Funding Global Improvements at the World Bank

Author: Deborah Jones

Last Tuesday's Global Human Health Symposium lecture "Alleviating Poverty, Improving Health: The Work of the World Bank," proved to be one of the most controversial of the week. Dozens of students crowded the Robert A. Jones '59 Conference Room to hear World Bank Group Economist Varun Gauri speak on his organization's approach to promoting increased health care in developing nations and to grill him on some of the institution's most contentious policies.

Gauri, aware that many people are unfamiliar with the Bank's work, began his lecture by explaining its role as a public international financial institution comprised of 180 nations that offers grants and loans to both governmental and non-governmental organizations for development projects. He also noted that the Bank has responded to the ideas and criticisms of others during its 58 years of existence, taking care to build sustainable social along with capitalistic development into its agenda. Indeed, Gauri's speech included a Power Point presentation of graphs that showed how the Bank has adjusted its budget and distribution tactics so that it now gives an average of $1.3 billion in new lending annually for health, nutrition and population projects (HNP), of which 50 percent goes to non-governmental organizations, often operating at the grassroots level.

However, the gasps from the audience suggest that his graphs were perhaps most effective when it came to demonstrating the health crises afflicting developing nations. Jaws dropped when Gauri showed how life expectancy in Zimbabwe dropped from approximately 62 in the early 1980s to just about 38 today as a result of autoimmune deficiency syndrome (AIDS). People shuddered upon seeing how AIDS is ravaging the age distribution in Botswana and leaving hundreds of thousands of children without parents.

"Most people [facing such health obstacles] aren't really able to plan a life," Guari explained. He went on to discuss the merits of promoting primary and secondary education, ensuring access to clean drinking water and nutritious food and increasing government spending on health care in ending epidemics of poverty and disease in less developed countries. Guari also took time to recognize the importance of curbing preventable illnesses affecting wealthier nations, particularly cancers induced by tobacco use.

The tone of the afternoon, however, took a substantial shift come question and answer time. Students bombarded the economist with inquiries about the Bank's policy of structural adjustment (in which the receiving country must often make substantial changes to its government or economy before getting its promised aid) and the amount of debt many lesser-developed countries find themselves in. Of particular concern was the Bank's imposition of user fees at public health clinics and respect for environment and culture during the developmental process. Some members of the audience also questioned Guari's assertion that world health is still a "moral" issue and not yet a "political" one, suggesting that it is impossible to separate the two.

"I knew a speaker from the World Bank would be slightly controversial, but I just knew that it was important to hear the economic perspective [on global human health]," Michael Azzara '02.5, organizer of the event, explained.

Although a number of the people present publicly questioned the Bank's agenda and effectiveness, the opposition remained fairly quiet. Peaceful protesters posted a few flyers around Proctor Hall and a banner on the tennis court fence across from the Robert A. Jones '59 House that declared "neo-liberalism breeds dis-ease." They also handed out information promoting reform at the lecture, which Azzara asked them to refrain from doing until after the speech was over as a courtesy to the speaker and the audience.

Ultimately, reception of Guari and his willingness to directly answer students' questions seemed positive. "I thought [Guari] did a good job of showing what the Bank is and isn't," said Ben Gore '04. "It is a bunch of people trying to do well and not succeeding often enough for a variety of complex reasons; it isn't an organization that knows how to save the world and is hard at work doing it. You'd be surprised how often Bank people take the second stance."