The World Bank: Hazardous to Africa’s Health

Via: Africa Action

"This newly-updated fact sheet argues that the policies imposed by the World Bank on African governments have devastated Africa's health care systems and fueled the fire of HIV/AIDS..."

ARTICLE EXCERPTS:
What does the World Bank do in Africa?
The World Bank uses conditions attached to its loans to effect economic policy changes in African countries. These changes cut back government services to the people, reduce trade barriers, and maintain economies as sources of cheap raw materials and cheap labor for multinational corporations. The results have been a decline in average incomes, worsening conditions of poverty, and an increase in Africa's foreign debt. Africa Action estimates that, between 1970 and 2003, African countries received about $540 billion in loans, and paid back $580 billion in debt service, yet the continent is still saddled with over $200 billion in external debt. The current debt relief framework – the Heavily Indebted Poor Countries (HIPC) Initiative – has proven to be an inadequate response to Africa’s debt crisis. Even the debt cancellation deal reached at the 2005 “Group of 8” summit is insufficient to address the continent’s debt burden, as it excludes the majority of African countries and the majority of Africa’s debt. The deal also establishes that countries must continue to fulfill World Bank conditions before becoming eligible for future debt cancellation

How has the World Bank undermined Africa's health?

* Forced cut-backs in spending on health care
Over the past two decades, the World Bank has forced African governments to reduce government spending on health care. This has resulted in the closure of hundreds of hospitals and clinics, and has left the remaining medical facilities under-staffed and lacking in essential supplies. Under the tutelage of the World Bank and IMF, in the 42 poorest countries in Africa, spending on health care fell by 50% during the 1980s. The World Health Organization (WHO)’s annual report for 2006 warns of a worldwide shortage of medical workers of over 4 million affecting 57 countries, 36 of which are in sub-Saharan Africa.

* Privatization of health care services and introduction of "user fees"
The World Bank has forced African governments to privatize government-held services such as health care, and to introduce "user fees" for receiving basic care. This has created a two-tier system, and has denied access to health care to the poor, who cannot afford to pay these fees. In countries like Uganda and Zambia, where “user fees” have recently been eliminated, health care has been made available to millions of people who were previously denied such access as a result of World Bank and IMF prescriptions.

* Demanding debt repayments take precedence over health
Across Africa, many governments are still forced to spend more money on debt repayments to the World Bank and rich country governments each year than they do on health care for their own populations. African countries are required to prioritize meeting World Bank and IMF conditions over meeting the basic needs of their own people. In 2003, African countries paid over $25 billion in debt service to creditors even as some 2.3 million Africans lost their lives to HIV/AIDS that same year.

* Intensification of poverty and underdevelopment
The World Bank's structural adjustment programs have not fostered economic growth and development in Africa, but have instead exacerbated conditions of poverty, food insecurity, and ill-health. There has been an increase in the spread of poverty-related diseases such as tuberculosis, and malnutrition has led to weakened immune systems, particularly among children. Since the 1980s, the devastating spread of HIV/AIDS has been facilitated by widespread poverty and the lack of access to health care facilities. Some 26 million Africans are currently living with HIV/AIDS, and more than 3 million new infections occurred in 2005.