Albania is a middle-income country. In recent years Albania has maintained positive growth rates, despite the ongoing economic crisis. The country is facing a challenge of maintaining growth in a difficult external environment while rebuilding fiscal buffers.
Read More »
Ladies and Gentlemen,Albania’s health outcomes are relatively strong by regional standards (such as: life expectancy at birth which reached 77 years by 2011 (80 for women and 74 for men), favora... Show More +bly comparing with other countries in the region); though key performance indicators are mixed (for ex: according to the 2008 Demographic and Health Survey (DHS), infant and neo-natal mortality were 18 and 11 per 1,000 live births, respectively, both of which are slightly higher than comparable statistics for other countries in South-Eastern Europe). A critical issue is that financial protection of households against high out-of-pocket payments (OOP) is relatively weak, and quality of care remains a significant concern.In 2013, Albanian public spending on health amounted to 2.6 percent of GDP, the lowest among countries in the region. Out of pocket expenditures accounted for as much as 55 percent of total expenditures on health (the highest among countries in the region) of which 45% was spent on pharmaceuticals. Hence the role of pharmaceuticals is critical.The goals of pharmaceutical reform are the same as those of health sector reform: equity and access, quality, and efficiency. However, because of differences in financing and provision of services, certain problems such as inequity may be more severe within the pharmaceutical sector.The Albanian Ministry of Health is embarking on health sector reforms. The World Bank is working closely to prepare a program of support under an upcoming Health Reform Project, which is seeking to (i) improve efficiency and quality of hospital services delivery; (ii) augmenting Health Management Information System (HMIS); and (iii) improve the Health Financing System, including design and piloting of innovative pharmaceutical policies (i.e: restructuring the existing reimbursed drug list, generic promotion and prescription, and piloting expanded coverage of outpatient drug benefit package).In parallel, the Ministry on its own initiative is undertaking an ambitious reform of the pharmaceutical sector aiming to rationalize expenditure, improve reimbursement decision-making and increase access to medicines (some reform measures have already been implemented: wholesale and retail markups were decreased and VAT is no longer charged on medicines as of April 2014). The World Bank provided technical assistance for reviewing the Pharmaceutical Policy, bringing in the experience of other countries. Today’s technical workshop has been organized to discuss the findings with you.While the benefits of spending on medicines are increasingly being understood, the key test is translating that understanding into policy action. Unmanaged spending runs the risk of contributing to fiscal problems for future generations, while too little spending runs the risk of Albania’s population being less healthy and less productive as it ages. Spending on medicines provides social and economic benefits that need to be recognized in any discussion about future policy and spending decisions.A key public policy challenge is how to ensure that the well-being of Albanians and the Albanian economy is enhanced to the maximum extent possible from the technological advances being made with medicines while maintaining an appropriate level of fiscal control. New medicines offer both valuable new treatments as well as improvements on existing treatments that allow for more appropriate care in response to the needs of individual patients. This can reduce both the incidence of associated downstream treatment issues and the overall cost of care.Let me share three key issues in pharmaceuticals highlighted in the Review Paper:First, Price comparisons to other Western Balkan countries (Serbia, Macedonia, Croatia) reveal that Albania, particularly if its economic context is taken into consideration, has significant potential to reduce prices of medicines. Second, Supply-side constraints still remain a major obstacle to achieving substantial reductions on medicine prices, which undermines the access of large groups of populations on expensive medicines. Evidence shows that hospitals face continuous lack of medicines and procuring medicines for hospitals still remains a challenge.Third, Potential regulatory measures of both supply and demand side can be implemented in a short – medium time. The objective would be to reduce high rates of co-payments, generate savings and ensure value-for-money for public health expenditures on medicines, increase access for lifesaving medicines, control the growth of expenditures on medicines, guarantee rational prescribing on medicines. What could be some measures to move towards addressing these issues? A top priority is the development of a comprehensive framework, capturing key technical aspects of pricing and reimbursement policy including regulation for prescribing and dispensing. This would avoid wasting of scarce resources and allow the government to control the growth of pharmaceutical expenditures.The Paper provides recommendations on both supply and demand side and these will be presented today for discussion. If these are taken on board, their successful implementation would require i) a sound legal basis, ii) political will, iii) enforcement capacity, iv) management skills and v) systems to collect data for measuring both the baseline and impact of a given measure.The World Bank remains available to provide continued technical support as Albania moves to reform this important part of the health sector.Thank you. Show Less -
TIRANA, July 16, 2014 – The World Bank and the Ministry of Health organized today a technical workshop on reforming the pharmaceutical sector in Albania. Participants in the event included the M... Show More +inister of Health Ilir Beqaj, the World Bank Country Manager for Albania Tahseen Sayed, managerial and technical staff from the Ministry of Health, Health Insurance Fund, Drug Laboratory Control Agency, representatives from the development partners, and associations involved in the sector.The findings and recommendations of a recently conducted “Review of Albania’s Pharmaceutical Policy” were presented by the World Bank technical expert. The Technical Paper presents an initial review, analysis and recommendations for the sector in Albania while also learning from reform experiences of other countries. The key areas highlighted include the importance of reforming the pharmaceutical sector in order to rationalize expenditures, improve reimbursement decision making and increase equitable access to medicines. The Paper recommends rational spending on medicines as this contributes to the well-being of citizenry while maintaining an appropriate level of fiscal control. Other key findings indicate that (i) in comparison to other Western Balkan countries, Albania has high potential of reducing prices of medicines; (ii) constraints in pharmaceutical supply remain a major obstacle to achieving substantial reductions on medicine prices leading to inequitable supply to the population and medicine shortages in hospitals; and (iii) phased implementation of a regulatory framework addressing both demand and supply side issues can begin to improve the existing distortions. “The Albanian Government is embarking on health sector reforms for improving the efficiency and quality of hospital services which the World Bank will be supporting under an upcoming Health Reform Project,” said the World Bank Country Manager for Albania Tahseen Sayed. “It is encouraging that the Ministry of Health, in its efforts to ensure equitable access to quality care, is also initiating a reform of the pharmaceutical sector as a part of its overall sector reforms“. Show Less -
WASHINGTON, July 15, 2014 - The World Bank Group* provided $11.9 billion to Europe and Central Asia (ECA) during fiscal year 2014, aimed at reducing poverty and boosting shared prosperity in the regio... Show More +n. Of this, IBRD/IDA provided $5.6 billion of support to the region, IFC delivered $4.7 billion in commitments, and MIGA provided $1.6 billion in political risk insurance and credit enhancement coverage.World Bank – International Bank for Reconstruction and Development (IBRD) / International Development Association (IDA)Comprising 43 projects, the $5.6 billion of World Bank support to the region over the past fiscal year consists of $4.7 billion in commitments from the International Bank for Reconstruction and Development (IBRD)1 and $0.9 billion from the International Development Association (IDA)2. In addition, the Bank’s Europe and Central Asia region produced important research and analytical work about critical issues in the region this fiscal year. It also signed 36 Reimbursable Advisory Service agreements with 13 countries in the region for a total amount of $47 million. These agreements provide technical advice to pension and education systems reform, public sector governance and institutional capacity-building, planning and management of infrastructure investments, and other issues.“Europe and Central Asia was the region hardest hit by the 2009 global economic crisis, and remains the slowest to recover. Although a modest rebound has occurred since 2010, GDP growth grew just 2.2 percent in 2013, and is expected to be only 1.7 percent in 2014,” said Laura Tuck, World Bank Vice President for the Europe and Central Asia Region. “The World Bank supported clients’ needs over the past fiscal year with innovative, demand-driven operations. We also acted quickly and effectively to respond to urgent situations, such as the crisis in Ukraine, and the catastrophic floods in Bosnia and Herzegovina and Serbia in May.”The World Bank Group stepped up its assistance in Ukraine to help stabilize the economy and support the delivery of critical public services. In May 2014, the Board approved a total of $1.4 billion in IBRD loans, including two large investment operations to improve municipal service delivery and a $750 million multi-sector Development Policy Loan (DPL). In addition, the Board approved a $250 million IFC investment project in support of a poultry private sector company. These four projects are part of the World Bank Group’s overall assistance to Ukraine announced in March 2014, which aims to provide up to $3.5 billion by the end of 2014.In mid-May, Bosnia and Herzegovina (BiH) and Serbia were hit by the worst flooding in more than 120 years. By June 30, the World Bank had approved a $100 million credit for the Floods Emergency Recovery Project for Bosnia and Herzegovina to finance critical goods, such as fuel and electricity imports, as well as the reconstruction of local infrastructure. The project was prepared in record time in view of the dire situation in the country and is financed from the International Development Association’s (IDA) Crisis Response Window. The Bank is also working with the BiH authorities to strengthen flood protection and implement early warning systems, including through the $24 million credit for the Drina Flood Protection Project, which is improving flood management of the Drina River in and around the towns of Bijelijna and Goražde. This combined immediate response will support economic recovery in the affected areas. In Serbia, the Bank has contributed to the joint Government, EU, UN, and World Bank Recovery Needs Assessment that is underway, and is in the process of restructuring its roads rehabilitation project to prioritize roads sections damaged by the floods. The Bank is also preparing an emergency recovery loan, as requested by the Government, to address urgent needs.World Bank ECA StrategyThe ECA region’s strategy focuses on two main pillars: 1) competitiveness and shared prosperity through jobs, and 2) environmental, social, and fiscal sustainability, including through climate action. Governance and gender continue to be thematic priorities within interventions of both pillars. Increasing competitiveness and shared prosperity through jobs The Bank is supporting competitiveness and job creation in the region in many ways. It has increased access to finance for small- and medium-size enterprises in Bosnia and Herzegovina and Croatia; helped improve skills and increase labor market flexibility in the former Yugoslav Republic (FYR) of Macedonia; invested in infrastructure in Azerbaijan and Ukraine; strengthened financial sector regulations, the business environment, and policies conducive to innovation in FYR Macedonia and Serbia; and offered advice on innovation, trade, and logistics systems in Poland and Turkey.The Bank published several important reports on the region during the fiscal year. The report Back to Work: Growing with Jobs in Europe and Central Asia examines why unemployment in ECA is high and job creation is weak, despite impressive reform efforts in many countries of the region and a decade of strong economic growth before the 2009 crisis.The report Shared Prosperity: Paving the Way in Europe and Central Asia suggests a new approach to development that combines the quest for economic growth with a concern for the inclusiveness of that growth.The region also launched its Diversified Development: Making the Most of Natural Resources in Eurasia report this fiscal year, produced in partnership with the Eurasian Development Bank. The report finds that having natural resources does not have to be a curse – it can be a blessing if countries ensure proper management of revenues, invest earnings in building up physical and human capital, and improve institutions.Environmental, social, and fiscal sustainability, including through climate actionThe Bank is supporting Armenia and Croatia in their efforts to improve the efficiency and fiscal sustainability of their safety net and pension systems. It is helping improve health care systems in Bulgaria, Croatia, Kosovo, Moldova, Romania, Tajikistan, and Uzbekistan. It is working to strengthen social cohesion by supporting community-driven development and social accountability in the Kyrgyz Republic and Tajikistan. In Romania, it is helping governments improve economic opportunities and public services for disadvantaged communities, including the Roma and unemployed youth.The Bank works with countries in designing and implementing reforms to improve the efficiency and fiscal sustainability of their pension, social protection, and health care systems. Its report Inverting Pyramid: Pension Systems Facing Demographic Challenges in Europe and Central Asia documents how pension systems in the region are facing increasing pressures from aging populations and a shrinking labor force, and countries require comprehensive, long-term, and socially sustainable reforms to pension systems so that they can protect the elderly poor and future generations.Climate adaptation and energy efficiency remain strategic priorities for Europe and Central Asia, the most energy-intensive region in the world. Greater energy efficiency delivers both environmental and economic gains. In Belarus, Bosnia and Herzegovina, and Turkey, the Bank is working to achieve these gains through policy reforms (such as energy pricing) and investments in both public infrastructure and private industry, including renewable energy and energy efficiency. Cumulative energy savings from the portfolio of Bank-supported projects in the region are equivalent to taking 1.4 million cars off the roads. The Bank is also working with client countries as they adapt to climate change. It is supporting improved water resource management (flood protection, water loss reduction, irrigation efficiency) in Kazakhstan; climate-smart agriculture (switching to more resilient crops) in Tajikistan; and improved institutional capacity for better weather forecasting and climate change monitoring in the Russian Federation. To facilitate the exchange of ideas and solutions for addressing climate change, the Bank holds an annual Central Asia Climate Knowledge Forum. The second forum, held in May 2014, concluded with a call from all five Central Asia countries for a regional program on climate resilience, to be prepared by the World Bank, in partnership with Central Asia countries and development partners. Additionally, the Reducing the Vulnerability of Albania’s Agricultural Systems to Climate Change reports examine the challenges and opportunities being created in the agriculture sector in Albania, the FYR Macedonia, Moldova, and Uzbekistan. International Finance Corporation (IFC)The International Finance Corporation (IFC) this year supported private sector development in ECA with $4.7 billion in commitments in 117 projects, including $1.2 billion in funds mobilized from its partners. IFC also delivered a solid advisory program worth $40 million with a focus on projects in IDA countries, fragile and conflict affected countries, and climate change.“IFC had another strong year in Europe and Central Asia as the weak economic performance in the Eurozone and political instability in parts of the region continued to affect many countries and businesses in the region,” said Tomasz Telma, IFC Director for Europe and Central Asia. “IFC’s efforts to support private sector development focused on helping small- and medium-enterprises, developing capital markets, tackling climate change, boosting food security by supporting agribusiness, and increasing private sector participation in infrastructure.”Highlights of IFC’s program addressing these regional priorities include:The region’s businesses received strong support through increased access to finance. IFC provided $1.1 billion of financing to banks for on-lending to smaller companies, including almost €150 million as equity investment in Raiffeisen Bank International to be channeled to small- and medium-enterprises (SMEs) via subsidiaries across Central and Eastern Europe.IFC continued to build and strengthen regional capital markets with several landmark deals, issuing the first foreign corporate bond in Armenia.IFC committed over $600 million in transactions addressing climate change.The region’s agribusiness sector received $400 million in commitments for projects aimed at boosting the region’s food production and increasing food security. This included the first $175 million commitment of IFC’s $250 million financial package to MHP, Ukraine’s leading poultry producer, which was raised amid challenging market conditions.With public sector budgets strained, the development of public-private partnerships (PPPs) has been a priority for governments across ECA. IFC’s PPP advisory team is assisting the implementation of CASA-1000 in Central Asia, a transformational power transmission project to carry summertime hydropower surpluses generated in Kyrgyzstan and Tajikistan to Afghanistan and Pakistan.IFC supported development of transport and municipal infrastructure, including two new tramway lines in Izmir in Turkey, improvements of heating systems in Timisoara and Botosani in Romania, and the award-winning transaction to build a new modern terminal at the Zagreb International Airport in Croatia.IFC delivered impact in less-developed and frontier areas of the region, investing almost $600 million.Multilateral Investment Guarantee Agency (MIGA)During fiscal year 2014, the Multilateral Investment Guarantee Agency (MIGA) provided support for six projects with $1.6 billion in political risk insurance and credit enhancement coverage in Europe and Central Asia (ECA). Through these guarantees, the Agency continued to bolster the region’s financial sector – a strong focus for MIGA in ECA. MIGA’s landmark support to Hungary’s Exim Bank this year represented the first use of the Agency’s credit enhancement product for a bond issue. “Support to middle-income countries is an important pillar of MIGA’s strategy,” said Keiko Honda, MIGA’s Executive Vice President and CEO. “Projects MIGA insures in the region increase banks’ ability to lend, diversify the kinds of financial services available to people and businesses, and attract new capital sources to keep industry moving forward.”-----------------------------------------------------------------* The World Bank Group institutions contributing to this financial outcome are: the World Bank, which is made up of the International Bank for Reconstruction and Development (IBRD), which provides financing, risk management products, and other financial services to middle-income countries; the International Development Association (IDA), which provides interest-free loans and grants to the poorest countries; the International Finance Corporation (IFC), which makes equity investments, and provides loans, guarantees, and advisory services to private-sector business in developing countries; and the Bank Group’s political risk insurance agency, the Multilateral Investment Guarantee Agency (MIGA).(1) IBRD provides financing, risk management products, and other financial services to countries.(2) IDA is the World Bank's fund that provides low-interest and interest-free credits and grants to 79 of the world's poorest countries. Show Less -
TIRANA, July 8, 2014— The Government of Albania and the World Bank conducted a joint portfolio review of World Bank supported projects on July 8, 2014. This exercise marked the initiation of a re... Show More +gular oversight process aimed at unlocking implementation issues to enable the projects to accomplish results. The meeting was chaired by the Minister Finance, Mr. Shkëlqim Cani. Ms. Tahseen Sayed, World Bank Country Manager for Albania led the World Bank team, while Mr. Erjon Luci led the discussions on project performance with Government and project officials from concerned ministries. The review meeting took stock of the implementation and results of 5 projects in the portfolio amounting to US$ 250 million. The review noted progress to date and focused on specific issues affecting performance. “It is important to ensure timely and efficient use of investment resources”, said the Minister of Finance Mr. Shkëlqim Cani. “The cross cutting and project specific issues require continuous and coordinated monitoring”.The review noted the need for the high level attention from line ministries to monitor progress and greater coordination and oversight on complex multi sectoral projects. Capacity constraints were specially highlighted in the area of procurement, including contract management, and monitoring and evaluation which persistently affect the progress under several projects. It was agreed to organize Ministry of Finance-led Joint portfolio reviews twice a year, and quarterly joint project-specific reviews with the Line Ministry. The next steps and a joint action plan were also agreed. “We believe that this systematic and regular portfolio oversight, complementing the ongoing technical and operational engagement, would contribute to further performance improvements”, said Ms.Tahseen Sayed, World Bank Country Manager for Albania. She welcomed the Ministry of Finance and line Ministries’ commitment to ensure timely implementation of the agreed next steps. Show Less -
WASHINGTON, July 8, 2014— The World Bank Group’s Board of Executive Directors today approved Euro 7.3 million in IBRD financing for the Environmental Services Project in Albania, which will benef... Show More +it farmers, forest associations, groups, and individuals in 310 rural communes and 2,980 villages across the country.The total project cost is Euro16.8 million, co-financed by a Trust Fund of Euro 7.3 million from the Swedish Government and a Trust Fund of Euro 2.2 million from the Global Environmental Facility (GEF).The project development objective is to support sustainable land management and increase communities’ incomes in erosion-prone rural upland areas. It seeks to open avenues for alternative livelihoods, and will contribute to sustainable utilization of wood and pasture products.“Reducing rural poverty and sustaining natural resources, especially forest resources, is an important Government priority. The Albanian forestry sector holds great potential to support national economic growth, rural employment, and environment preservation,” said Tahseen Sayed, World Bank Country Manager for Albania.Project interventions will promote the financial, economic, and institutional sustainability of land use and natural resources management. It will also help build capacities of Albanian farmers, community organizations, and central and local government institutions to efficiently use EU funding. Equal opportunities will be created for women and vulnerable groups to participate in environmental services.The Project will also contribute to the conservation of water resources and sustainability of water resources management by reducing the sedimentation in rivers and dams from land degradation. It is expected that more than one million will benefit indirectly through improved availability and quality of water and reduced flooding“The project builds on the experience gained in previous World Bank financed projects that supported environmental protection, community forest management, and carbon sequestration,” said Drita Dade, World Bank Senior Specialist for Natural Resource Management and Project Leader. “Its innovative features include the establishment of a forest management information system, and introduction of a competitive grants scheme to improve land use management and provide alternate livelihood opportunities to communities.”Since Albania joined the World Bank in 1992, a total of 82 projects comprising over US$1.8 billion of IDA credits and grants and IBRD loans have been provided to the country. Show Less -
IBRD Loan: EUR 7.3 millionTerms: Maturity = 20 years, Grace = 7 yearsGEF Grant: EUR 2.2 millionProject ID: P130492Project Description: The objective of the project is to support sustainable land manag... Show More +ement practices and increase communities' monetary and non-monetary benefits in targeted project areas which are mainly in erosion prone rural upland areas. More information Show Less -