The equity gap: Latin America, the Caribbean and the Social Summit

The World Summit for Social Development, held in Copenhagen, Denmark, from 6 to 12 March 1995, brought together a large number of heads of State and Government and official representatives from States Members of the United Nations and culminated in the adoption of the Copenhagen Declaration on Social Development and the Programme of Action of the World Summit for Social Development. These two documents —the first containing policy statements, the other dealing with their practical application— imply commitments at the national, regional and international levels. Barely two years have passed since this summit was held, too short a period to permit an evaluation of the impact of the actions that the Latin American and Caribbean Governments set out to undertake. On the other hand, most of the countries were already implementing a variety of official policies related to the great objectives of the World Summit for Social Development. Al reunirse ahora los países miembros de la CEPAL para examinar, por vez primera, los avances hacia la aplicación de los resultados de la Cumbre,1 la Secretaría ha centrado su estudio en tres aspectos. Primero, en examinar, desde la óptica latinoamericana y del Caribe, la situación actual en materia de pobreza, empleo e integración social, los principales temas de la Cumbre. Segundo, en el ámbito de las políticas, en reseñar las tendencias que resultan más relevantes para el cumplimiento de los compromisos antes mencionados. Tercero, en proponer algunas orientaciones adicionales sobre el contenido y alcance de las políticas tendientes a facilitar el pleno cumplimiento futuro de dichos compromisos. Se procura con ello orientar el debate de los gobiernos y de la sociedad civil en América Latina y el Caribe acerca de cómo se están instrumentando en la región los compromisos de la Cumbre de Copenhague.

Social equity and changing production patterns: an integrated approach

In accordance with the mandate it received at the twenty-third session, in this document the secretariat has attempted to delve further into the links among technical progress, international competitiveness and social equity, although it does not, certainly, purport to have exhausted these subjects. Two qualifying remarks are called for here. First, the secretariat is deliberately abstaining from becoming embfoiled in the theoretical aspects of a controversy which has raged for centuries, and particularly since the French revolution, i.e., the debate surrounding the cause-and-effect relationships and possible areas of incompatibility among democratic governance, economic stability, growth and well-being. Rather than concerning itself with doctrine, the secretariat prefers to deal with the realities confronting virtually all the Governments of the region. These realities include the need to resume a sustained (and environmentally sustainable) growth process within the framework of the consolidation of pluralistic, democratic societies -societies that are faced with very real demands to address the many ways in which the majority of the population has been bypassed by development. Secondly, no attempt has been made in this document to provide a list of suitable policies for changing production patterns or for attaining greater social equity. Instead, the focus is on how certain pivotal analytical and policy aspects can be linked within an integrated approach so as to reinforce any existing areas of complementarity between efforts to achieve greater growth and efforts to seek greater social equity. This approach highlights the central tenet of the document: that growth, social equity and democracy can be compatible. What is more, there are significant but as yet largely unexplored areas in which social equity and changing production patterns complement and reinforce one another.

Tiered Pricing and Cost Functions: Are Equity, Cost Recovery and Economic Efficiency Compatible Goals?

Suppliers of water and energy are frequently natural monopolies, with their pricing regulated by governmental agencies. Pricing schemes are evaluated by the efficiency of the resource allocation they lead to, the capacity of the utilities to capture their costs and the distributional effects of the policies, in particular, impacts on the poor. One pricing approach has been average cost pricing, which guarantees cost recovery and allows utilities to provide their product at relatively low prices. However, average cost pricing leads to economically inefficient consumption levels, when sources of water and energy are limited and increasing the supply is costly. An alternative approach is increasing block rates (hereafter, IBR or tiered pricing), where individuals pay a low rate for an initial consumption block and a higher rate as they increase use beyond that block. An example of IBR is shown in Figure 1 (on next page), which shows a rate structure for residential water use. With the rates in Figure 1, a household would be charged $0.46 and $0.71 per hundred gallons for consumption below and above 21,000 gallons per month, respectively.

Measuring the Performance of Cooperative Equity Redemption Plans

Cooperatives differ from other businesses in that they are owned by their patrons and net margins are distributed to patrons on the basis of use instead of capital investment. For financing, cooperatives often rely on allocated equities from retained patronage refunds. Retained patronage refunds are noncash allocations of net margins reinvested in a cooperative by patrons. Under an ideal program of equity formation, equity is held by patrons in proportion to patronage. Each patron’s share of financing the cooperative is equal to the share of benefits received. Equities of former patrons are retired as active patrons take on more of the responsibility of financing the organization.

Precautionary principle, economic and energy systems and social equity

In this paper the precautionary principle is reviewed alongside the process of international implementation. Adoption of the precautionary principle is advocated to deal with energy choices as a mechanism to account for potential climate change impacts, notwithstanding the debate on scientific uncertainty on the links between solar activity, greenhouse gas concentration and climate. However, it is also recognized that the widespread application of the precautionary principle to energy choices does not seem to be taking place in the real world. Relevant concrete barriers are identified stemming from the intrinsic logic governing the hegemonic economic system, driving the energy choices by economic surplus and rent generation potential, the existence of social asymmetries inside and among societies as well as by the absence of democratic global governance mechanisms, capable of dealing with climate change issues. Such perception seems to have been reinforced by the outcome of the United Nations Climate Change Conference, held in Copenhagen in December 2009. (c) 2010 Elsevier Ltd. All rights reserved.

Equity in health: tuberculosis in the Bolivian immigrant community of Sao Paulo, Brazil

Objectives To analyse the profile of tuberculosis (TB) among Bolivian immigrants, investigate the impact that this population has on the trends of TB and assess equity in access to TB treatment, in the city of Sao Paulo, Brazil. Methods Descriptive study of the epidemiological profile of TB in four city districts with large Bolivian populations, comparing cases among Brazilians and Bolivians, during the 19982008 period was carried out. We used logistic regression to adjust the treatment outcome for potential confounders. Results We identified 2056 new TB cases: 65.7% in Brazilians, 32.1% in Bolivians and 2.2% among other nationalities. Although TB incidence remained stable (high) over the study period, the annual proportion of cases among Bolivians increased from 15.0% to 53.0%. In comparison with the Brazilians, the Bolivians were younger (median age, 24 vs. 40 years; P < 0.0001) and presented a lower unemployment rate (3.1%vs. 11.6%; P < 0.0001), a lower rate of HIV co-infection (1.5%vs. 28.5%; P < 0.001), a higher proportion of individuals receiving supervised treatment (81.5%vs. 62.0%; P < 0.0001) and a higher proportion of cures (71.6%vs. 63.2%; P < 0.0001). After having been adjusted for potential confounder, cure after treatment was not associated with nationality. Conclusions Bolivian immigrants influenced the incidence but not the trends of TB among Brazilians in the study area. We found no significant differences between Bolivians and Brazilians regarding healthcare access or treatment outcome. Guaranteed universal health care access for all, including undocumented individuals, contributes to health equity. Specific intervention strategies are warranted for immigrants with tuberculosis.

Equity and women's health services for contraception, abortion and childbirth in Brazil

This paper addresses equity in health and health care in Brazil, examining unjust disparities between women and men, and between women from different social strata, with a focus on services for contraception, abortion and pregnancy. In 2010 women's life expectancy was 77.6 years, men's was 69.7 years. Women are two-thirds of public hospital services users and assess their health status less positively than men. The total fertility rate was 1.8 in 2011, and contraceptive prevalence has been high among women at all income levels. The proportion of sterilizations has decreased; lower-income women are more frequently sterilized. Abortions are mostly illegal; women with more money have better access to safe abortions in private clinics. Poorer women generally self-induce abortion with misoprostol, seeking treatment of complications from public clinics. Institutional violence on the part of health professionals is reported by half of women receiving abortion care and a quarter of women during childbirth. Maternity care is virtually universal. The public sector has fewer caesarean sections, fewer low birth weight babies, and more rooming-in, but excessive episiotomies and inductions. Privacy, continuity of care and companionship during birth are more common in the private sector. To achieve equity, the health system must go beyond universal, unregulated access to technology, and move towards safe, effective and transparent care. (C) 2012 Reproductive Health Matters

Le Finanziarie regionali come operatori di private equity

Obiettivo del presente lavoro è approntare un’analisi interpretativa dell’operatività dalle Finanziarie regionali, valutarne gli investimenti in capitale di rischio e, in particolare, l’attività di private equity, evidenziando le tendenze in atto, i possibili percorsi evolutivi e le eventuali criticità. La metodologia adottata ha previsto un’articolazione del lavoro lungo due principali direttive: un’analisi di tipo quantitativo sui bilanci di sette esercizi (dal 2002 al 2008), con la finalità di indagare nel dettaglio gli aspetti economici, finanziari e patrimoniali delle Finanziarie regionali attive sul territorio italiano; un’analisi qualitativa basata su un’approfondita rassegna della letteratura internazionale e su interviste mirate ad un campione ampiamente rappresentativo della popolazione osservata. I risultati raggiunti fanno ragionevolmente supporre che sia in atto una profonda ristrutturazione dell’intero sistema delle Finanziarie, che ha visto innanzitutto aumentare il controllo pubblico nella compagine sociale. L’indagine contabile ha permesso di identificare la presenza di due modelli di business ben differenziati: alcune Finanziarie sono orientate ad attività con forte contenuto di intermediazione finanziaria; altre invece sono focalizzate sull’attività di erogazione di servizi sia finanziari di consulenza che reali. L’investimento in capitale di rischio costituisce un attività centrale per le Finanziarie regionali; l’analisi dedicata a tali impieghi ha permesso di individuare, tra esse, alcune realtà tipiche del merchant banking, e più di frequente, del modello di holding. Complessivamente le Finanziarie campionate detengono oltre 400 partecipazioni per un valore che supera 1,7 miliardi di euro; prevalentemente concentrati su una ristretta cerchia di realtà spesso con impatto strategico sul territorio, ovvero strumentali. Segnatamente all’attività di private equity, è stato possibile rilevare come la politica d’investimento delle Finanziarie regionali sia complementare rispetto a quella mediamente espressa dal mercato domestico, anche se restano critici, anche per le Finanziarie, gli investimenti su imprese target con fatturato compreso tra 2 e 10 milioni di euro. Le evidenze circa la struttura dei contratti segnalano una parziale conformità alla best practice individuata dalla letteratura internazionale. In particolare l’uso limitato dello stage financing, la bassa partecipazione alla gestione sono le principali criticità individuate. Infine, della fase di riorganizzazione che pare interessare il sistema delle Finanziarie, si trova conferma nella percezione dei suoi operatori. Interpellati sul futuro dell’attività di investimento in capitale di rischio, hanno fornito indicazioni che consentono di concludere l’esistenza di una polarizzazione delle Finanziarie su due gruppi: da un lato quelle che implementeranno, più o meno, l’attività di private equity, dall’altro quelle che, viceversa, abbandoneranno tale strumento. La normativa sulle società a partecipazione pubblica regionale e la scarsa autonomia nella gestione delle misure affidate sono ritenute, dalle Finanziarie “interessate”, il principale fattore di freno alla loro crescita nel mercato del private equity.