Study Claims World Bank Health Efforts Ineffective in Africa

by Rathi Manohar on  June 10, 2010 at 9:47 AM Research News
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A study claims that the efforts taken by the World Bank and other agencies in spending billions of dollars over health programmes in Africa have not been effective.
Study Claims World Bank Health Efforts Ineffective in Africa
Study Claims World Bank Health Efforts Ineffective in Africa

The survey funded by the Bill & Melinda Gates Foundation said the international lender and its partners' approach "is not achieving intended outcomes," especially against diseases like tuberculosis.

It criticized the so-called sector-wide approaches (SWAps) in which donors support a government for broad-based improvements in the country's health care system instead of more targeted aid.

The World Bank and partner agencies failed to do enough to control TB in the poorest countries in Africa between 2001 and 2008, said the report released by the ACTION (Advocacy to Control TB Internationally) group.

"Given the global economic crisis, now more than ever we must ensure that aid is good value for money and delivers planned results," said report co-author Richard Skolnik, a former manager of World Bank programs in South Asia.

"Unfortunately, this report shows that important support from the World Bank and its partner agencies for health in Africa is not improving the health of the poorest Africans as planned."

The report noted that there were 9.4 million new TB cases in 2008 and 1.8 million deaths linked to the disease, 44 percent of them in Africa. It said most TB patients in sub-Saharan Africa go undiagnosed, including many cases of drug-resistant TB.

The study said that instead of using TB-specific programs employed in other countries, the World Bank has relied on the broader model in Africa, even in countries where the rate of infection tops 20 percent.

The release of the report coincides with an upcoming replenishment meeting where the World Bank will plan for new funding from donors.

"The World Bank is fundraising this year from the perspective that its aid is needed now more than ever," said ACTION policy analyst Paul Jensen, who helped author the report.

"As donor governments provide financing for the Bank, they must demand that support for Africa deliver better health for the poorest people. Our report shows that donors may get a bigger bang for their buck elsewhere, unless substantial changes are made to the SWAps approach. "

Tuberculosis is the world's second leading infectious killer after HIV/AIDS, and the problem is growing with the emergence of new TB strains resistant to conventional drugs.

Source: AFP

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Rathi, please note that the World Bank has responded. It is also good to look at the latest Bank project that strengthens [among other things] TB diagnostic capacity across East Africa

Here's the Bank's response:

World Bank Response to Report by TB advocacy group ACTION
Washington DC, June 9, 2010—Tuberculosis (TB) and other communicable diseases are serious health and development challenges. The World Bank, its developing country clients, and their aid partners agree that it is better to prevent TB rather than treat it in Africa.

However, the Bank disagrees with the basic approach of “Aid without Impact, a new report by Advocacy to Control TB Internationally (ACTION). This one-dimensional report sets out to critique sector-wide approaches (SWAps) in Africa and in particular their impact on TB. It does not consider the Banks work on health in Africa as a whole. Yet ACTION makes the broad claim that the Bank health programs fail to improve health outcomes. This claim is based on weak methodology and a linear look at a complex picture involving many actors and multiple health sector reforms being implemented in parallel.

The Bank is focused on achieving tangible results. The Bank is committed to carefully monitor results on the ground and is widely acknowledged as a leading institution in the area of monitoring and evaluation. For example, the Bank has carried out hundreds of randomized trials of development innovations and invests heavily in building national capacity to measure socioeconomic progress.

A number of different partners are involved in SWAps in Africa. Notably, the World Bank provides a relatively small share of the financing—usually less than 20 percent—with many other donors contributing. For example, in the large Tanzania SWAp, the government is by far the largest financier. Of the numerous donors’ contribution to this SWAp, the World Bank only accounts for about 15 percent . Partners currently contributing to the pooled funds include Canada, Denmark, Germany (GTZ and KfW), Ireland, Netherlands, Norway, Switzerland, UNFPA, UNICEF and the WB. Other major donors outside the pool include DfID, USAID and the Global Fund.

The majority of World Bank health operations in Africa do not involve SWAps.


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