The World Bank: a force for poverty reduction or a bank that serves big business?

Most people interested in global health will be able to tell you something about the World Health Organisation.

The World Bank however is more difficult to pin down. The concept of a bank being involved in health care is, understandably, poorly grasped by many, including the majority of health workers. Kamran Abbasi's recent editoral in the British Medical Journal criticising the choice of Paul Wolfowitz was met with a flurry of 'rapid responses.' (read them here).

An example of one of these heated responses was :

I question the wisdom of devoting the valuable space of the BMJ and the time ( at least some ) of the readership on a subject which has only a peripheral connection to the , "...social,political and economic factors affecting health " which is a stated aim of the BMJ.

Another doctor countered: The medical fraternity should commend Dr Abassi for showing that doctors can properly talk about issues other than medicine rather than damning him.

Were they right? Is the leadership of the World Bank a topic which doctors and health care professionals around the world should worry about? I would agree with Kamran Abbasi on this point.

The World Bank is one of the world's largest donors for health care in the world's low and middle-income countries. The amount of funds it has available for health outstrips the resources of the WHO, though the two organisations work in partnership on several high profile intitiatives such as the Global Fund to fight AIDS, Tuberculosis and Malaria.

The forthcoming Global Health Watch's 'alternative health report' believes the World Bank deserves due attention because of the effects of the conditions attached to its loans on health, particularly of the world's poorest. The World Bank has, in previous years, come under heavy criticism from international health advocates such as UNICEF and grass roots activists alike.

I was glad to write an article about the World Bank to accompany Dr Abbasi's editorial when it was published in the Student BMJ. You can read it and the editorial in question here and make up your own mind.

If you want to read more about international institutions such as the World Bank, the World Trade Organisation, the World Health Organisation and their impact on global health, download free The Elective Pack: the medical student's guide to essential international health and development from http://www.ihmec.ucl.ac.uk.

Rebecca Hope
rebecca.hope@almamata.net