as marginal urban neighborhoods.

    In addition, the project supports further decentralization to enable local agencies to manage and monitor health care services while strengthening the role of the Ministry of Health in policy-guidance and regulation and the role of municipalities in implementation.

    The $35 million-credit is provided under standard IDA terms, with a 40-year maturity and a 10-year grace period.

Caribbean: World Bank Approves $155 Million to Support Programs to

    Fight HIV/AIDS

    Loans approved for Dominican Republic and Barbados

    The World Bank's Board approved a US$155 million multi-country HIV/AIDS prevention and control lending program for the Caribbean. The first loans to support national programs were also approved, US$25 million to the Dominican Republic and US$15.5 million to Barbados.

Consistent with the UN Declaration of Commitment on HIV/AIDS announced at

    the recently concluded UN General Assembly Special Session on HIV/AIDS, the 10

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