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Improving Access to HIV Services for Mobile and Migrant ...

Improving Access to HIV Services for Mobile and Migrant ...

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authority to impose new tax regimes and innovative financing mechanisms the existence of pressure groups and regional mechanisms can act as an extra hurdle in the implementation of policies and legislation. a. There is no revenue data available in relation to Antigua & Barbuda. Whilst there is some financial data available from Digicel and Cable & Wireless, at the level of Earnings before interest, taxation, depreciation and amortization across the region there is insufficient data to provide a reasonable estimate of how the revenue can be disaggregated to Antigua and Barbuda. b. With respect to APUA the state owned operator, there is no requirement to publically report financial results of the organisation and no data has been obtained in respect the revenue raised by the Telecommunications Division 14. User Fees. Awaiting Data 15. Debt Conversion. Another option that has been given some consideration internationally is the possibility of debt-for-health swaps. In this case it could be applied whereby external governments, e.g. the European Union, allowing debt repayment by Caribbean countries to be used for healthcare improvements with agreed conditions such as Universal Coverage. This could be approached on an individual country basis or coordinated by a regional organisation. There is much literature on the subject all related to highly indebted low income countries (together with the south cone of the Americas and Mexico dating from the mid 80s) and Greece this year. a. In the case of Antigua however, facilitated by the IMF the government has had discussions with the domestic banks, in respect to re-structuring public debt, implementation of fiscal measures that would begin to eliminate the arrears on the public debt and to seek debt relief from public and private creditors. The problem for Antigua & Barbuda was that following the contraction in the economy from 2009, together with the accumulation of arrears to domestic and external creditors the interest bill was projected to be an unsustainable 9% of GDP. The debt restructuring included the lengthening of loan maturity rates with domestic and international lenders and reduced interest rates. In addition, the payment arrears which had generated with 34

multi-lateral financial institutions have either been cleared or agreements have been reached on their clearance. 10 b. As the country has recently undertaken a series of debt restructuring measures it is unlikely that further measures can be considered at this stage. 10 Antigua and Barbuda: 2010 Article IV Consultation and Request for Stand-By Arrangement—Staff Report; Supplements; Public Information Notice; Press Release; and ED’s Statement. International Monetary Fund, September 2010. 35

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