Public Health and the World Bank

It is interesting to note that the lending policies of the World Bank, one of the world’s largest International Financial Institutions, are intended to do more than improving the economies of developing countries.  A large part of the World Bank’s mission is also to improve health, sanitation, and nutrition in these nations in order to protect the people of the nation from the impoverishing effects of illness and communicable diseases.  They are also very involved in funding health policy research, AIDS prevention campaigns, and reproductive health services.  The World Bank plays a huge role in international health-care funding through its loans; according to the website of the World Health Organization, its health-related activities are now larger than those of the WHO and UNICEF.  In 2002, the World Bank loans intended to help developing countries improve their health, nutrition, and population, known as HNP, totalled 1.4 billion US dollars, and this did not include additional funding of disease awareness and prevention programs.  The Bank’s requirements of the countries to which it lends money often include health sector reforms to improve public health activities.  The money that the World Bank provides, whether to fund public health projects or to improve the economy of a nation, is a loan that the nation is expected to repay.  This differs from most humanitarian organizations, such as the Red Cross, whose funds and services are generally donated.  However, many of the stated goals of the World Bank regarding public health improvement are similar to those of the WHO and many humanitarian NGO’s, and since they have a wider base of funds as well as some political sway over the counties that borrow their funds, they could arguably be more effective in long-term public health projetcs.  On the other hand, since voting power in the World Bank depends on contributions, dominant developed nations such as the United States, Great Britain, Canada, France, and Japan hold over 50% of the vote.  From a radical/Marxist perspective, one could argue that the World Bank’s efforts to influence the public health as well as economic sectors in developing countries only provide more of a foothold for bourgeoisie capitalist nations to exert control over the global poor.  So whether the World Bank resembles a humanitarian organization or a global hegemon in this instance seems to depend on your perspective.