Neoliberalism and the World Bank’s Changing Approach to Health



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.


  1. Abbasi, K. (1999). The World Bank and world health: Interview with Richard Feachem. BMJ (Clinical Research ed.), 318(7192), 1206–1208.CrossRefGoogle Scholar
  2. Anand, S., & Hanson, K. (1998). DALYs: Efficiency versus equity. World Development, 26(2), 307–310.CrossRefGoogle Scholar
  3. Antia, N. (1994). The World Development Report 1993: A prescription for health disaster. Social Scientist, 22, 147–151.Google Scholar
  4. Bank, W. (1975). Health. Washington, DC: World Bank.Google Scholar
  5. Bank, W. (1980). Health sector policy paper (World Bank). Washington, DC.Google Scholar
  6. Bank, W. (1993). World development report: Investing in health. Washington, DC: World Bank.Google Scholar
  7. Bank, W. (1997). Sector strategy: Health, nutrition, & population. Washington, DC: World Bank Group.Google Scholar
  8. Bank, W. (2016). Remarks by World Bank Group President Jim Yong Kim at the Universal Health Coverage in Africa Side Event. August 26, 2016. Accessed 14 Jan 2017.
  9. Bryant, R. L., & Bailey, S. (1997). Third world political ecology. New York: Psychology Press.Google Scholar
  10. Chhibber, A., Batemen, D., Hutcheson, T., Krumm, K., Oliveros, G., Rocha, R., et al. (1991). The use of bank lending instruments: The inter-relation between adjustment and investment lending annual review of development effectiveness, February 7, 1991. World Bank Archives.Google Scholar
  11. Coburn, C., Restivo, M., & Shandra, J. M. (2015). The World Bank and child mortality in Sub-Saharan Africa. Sociology of Development, 1(3), 348–373.CrossRefGoogle Scholar
  12. Cornia, G. A., Jolly, R., & Stewart, F. (1987). Adjustment with a human face. Vol. 1: Protecting the vulnerable and growth. Oxford.Google Scholar
  13. Deacon, B. (2007). Global social policy and governance. Thousand Oaks: Sage.Google Scholar
  14. Fair, M. (2008). From population lending to HNP Results: The evolution of the World Bank’s strategies in health, nutrition and population. Washington, DC: World Bank.Google Scholar
  15. Giedion, U., Alfonso, E. A., & Díaz, Y. (2013). The impact of universal coverage schemes in the developing world: A review of the existing evidence. Washington, DC: World Bank.Google Scholar
  16. Hutchful, E. (1994). ‘Smoke and mirrors’: The World Bank’s social dimensions of adjustment (SDA) programme. Review of African Political Economy, 21(62), 569–584.CrossRefGoogle Scholar
  17. IHME. (2016). Development assistance for health database 1990–2015. Seattle, United States: Institute for Health Metrics and Evaluation.Google Scholar
  18. Irvine, A., Drew, P., & Sainsbury, R. (2013). ‘Am I not answering your questions properly?’ Clarification, adequacy and responsiveness in semi-structured telephone and face-to-face interviews. Qualitative Research, 13(1), 87–106.CrossRefGoogle Scholar
  19. Jayarajah, C., Branson, W., & Sen, B. (1996). Social dimensions of adjustment: World Bank experience, 1980–1993. Washington, DC.Google Scholar
  20. Kaasch, A. (2015). Shaping global health policy: Global social policy actors and ideas about health care systems. New York: Springer.CrossRefGoogle Scholar
  21. Lopez, A. D. (2005). The evolution of the Global Burden of Disease framework for disease, injury and risk factor quantification: Developing the evidence base for national, regional and global public health action. Globalization and Health, 1(1), 1.CrossRefGoogle Scholar
  22. McMichael, P. (2016). Development and social change: A global perspective. Thousand Oaks: Sage.Google Scholar
  23. Paalman, M., Bekedam, H., Hawken, L., & Nyheim, D. (1998). A critical review of priority setting in the health sector: The methodology of the 1993 World Development Report. Health Policy and Planning, 13(1), 13–31.CrossRefGoogle Scholar
  24. Peet, R. (2003). Unholy trinity: The IMF, World Bank and WTO. London: Zed Books.Google Scholar
  25. Ruger, J. P. (2005). The changing role of the World Bank in global health. American Journal of Public Health, 95(1), 60–70.CrossRefGoogle Scholar
  26. Shandra, C. L., Shandra, J. M., & London, B. (2011). World bank structural adjustment, water, and sanitation: A cross-national analysis of child mortality in Sub-Saharan Africa. Organization & Environment, 24(2), 107–129.CrossRefGoogle Scholar
  27. Shandra, C. L., Shandra, J. M., & London, B. (2012). The international monetary fund, structural adjustment, and infant mortality: A cross-national analysis of Sub-Saharan Africa. Journal of Poverty, 16(2), 194–219.CrossRefGoogle Scholar
  28. Shandra, J. M., Nobles, J., London, B., & Williamson, J. B. (2004). Dependency, democracy, and infant mortality: A quantitative, cross-national analysis of less developed countries. Social Science and Medicine, 59(2), 321–333.CrossRefGoogle Scholar
  29. Shandra, J. M., Shandra, C. L., & London, B. (2010). Do non-governmental organizations impact health? A cross-national analysis of infant mortality. International Journal of Comparative Sociology, 51(1–2), 137–164.CrossRefGoogle Scholar
  30. Stephens, N. (2007). Collecting data from elites and ultra elites: telephone and face-to-face interviews with macroeconomists. Qualitative Research, 7(2), 203–216.CrossRefGoogle Scholar
  31. UN (2015a). Sustainable development goal, goal 3: Ensure healthy lives and promote well-being for all at all ages. Accessed 11 Feb 2017.
  32. UN (2015b). Sustanaible development goals. Accessed 11 Feb 2017.
  33. Williamson, J. (2000). What should the World Bank think about the Washington Consensus? The World Bank Research Observer, 15(2), 251–264.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2017

Authors and Affiliations

  1. 1.Department of SociologyUniversity of WyomingLaramieUSA

Personalised recommendations