>Delivered-To: [EMAIL PROTECTED] >Date: Thu, 12 Oct 2000 08:52:04 -0400 (EDT) >From: Robert Weissman <[EMAIL PROTECTED]> >To: [EMAIL PROTECTED] >MIME-Version: 1.0 >Subject: [corp-focus] IMF/World Bank: Stupid, Cruel, Brutal >Sender: [EMAIL PROTECTED] >X-Mailman-Version: 1.1 >Precedence: bulk >List-Id: Sharp-edged commentary on corporate power ><corp-focus.lists.essential.org> >X-BeenThere: [EMAIL PROTECTED] >Status: > >IMF/World Bank: Stupid, Cruel, Brutal >By Russell Mokhiber and Robert Weissman > >There is no policy of the International Monetary Fund (IMF) and World Bank >that is more stupid, cruel and brutal than the insistence that poor >countries charge fees for children to attend school and for people to >access basic health services. > >The IMF and World Bank condition loans to impoverished countries on the >adoption of Contract with America-style "structural adjustment" policies. >User fees -- also known as community financing, cost sharing or cost >recovery -- are often one part of the structural adjustment policy >package. > >In passing an appropriations amendment in July that would stop future >funding for the IMF and the World Bank if the two lending agencies do not >stop imposing user fees for basic healthcare and education services, the >U.S. House of Representatives has taken an important step toward ending >this callous and wrongheaded policy. > >Unfortunately, the Treasury Department, anxious to avoid any >appropriations limitations for its IMF and World Bank policy arms, is >working to block inclusion of the amendment in the final foreign >operations appropriations bill. As administration officials and members of >Congress and their staffs negotiate the terms of a final foreign >operations appropriations bill, the educational opportunity and health of >millions of people in the world's poorest countries hang in the balance. > >The evidence accumulated from around the world over the last decade is >quite clear. User fees for education lower school attendance rates, >especially among young girls. User fees for primary health services deny >access to care and preventative treatment for the poor, leading to the >spread of unnecessary and preventable death and disease. And user fee >"exemptions" for the poor, or sliding payment scales, routinely fail due >to administrative problems, corruption, inadequate notice to the poor or >other difficulties. > >* In Gambia, in primary health care program villages with insecticide >provided free of charge, bednet impregnation -- for malaria prevention -- >was five times higher than in villages where charges were introduced. >Households consistently cited lack of money as the main reason they chose >not to dip bednets. > >* Introduction of a 33 cent fee for visits to Kenyan outpatient health >centers led to a 52 percent reduction in outpatient visits. After the fee >was suspended, visits rose 41 percent. In Papua New Guinea, the >introduction of user fees led to a 30 percent decline in outpatient >visits. Studies in Niger have found that user fees extend the period that >patients wait before seeking outpatient care. > >* UNICEF reports that in Malawi, the elimination of modest school fees and >uniform requirements in 1994 caused primary enrollment to increase by >about 50 percent virtually overnight -- from 1.9 million to 2.9 million. >The main beneficiaries were girls. Malawi has been able to maintain near >full enrollment since that time. > >* In India, reports Dr. Vineeta Gupta, general secretary of Insaaf >International, a Punjab, India-based organization, a World Bank-inspired >system which is supposed to exclude the poor from healthcare charges fails >in practice due to corruption and administrative difficulties, denying the >poorest Indians access to healthcare services. > >The purported logic of education and healthcare user fees is that payments >from children's families and sick people will enable government service >agencies to provide services to more people. > >But this is a twisted rationale, which should be rejected on both >principled and practical grounds. As an issue of principle, access to >primary education and healthcare is a right that should not be conditioned >on ability to pay. > >In practical terms, the real-world record shows that user fees deny >children educational opportunity and people of all ages access to basic >health services. Charges typically generate little revenue in any case. So >the ultimate result of user fees is service denial, not expansion. > >The IMF/Bank user fee rationalization presents a false choice: even poor >country governments have multiple sources of potential revenue there are >ways to increase funding for basic services without imposing charges. Most >importantly, the real way to free up resources for education and >healthcare is for the World Bank and IMF, without delay, to use their >existing assets to cancel the debts owed them by poor countries. > >There are no significant corporate or monied interests served by the >imposition of user fees in desperately poor countries. The IMF and World >Bank continue to support them out of a dogmatic commitment to a marketized >ideology that refuses to concede to empirical refutation. The Treasury >Department is opposing corrective legislation so that it can preserve its >control of the IMF and World Bank without Congressional interference. > >These are shameful counterweights to the humanitarian imperative of >removing user fees. Whether the humanitarian claim prevails will depend, >in significant part, on whether U.S. citizens act now to put an end to >user fee nightmare. > > >Russell Mokhiber is editor of the Washington, D.C.-based Corporate Crime >Reporter. Robert Weissman is editor of the Washington, D.C.-based >Multinational Monitor. They are co-authors of Corporate Predators: The >Hunt for MegaProfits and the Attack on Democracy (Monroe, Maine: Common >Courage Press, 1999). > > > >_______________________________________________ > >Focus on the Corporation is a weekly column written by Russell Mokhiber >and Robert Weissman. Please feel free to forward the column to friends or >repost the column on other lists. If you would like to post the column on >a web site or publish it in print format, we ask that you first contact us >([EMAIL PROTECTED] or [EMAIL PROTECTED]). > >Focus on the Corporation is distributed to individuals on the listserve >[EMAIL PROTECTED] To subscribe to corp-focus, send an e-mail >message to [EMAIL PROTECTED] with the text: subscribe > >Focus on the Corporation columns are posted at ><http://www.corporatepredators.org>. > >Postings on corp-focus are limited to the columns. If you would like to >comment on the columns, send a message to [EMAIL PROTECTED] or >[EMAIL PROTECTED] >
