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This article considers the World Bank as a political thinker. This involves an interpretation of the values, methodologies, and theoretical references contained within the Bank's governance documentation. Generally, the Bank steers away from a serious engagement with the nature of states, or the dynamics of reform execution, even in its more detailed policy documents in reform areas such as administrative reform. But, by looking at the World Bank's involvement in African states, we can understand the ways in which the World Bank works with certain expectations concerning how reforms will work. The article critically analyses the Bank's 'political vision' by comparing it with prominent theories of African politics. The article concludes that the World Bank's governance agenda misses three pivotal aspects of African politics: the unity of political and economic power, the extreme openness of African states to external pressures, and the salience of historically-embedded cultural and political relations. These three points directly raise important questions about the prospects of good governance reforms in Africa, and the involvement of the Bank therein.

This article contributes to the discussion of the nature of external intervention in the reform processes of indebted states. Looking at administrative reform in Uganda and Tanzania, it is argued that external involvement in sub-Saharan Africa is becoming increasingly differentiated. For some states Ð including the two cases dealt with here Ð a key set of continuities and changes allows us to conceptualize a regime of post-conditionality. Post-conditionality regimes exist where extreme external dependence and economic growth produce a set of political dynamics in which external±national distinctions become less useful, in which there emerge a set of unequal mutual dependencies, and in which donor/creditor involvement in reform becomes qualitatively more intimate, pervading the form and processes of the state. Details of this dispensation are provided in an analysis of key ministries and key interventions by donors/ creditors. The article finishes by considering the contradictions of the postconditionality regime, and its prospects.

This Working Paper should not be reported as representing the views of the IMF. The views expressed in this Working Paper are those of the author(s) and do not necessarily represent those of the IMF or IMF policy. Working Papers describe research in progress by the author(s) and are published to elicit comments and to further debate. A key feature of the invoice-credit form of value-added tax (VAT) is that some businessesnotably exporters-will pay more tax on their purchases than is due on their sales, and so can seek refunds of excess credits from government. While refunding is straightforward in principle, serious problems arise in practice, including opportunities for fraud and corruption, and denial of refunds by governments with cash shortages. This makes the refund process the "Achilles heel" of the VAT. This paper examines the refund approaches of tax administrations in 36 developing, transitional, and developed countries. It evaluates the effectiveness of these approaches and suggests a model of best practice that takes into consideration compliance issues faced by countries during different stages of development.

Objective To assess the effects of aromatase inhibitors in women symptomatic of pain with endometriosis.Design A systematic review of published literature.Material and methods We conducted a comprehensive literature search to identify all the published observational and randomised studies evaluating the efficacy of aromatase inhibitors on pain associated with endometriosis. A combination of keywords was used to identify the maximum number of relevant citations in MEDLINE, EMBASE, CINAHL and the Cochrane Database.Outcome Pain relief, lesion size and quality of life.Results There were eight studies (137 women) evaluating outcomes of aromatase inhibitors. In case series/reports (seven studies, 40 women), aromatase inhibitors combined with progestogens or oral contraceptive pill or gonadotrophinreleasing hormone (GnRH) analogues reduced mean pain scores and lesion size and improved quality of life. An RCT (97 women) demonstrated that aromatase inhibitors in combination with GnRH analogues significantly improved pain (P < 0.0001) compared with GnRH analogues alone together with significant improvement in multidimensional patient scores (P < 0.0001). There was no significant reduction in spine or hip-bone densities.Conclusion Aromatase inhibitors appear to have a promising effect on pain associated with endometriosis, but the strength of this inference is limited due to a dearth of the evidence available.