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

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

Chapter 7: Gaps

Chapter 7: Gaps and Challenges 6. An evaluation methodology is proposed that identifies gaps and challenges and asks the following questions: a. Can the mechanism be easily implemented? What are the obstacles to implementation? i. Legislation – Under Corporation Tax Law domestic companies pay tax at 40% however, under the Fiscal Incentive Act Tax holidays apply for foreign based companies which invest in Antigua & Barbuda. Some of the tax privileges include: 1. Freedom from the payment of Corporate Tax on the profits arising out of the profitable operations of the company for a period of 15 years. The company can then apply for a renewal for a period of a further 15 years; 2. waiver of all import duties on consumption tax on the importation of materials and equipment used in the operations of the company; 3. grant of an export allowance in the form of an extended tax holiday on the exportation of goods produced in Antigua and Barbuda; 4. The right to repatriate all capital royalties, dividends and profits free of all taxes or any other charges on foreign exchange transactions. 5. All office equipment and vehicles to be used in the company's operations can be imported free of duty and consumption taxes. The government grants all work permits and the necessary residential status to all expatriates who are key to a company's operations.. ii. In order to collect taxes under an innovative financing mechanism it is likely that the current corporation tax rules could need to be amended and industry specific levy charged. iii. Political willingness of countries to adopt it. This may well depend on a number of factors, which would include a realization of the extent of the problem in terms of, the extent of HIV, together with the extent of HIV in the migrant population, and the influence of business interests who would be against additional taxation. For Antigua & Barbuda the willingness would need to be 38

demonstrated in amending the tax holidays associated with foreign investment and the Fiscal Incentive Act. b. What problem is it addressing? i. Does the target population have problems accessing the services. Whilst at the policy level references are made to citizens of Antigua & Barbuda at the actual service delivery level services are provided free of charge and access to based on need. The service has been described by the Ministry of Health as universal access as there are no user fees or requirements to produce identity cards to prove nationality prior to receiving Health Services. c. What impact will it have on the problem? d. Is there a current methodology for the identification of the target population as they access the health services? The challenge for the feasibility study here is that there is no process of identification of the target population as they access services. In addition, there is no funding mechanism in existence which links services performed to contracts and payments. e. Who will benefit or be adversely affected (e.g. health-care consumers, developing country governments, taxpayers, industry)? f. Is it likely to generate additional (incremental) funding or simply replace current support? i. Whilst there are some incremental revenues generated they are generally small and the collection costs may exceed the revenue collected. 7. Travel Tax a. This tax is not recommended as an additional 0.2% tax of GDP was implemented in 2010 following the fiscal reforms associated with the IMF Loan. 8. The Gambling Industry a. Additional tax here is not recommended to pursue as it is doubtful that there is political willingness to introduce new tax measures. The government of A&b together with the on-line gambling industry is currently involved in a long running battle with the US and the World Trade Organisation on the ‘legality’ of cross border online gambling. In addition, the industry enjoys protection from standard corporation tax rules through the Financial Services Regulatory Authority (FSRC). 9. Tobacco. 39

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