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Problems with the rural development and agriculture projects conducted by USAID in Afghanistan include overspending in 2009, followed by sharp cutbacks in 2010 and 2011 as budget cuts were made. In 2009 USAID made a grant of $300 million to Arlington based International Relief and Development (IRD) to help farmers in Kandahar and Helmand improve productivity over just one year, at the insistence of Richard Holbrooke. The focus was on paying for day labor jobs to clean canals, offer subsidized seeds to encourage switching from opium poppies, distributing tractors, and building gravel roads. Because many districts of the two provinces were considered unsafe for work, much of the money was concentrated on a few districts and in one year. As a result farmers in Kandahar got more seed than they needed and they in turn sold tons of seed and tractors in Pakistan for cash. A senior program official at IRD says it wasn't realistic to pour so much money in one year. But USAID officials say overspending and poor oversight made the program seriously flawed. There was also a difference in the views of the military and USAID on the value of day jobs. The U.S. military sees this as away of protecting its efforts, of literally protecting its flanks, as this keeps unemployed youth from joining the Taliban. At the same time senior USAID officials wanted to see multiple companies bid for the next $350 millon on a follow-on project. When the USAID team of specialists again awarded it to IRD, senior offficials at USAID decided to cancel the program. The program was then redesigned in the expectation that other companies would bid for it. In the meantime USAID gave IRD 3 quarterly extensions, the last expiring June 30, 2011. The US military sees the day labor program as crucial for its military efforts, so there is kind of an impasse with USAID reluctantly giving in. IRD meantime is shutting down activites in Helmand and will do this also in Kandahar probably by the end of May, as its contract has not been renewed because of problems with the program. USAID has a high staff turnover rate of 85% a year in Kabul which complicates things with the shifting priorities of different officials. Some programs are being scaled back- a job retraining program seen as requiring $125 million over 18 months is being scaled back to $40 million. Others such as a USAID project for coordinating disparate rural rehabilitation projects for $140 million is held back because of lack of agreement with the Afghan government about how it should proceed. In parts of Kandahar USAID had found several contractors doing the same work. See the groups on Dexter Filkins, and on Commander Adams, which touch on serious development issues and the war....

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Afghan warlord of a previous era Hekmatyar is proving difficult to buyout or win over, a strategy pursued with Iraqi insurgents. Younger Taliban insurgents are even harder to convert or buyout. THis raises questions about the chances of this kind of effort succeeding in Afghanistan, especially considering the "allergy" to foreign presence or foreign boots on the ground among Afghan people and the part religious fervour plays. Religious fervour was much less of a factor with Iraqi Sunni insurgents. Add to this the terrain differences, between desert and high mountains, makin the kind of house to house searches and securing of areas extremely difficult.

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U.S. Fed Governor Stein says he is is concerned about the costs of the accomodative stance taken by the Fed under Bernanke, even though he understands the reasons for the accomodative policies.

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Denmark's central bank sells $16.3 billion in Kroner in January 2015 alone to protect the peg to the euro at 7.46 Kroner. The move is designed to avoid deflation and preserve export competitiveness. Similiar moves were made by the Swiss central bank till it sold Swiss francs for about 80% of GDP, finally abandoning a peg setup in 2011. Denmark has sold Kroner for about 30% of GDP in comparison to the Swiss. The Danish situation is different from the Swiss, say analysts, as the Danish Krona may be slightly overvalued and should be closer to 8 to the euro, as the Swedish Krona is about 9.4 to the dollar.

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The devaluation of the Argentine peso from 9.8 to the dollar to 13 to the dollar in Dec. 2015 by president Macri is leading to higher inflation hurting the working class. The cutting of export taxes is helping farmers. Removing most currency controls is designed to help increase foreign investment by letting foreign companies freely repatriate profits. Also expected to be removed are bureaucratic procedures that limit imports of new equipment for manufacturers. Middle class voters see the moves helping the economy in the long run with new foreign investment and changing the outlook for investment. A former central bank president Mario Blejer points out that after 12 years of the previous Kirchner administration Argentina needs investment- by improving the outlook for investment and removing import controls the government plans to stimulate investment to lead to economic growth. Inflation is up 25% and Macri is keeping Mrs. Kirchner's price control programs in place to prevent a surge in inflation beyond the impact of the devaluation. ...

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Criticism of the US Federal Reserve's $600 billion quantitative easing decision and Bernanke's defense of the Fed's decision. Bernanke says this is no different than other moves in monetary policy made by the Fed, and the aim is to address deflationary trends and unemployment.

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Japan's situation, a strong yen and a stagnant economy, continues in 2010.

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Jens Weidmann, president of the Bundesbank, says central bank "independence is lost when monetary policy is tied to the wagon of fiscal policy and then loses control over prices." Weidmann and Merkel emphasize their continued opposition to euro-bonds. Merkel tells the German parliament on Dec. 14, 2011, euro-bonds "aren't suitable as a rescue measure." Italian prime minister Mario Monti, tells the Italian Senate: "the Italian government insisted heavily on euro bonds, which are not a back-door way to allow fiscal laxity but will boost growth." Monti says the euro bond proposals will be on the agenda for the EU summit in March. Italy auctioned its 5 year bonds at 6.47%, as German two year bonds had a yield of 0.29%, showing the widening divergence between the bonds of the two countries.

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Turkey is reviving its relations with Saudi Arabia and the UAE. Prince Bin Salman will visit Turkey as part of a remake of Turkey Saudi relations. Turkey's economic crisis has revived the relationship as Turkey badly needs aid for its economy. The pressure on emerging markets is increasing with US central bank raising rates reducing inflows of western money into Turkey even further. Prince Salman has already received visits from French and British leaders. He visited Jordan and Egypt this week and will now be in Ankara. In the summer he will visit Greece and Cyprus. Saudis are modernizing their economy changing culture in relationships of men and women, in women's rights and education, and broadening relationships with the world under Salman. There is an astonishing openness to science and technology in a drive to be modern. The old Saudi monarchy and conservative rule with ancient traditions is giving way to what the Saudis in the group under Salman see as the modernization of Europe and America in the 20th century using science and technology as what they would like to see in their own country. There is also a drive to think independently from the dogmatic positions of the past that have turned the Kingdom into an American dependency with no obligation or incentive to modernize its culture and be open to the world outside.  The US fought a war to ostensibly modernize a backward mountainous remote state as Afghanistan, while being perfectly comfortable with the old Saudi monarchies of the past that made little change in the ancient culture and tradition and in women's rights and education. Such were the contradictions in American policy and the failure to think anew. As president Lincoln said "as our case is new we must think anew, and act anew." President Biden will now visit Saudi Arabia to build a new relationship with an independent nation, which along with the UAE is bringing change to the Middle East through infrastructure development and modernization. Salman's modernization comes as the kingdom also faced a need to make a transition out of dependence on fossil fuels. Salman sees trips to Greece and Turkey as opening up to all sides. Saudis have good relations with Israel and Egypt another part of this openness. The US senses this, India has sensed this. India's Modi government  made sending the Oxford vaccines manufactured in India to Saudis a priority during 2021. The Indian example is also changing the way the UAE and Saudis see infrastructure development and modernization in the region. This is also changing the way the region is looking at itself. For decades Egypt lacking the resources to build infrastructure on its own has languished economically. A helping hand from the Saudis is changing Egypt. The entire rail system is being modernized with the latest technology from Siemens. The Saudis have stabilized the Egyptian economy with a $5 billion deposit in the Central Bank of Egypt. On June 21 Egypt and Saudis signed $7.7 billion in investment deals for infrastructure, logistics, port administration, food, industry, medicine, energy and technology. In the investments in Egypt some of the oil money going to Saudis with $100 per barrel oil price is going to an economy in Egypt that can easily absorb and make good use of the investment to modernize.   The influence of Saudi leverage in fossil fuels which drove the US relationship with Saudis since FDR is being replaced with an independent Saudi kingdom making decisions to modernize across the board in all aspects compared to one that favored a few American companies such as Exxon Mobil and ARAMCO or arms makers such as Boeing and Lockheed that helped recycle American money going to pay for Saudi fossil fuels back to America.    ...

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A whole range of issues can be seen in the debt crises in developing countries. The margin for error shrinks with poor governance, lack of honest assessment and transparency for finances, wars and conflicts within or outside the countries, living beyond their means, lack of focus on development, infrastructure that is unproductive or unaffordable including some Belt and Road Initiative infrastructure at higher interest rates. Countries that are dependent on overseas remittances, tourism, that were hit hard by the pandemic have seen their finances further weakened reducing the margin for error even more to the point that the smallest tipping point can lead to huge crises. Once the finances are weak all it takes is an external tipping point that creates serious crisis. The war in Ukraine with shortages of wheat, fertilizer and skyrocketing oil prices acted as that tipping point. Because this was a major blow the crises have a level of magnitude that is more than a payments crisis. One sees this in South Asia in Sri Lanka and Pakistan, and in the Middle East for countries such as Egypt and Tunisia shown in this WSJ report. It is now not simply a crisis but a crisis of great magnitude because in the case of Sri Lanka and Pakistan this WSJ report says that both countries foreign exchange reserves have dwindled to the point where they can pay for only one or two months of imports according to central bank data, analysts and IMF. This crisis has affected countries that were seeing steady foreign investment such as Turkey for decades, then a sharp falloff in foreign investment with a change in the climate for foreign investment. The crisis has taken the form of high inflation, significant depreciation of currency that makes imports costlier so that shrinking revenues from loss of remittances, tourism, or other sources will now have less value in supporting import needs. Lack of a credible path can delay setting a path out of the crisis. The $1.5 billion fuel and electricity subsidy made by the prime minister of Pakistan in late February was done without IMF approval leading to the IMF program having to be renegotiated. Lack of national political and cultural consensus on a solution simply makes it that much more difficult to find the way through it. In this regard South Korea was able to tackle the 1997 financial payments crisis effectively because of a national consensus. The situation in Egypt- Egypt has borrowed $20 billion from the IMF since 2016., placing it second to Argentina in aid from IMF since 1980's.  In 2020 and 2021 Egypt' government spent more than 40% of its revenue servicing its debt, and is forecast to do the same in 2022. The situation in Tunisia- A shortage of sugar, flour, and other critical supplies, and government delaying wage payments to civil servants. The government got $400 million in financing last month from the World Bank and hopes to secure a lifeline from the IMF. Compared to the period between the 2 World Wars the two bright spots are China and India where lessons of the past of civil wars, religious or political conflict, and poor governance, lack of knowledge of how the western countries industrialized and modernized, was replaced with the conviction that drives patient effort, courage in the face of adversity, honesty, and humility to learn including from western countries that have forged their own path through the same difficult road. The most difficult experiences have offered lessons which were learned- for South Korea the Korean War and invasion from the north, China the civil war and Japanese invasion, for India the partition of India and million of refugees. Stagnation from stumbled efforts also taught lessons, the Great Leap Forward in China, the License Raj with corruption in India.       ...

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WSJ looks at the changes in the way medicine should be practiced in the light of what we have learned from the pandemic.  Medicine practiced before the pandemic and still today relies mainly on a visit to the doctor or specialist who is short of time. There is a shortage of doctors. Patients have many illnesses as a result of decades of neglect of proper nutrition, and exercize habits. Obesity is at about 40% in the U.S. about 30% in the UK and 17% in France, and high also in other parts of the world. These high rates were unknown throughout history and result in many illnesses and increase by four times the vulnerability to the coronavirus. One authority in medicine calls obesity pouring gasoline on a fire for effects of the virus.  A doctor's appointment with doctors short of time with no coordination around a whole range of factors related to obesity, illnesses, health checkups, mental health, is now seen as a heavily handicapped way to practice medicine or for patient healthcare and wellbeing. The alternative is discussed here as the way forward. A  team will be responsible for a patient's care not just an individual doctor. The team would care for general health after a patient's checkup, cover individual illnesses, weight issues, mental health, exercize nutritional needs and other good healthcare habits. Instead of relying on doctors at a time of shortages of doctors the team would be led by nurse practitioners.  A nurse practitioner is someone with a bachelors degree and a masters degree or doctoral degree in nursing with 1000 hours of clinical training. Studies have shown that they are effective and even more effective than individual doctors. Today particularly with the problem of doctors with limited time compounded by the built up problems of decades of bad habits in nutrition and exercize and poor "cultural" habits getting entrenched, there has never been a greater need for a better way to practice real healthcare for a person's wellbeing. Particularly in rural areas with an even larger shortage of doctors the health practitioner led team will play a big role. Patients will under this setting receive more care virtually and get more followup care by phone and video messaging. The numbers tell the story- there are shortages of doctors in USA, Europe, Africa, Latin America and Asia. In the U.S. shortage of doctors is 55,000 projected to 2033 by Association of American Medical Colleges. There are 290,000 nurse practitioners licensed in the U.S. and 131,0000 physician assistants. The goal will be to get an adequate number of nurse practitioners licensed in this decade to take care of these teams. The pandemic has made virtual visits to doctors and nurse practitioners popular. Medicine reimbursement should and would be practiced on the basis of how well a patient is doing not on a fee for each micro service that is delivered. For this to happen the teams led by the nurse practitioner have to commit to patient education of the benefits from good practices and good habits for nutrition, exercize, caring for oneself. A doctor short of time is hardly the person to carry on this patient education which is where the major opportunities for a new system arise. The virtual care also provides a new medium for patient education and awareness of the risks of getting illnesses, preventive actions to be taken in advance. One approach being tested in California and Texas is for a monthly fee for patients more payments by health plans to doctors or healthcare teams if the patient is healthier. Additional health professionals are added to the team including health coaches, dietitians and medical assistants to increase its effectiveness in counseling and education and monitoring.  The nurse practitioner team approach is already being practiced in parts of the U.S. including the example of New Hampshire shown here, and is predicted to be the approach for primary care in the next decade. ...

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The WSJ looks at Elizabeth Warren's Medicare for All plan that marks a major shift for the U.S. economy.  Households would see their costs go down by $11 trillion, boosting their ability to spend on other goods and services. Because income and wealth was highly skewed in the past three decades in one direction, the spending capacity of lower and middle income households was pushed down. This and other similar plans would help restore a higher level of spending and with it an essential element of inflation of 2-3% to the U.S. economy which was missing in the last decade. This sets the tone for the kind of broad based recovery that happened after 1950 that strengthened America's middle class and made it the core of the economy, the core of the post World War II recovery in America and Europe. The plan would be paid for by higher taxes on corporations, tax rate of 21% for corporations going back up to 35%, and reverse depreciation schedules in the 2017 Republican tax law. The argument that this would reduce business investment does not hold that much says the WSJ because amid new trade tensions business investment has declined over the last 2 quarters, and has been sluggish overall. The other source for the estimated $13 to $20 trillion cost of Medicare for All plan of Elizabeth Warren is a 6% annual wealth tax on billionaires, in an attempt to have all pay their fair share and reduce wide disparities in wealth. Mark Zandl, chief economist of Moody's Analytics, says his sense is at the end of the day from a macroeconomic view- because $11 trillion in the hands of 80% of households who could boost spending after lagging behind in the last decade- the negative effect on business investment will be cancelled out by the higher consumer spending. The overall effect and today's context is infused in this analysis. Private insurance, premiums for insurance, and out of pocket cost that the public pays would disappear in this new system where all health payments pass through the government. Health insurance premiums paid by employers would convert into a new employer Medicare contribution to the government starting at an amount employers pay now and adjusting gradually toward national averages over time. Smallest businesses are exempted. Mr. Zandl says the most important aspect of this now is that Mrs Warren has shown that her plan's revenue sources match the cost so that the plan would not lead to deficits increasing and pushing interest rates higher, leading to negative effects on the economy. Republicans under Mr. Trump have paid little attention to expanded deficits caused by their tax law, and economists across the landscape have also shown less concern. Still attacks are made if the plans don't add up. For this reason a sound assessment in today's context of depressed consumers and an overall impact becomes essential. The WSJ quotes from a pre- assessment of Warren's plan by Simon Johnson, a Massachusetts Institute of Technology economist who co-wrote it with Mr. Zandl and Betsey Stevenson of the University of Michigan. What they point out is that putting cash in the pockets of the lower and middle class for spending makes a lot of sense today, and taking money out of the pockets at the way upper wealthy end,  does not contract the economy at all. Other effects they say are constructive by letting all workers get health coverage from the government instead of employers, this makes it easier to change jobs increasing labor mobility and productivity. A worker getting a better job and better utilization of skills could then shift without looking at the employer health care plan. Warren says there would be a five year transition so that workers in health care insurance industry can work in other insurance fields and in Medicare, no one would be left behind. The important thing being to build America's middle class again. ...