Archives

Washington: Policies pushed by the World Bank and the International Monetary Fund (IMF) on debt-strapped African countries over the past two decades bear major responsibility for the region's health crisis, including the devastating spread of HIV/AIDS according to a new report by a major US-Africa advocacy group.

Africa Action, a merger of three grassroots anti-apartheid groups, charged that structural adjustment programmes (SAPs) backed by the Bank and Fund wreaked havoc on African health budgets and systems, while more recent efforts to rely on 'user fees' to fund health care have made it much more difficult for the majority of Africans who are poor to gain medical help. And while the bank has recently increased its health funding, for HIV/AIDS programmes in particular the staggering debt burden carried by most African countries, which so far has been inadequately addressed by the IMF and the Bank, represents a major obstacle to real progress, the report said.

'The policies of the World Bank and IMF have eroded Africa's healthcare systems and intensified the poverty of Africa's people,' said Salih Booker, executive director of Africa Action. 'These institutions must be made accountable for their role in causing the worst health crisis in human history, which Africa now faces.'

The report, Hazardous to Health: The World Bank and IMF in Africa, was released on 18 April, in advance of the 20-21 April spring meetings here of IMF and Bank governing committees. As in recent years, the meetings are attracting dozens of non-governmental organisations (NGOs) and globalisation activists long critical of SAPs and other Bank-IMF initiatives.

The two agencies, which together provide some $35 billion in loans to poor countries per year, have increasingly made their lending conditional on the implementation of policy reforms by borrowing countries.

Those policy conditions - which have often come in the form of SAPs - are generally intended to increase the integration of the borrowing country into the global economy and make it more attractive to private and foreign investment.

Among other measures, SAPs, which have been applied to more than 90 borrowing countries over the past two decades, are aimed at cutting government expenditures; privatising state-owned companies; liberalising trade and financial regimes; and expanding exports.

NGOs have long argued that such policies are ruinous to the poorer and more vulnerable sectors in developing countries, especially because governments under pressure to reduce spending usually begin with cuts to health, education, other social programmes and food subsidies on which the poor often depend.

That was the case in sub-Saharan Africa during the 1980s and early 1990s, according to the report, which noted that the health systems of many of these countries had recorded major successes in reducing infant and maternal mortality rates and training medical personnel and teachers in the years that followed independence from European powers.

A combination of rising world oil prices and interest rates and falling prices for their export commodities during the late 1970s and early 1980s however forced many of these same countries to go to the Bank and the Fund for loans needed to service a growing debt burden. Many studies conducted over the past decade have shown that SAPs have hurt the poorest sectors hardest by diminishing their access to basic services.

Indeed, a just-released seven-nation study on the impact of SAPs undertaken jointly by the Bank and an international group of NGOs known as the Structural Adjustment Participatory Review Initiative (SAPRI) Network concluded that 'poverty has been further deepened by the inability of the poor to access essential services at affordable rates'.

In africa, the impact on access to health care has been particularly dramatic, as even the Bank now concedes.In the 42 poorest countries in Africa for example spending on health care fell by 50 percent during the 1980s, by the end of which public health experts were beginning to recognise the potentially devastating impact of the HIV-AIDS pandemic in Africa.

- Third World Network Features/IPS.

News | Business | Features | Editorial | Security
Politics | World | Letters | Sports | Obituaries |

Produced by Lake House
Copyright 2001 The Associated Newspapers of Ceylon Ltd.
Comments and suggestions to :Web Manager