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Neoliberalism and the World Bank’s Changing Approach to Health

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Banking on Health

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Abstract

This chapter places the focus more fully on the World Bank and examines its changing approach to health. I trace the World Bank’s discussions of health in its policy documents, starting in 1980 when the World Bank formally committed to direct involvement in health projects and loans. I discuss criticisms of and the Bank’s response to these critiques of structural adjustment approaches that promote economic growth and often mandate cutbacks in public safety nets. I discuss the seminal 1993 World Development Report on health and the 2004 World Development report on improving services for poor people. I catalog an increasing emphasis in the Bank on outcomes and systems. I trace both continuity and shifts in the World Bank’s work in health, a return to the lost focus on equity in the interest of poverty amelioration and economic growth via investments in human capital, an enduring concern with efficiency, and relatively stable financial commitments to health since the 1990s. This chapter concludes by discussing the Bank’s recent renewed discursive commitment to universalism in health, questioning how and whether it will play out in deed.

Greater involvement by the Bank in the health sector is justified for several reasons. First, the Bank’s expertise in country programming and in sector analysis is needed to help ensure the success of emerging national policies to expand the coverage of health care… Second, significant involvement in the health sector is an important element of the Bank’s concern for alleviating poverty in the developing countries . An expanded policy for health operations is essential to deal effectively with the problems of poverty and low productivity among the poor.

—World Bank Health Sector Policy Paper 1980: 63–64, which formally committed the World Bank to lending in the health sector

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  1. Department of Sociology, University of Wyoming, Laramie, WY, USA

    Shiri Noy

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Noy, S. (2017). Neoliberalism and the World Bank’s Changing Approach to Health. In: Banking on Health. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-319-61765-7_2

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  • DOI: https://doi.org/10.1007/978-3-319-61765-7_2

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  • Publisher Name: Palgrave Macmillan, Cham

  • Print ISBN: 978-3-319-61764-0

  • Online ISBN: 978-3-319-61765-7

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