Energy drinks are a fast-growing class of beverage containing high levels of caffeine and sugar. Advertising and marketing have been key to their growth in South Africa. This paper documents trends in energy drink consumption and energy drink advertising, and examines the relationship between exposure to energy drink advertising and consumption. Logistic regressions were estimated of categories of energy drink consumption on individual characteristics, as well as exposure to energy drink advertising. Exposure to advertising is measured by reported viewing of channels high in energy drink advertising. Energy drink consumption in South Africa is higher among younger, wealthier males. Spending on energy drink advertising is mostly focused on television. Targeted channels include youth, sports and general interest channels. Viewers of channels targeted by energy drink advertisers have higher odds of any and moderate levels of energy drinks consumption.

This paper estimated the distributional impact of the main elements of general government taxation and spending in South Africa, applying fiscal incidence analysis to the 2010/11 IES (Stats SA 2012b). On the tax side, it analyzed the incidence of 64.5 percent of total tax revenue, including PIT, VAT, excise taxes on alcohol and tobacco, and the general fuel levy. On the expenditure side, it analyzed the incidence of 43 percent of general government expenditures, focused on social spending including direct cash transfers, free basic services, and health and education spending.The results show that South Africa uses its fiscal instruments to significantly reduce market income inequality and poverty through a progressive tax system and highly progressive social spending. The rich in South Africa bear the brunt of taxes that we examined, and the government redirects these resources to the poorest in society to raise their incomes. Only the top three deciles of the income distribution pay more in taxes than they receive in transfers. As a result, the fiscal system lifts some 3.6 million individuals out of poverty. Despite the large fiscal redistribution, however, South Africa remains one of the most unequal countries in the world. More can and should be done to improve the quality of education and health service delivery.

This paper estimated the distributional impact of the main elements of general government taxation and spending in South Africa, applying fiscal incidence analysis to the 2010/11 IES (Stats SA 2012b). On the tax side, it analyzed the incidence of 64.5 percent of total tax revenue, including PIT, VAT, excise taxes on alcohol and tobacco, and the general fuel levy. On the expenditure side, it analyzed the incidence of 43 percent of general government expenditures, focused on social spending including direct cash transfers, free basic services, and health and education spending.The results show that South Africa uses its fiscal instruments to significantly reduce market income inequality and poverty through a progressive tax system and highly progressive social spending. The rich in South Africa bear the brunt of taxes that we examined, and the government redirects these resources to the poorest in society to raise their incomes. Only the top three deciles of the income distribution pay more in taxes than they receive in transfers. As a result, the fiscal system lifts some 3.6 million individuals out of poverty. Despite the large fiscal redistribution, however, South Africa remains one of the most unequal countries in the world. More can and should be done to improve the quality of education and health service delivery.

BackgroundSince 2000, international funding for HIV has supported scaling up antiretroviral therapy (ART) in sub-Saharan Africa. However, such funding has stagnated for years, threatening the sustainability and reach of ART programs amid efforts to achieve universal treatment. Improving health system efficiencies, particularly at the facility level, is an increasingly critical avenue for extending limited resources for ART; nevertheless, the potential impact of increased facility efficiency on ART capacity remains largely unknown. Through the present study, we sought to quantify facility-level technical efficiency across countries, assess potential determinants of efficiency, and predict the potential for additional ART expansion.MethodsUsing nationally-representative facility datasets from Kenya, Uganda and Zambia, and measures adjusting for structural quality, we estimated facility-level technical efficiency using an ensemble approach that combined restricted versions of Data Envelopment Analysis and Stochastic Distance Function. We then conducted a series of bivariate and multivariate regression analyses to evaluate possible determinants of higher or lower technical efficiency. Finally, we predicted the potential for ART expansion across efficiency improvement scenarios, estimating how many additional ART visits could be accommodated if facilities with low efficiency thresholds reached those levels of efficiency.ResultsIn each country, national averages of efficiency fell below 50 % and facility-level efficiency markedly varied. Among facilities providing ART, average efficiency scores spanned from 50 % (95 % uncertainty interval (UI), 48–62 %) in Uganda to 59 % (95 % UI, 53–67 %) in Zambia. Of the facility determinants analyzed, few were consistently associated with higher or lower technical efficiency scores, suggesting that other factors may be more strongly related to facility-level efficiency. Based on observed facility resources and an efficiency improvement scenario where all facilities providing ART reached 80 % efficiency, we predicted a 33 % potential increase in ART visits in Kenya, 62 % in Uganda, and 33 % in Zambia. Given observed resources in facilities offering ART, we estimated that 459,000 new ART patients could be seen if facilities in these countries reached 80 % efficiency, equating to a 40 % increase in new patients.ConclusionsHealth facilities in Kenya, Uganda, and Zambia could notably expand ART services if the efficiency with which they operate increased. Improving how facility resources are used, and not simply increasing their quantity, has the potential to substantially elevate the impact of global health investments and reduce treatment gaps for people living with HIV.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-016-0653-z) contains supplementary material, which is available to authorized users.

This paper studies the effect of unconditional teacher salary increases on teacher and student outcomes. To study the issue, we evaluate the rural hardship allowance in Zambia, which corresponds to a salary increase of 20%. This allowance is allocated to schools on the basis of a distance criterion allowing us to use a regression discontinuity design. We use administrative data from 2004 to 2015 on school, teacher characteristics and test scores. The administrative data are complemented with a telephone survey of schools close to the eligibility threshold. We find that crossing the threshold increases the share of teachers obtaining the allowance by 40%. Because of some non‐compliance with the allocation rule, our estimates are fairly imprecise. Focusing on provinces with better compliance we find some, albeit weak, evidence that the allowance increases the stock of teachers. We, however, find no effects on teacher characteristics or on student test scores.