Abstract
Healthcare policy has long been impacted by actors and governance processes outside of the control of national jurisdictions and governments. As part of neoliberal reform processes promoted by various multilateral organizations in the aftermath of the 1982 debt crisis, especially the international financial institutions (IFIs) (the World Bank and the International Monetary Fund, IMF), social policy choices have been increasingly circumscribed by structural adjustment programmes (SAPs). In consequence, the World Bank and the IMF became important agenda-setters in global healthcare policy. While some of the emerging criticisms of SAPs undermined the authority and legitimacy of the IFIs throughout the 1990s and 2000s, with the onset of the global financial crisis in 2008, their relevance has (again) increased significantly, especially when they were made the main vehicles to fight the global financial crisis by the Group of 20 countries (G20). Yet, the role of the IFIs in the setting of global healthcare policy, especially in low-income countries, often remains unacknowledged in debates about healthcare policy and governance.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Arrow, K. J. (1963) ‘Uncertainty and the Welfare Economics of Medical Care’, The American Economic Review, 53(5), 941–73.
Bartlett, S. (2011) ‘Poverty Reduction Strategy Papers and Their Contribution to Health: An Analysis of Three Countries’, McGUl Journal of Medicine, 13(2), 22–7.
Bradshaw, S. and B. Linneker (2003) ‘Civil Society Responses to Poverty Reduction Strategies in Nicaragua’, Progress in Development Studies, 3, 147–58.
Breman, A. and C. Shelton (2001) Structural Adjustment and Health: A Literature Review of the Debate, Its Role-Players and Presented Empirical Evidence, Commission on Macroeconomics and Health (Geneva: World Health Organization).
Cammack, P. (2004) ‘What the World Bank Means by Poverty Reduction, and Why It Matters’, New Political Economy, 9(2), 189–211.
Dijkstra, G. (2011) ‘The PRSP Approach and the Illusion of Improved Aid Effectiveness: Lessons from Bolivia, Honduras and Nicaragua’, Development Policy Review, 29(si), 110–33.
Eurodad and Third World Network (TWN) (2010) Standing in the Way of Development? A Critical Survey of the IMF’s Crisis Response in Low Income Countries, A Eurodad and Third World Network Report (Berlin: Heinrich Böll Foundation).
G20 (2009) London Summit — Leaders’ Statement, 2 April 2009, at: http://www.g20.utoronto.ca/2009/2009communique0402.pdf, accessed 15 January 2012.
Goldsborough, D. (2007) Does the IMF Constrain Health Spending in Poor Countries? Evidence and an Agenda for Action, Report of the Working Group on IMF Programs and Health Spending (Washington, DC: Center for Global Development).
Hossen, M. A. and A. Westhues (2012) ‘The Medicine That Might Kill the Patient: Structural Adjustment and Its Impacts on Healthcare in Bangladesh’, Social Work in Public Health, 27(3), 213–28.
Houston, M., M. Day, M. de Lago and J. Zaracostas (2011) ‘Health Services Across Europe Face Cuts as Debt Crisis Begins to Bite’, British Medical Journal, 343 (5266), 1–2.
International Monetary Fund (2006) Aid Scaling Up: Do Wage Bill Ceilings Stand in the Way?, WP/06/106, at: http://www.imf.org/external/pubs/ft/wp/2006/wp06106.pdf, accessed 15 January 2012.
International Monetary Fund (2009a) The IMF Response to the Global Crisis: Meeting the Needs of Low-Income Countries, Background Note (Washington, DC: IMF).
International Monetary Fund (2009b) Creating Policy Space — Responsive Design and Streamlined Conditionality, in Recent Low-Income Country Programs (Policy and Review Department, Washington, DC: IMF).
Koivusalo, M., T. Schrecker and R. Labonté (2008) Globalization and Policy Space, Globalization Knowledge Network (Geneva: World Health Organization Commission on Social Determinants of Health).
Labonté, R. and R. Torgerson (2005) ‘Interrogating Globalization, Health and Development: Towards a Comprehensive Framework for Research, Policy and Political Action’, Critical Public Health, 15(2), 157–79.
Laterveer, L., L. W. Messen and A. S. Yazbeck (2003) ‘Pro-Poor Health Policies in Poverty Reduction Strategies’, Health Policy and Planning, 18(2), 138–45.
Lister, J. and R. Labonté (2009) ‘Globalization and Health Systems Change’, in R. Labonté, T. Schrecker, C. Packer, and V. Runnels (eds.), Globalization and Health: Pathways, Evidence and Policy (New York: Routledge), 181–212.
Lugalla, J. L. (1995) ‘The Impact of Structural Adjustment Policies on Women’s and Children’s Health in Tanzania’, Review of African Political Economy, 22(63), 43–53.
McGregor, S. (2001) ‘Neoliberalism and Healthcare’, International journal of Consumer Studies, 25(2), 82–9.
Mladovsky, P., D. Srivastava, J. Cylus, M. Karanikolos, T. Evetovits, S. Thomson and M. McKee (2012) Health Policy Response to the Financial Crisis and other Health System Shocks, Policy Summary S (Copenhagen: WHO Regional Office for Europe).
Mohindra, K. S. (2007) ‘Healthy Public Policy in Poor Countries: Tackling Macro-Economic Policies’, Health Promotion International, 22(2), 163–9.
Mouelhi, M. and A. Ruckert (2007) ‘Ownership and Participation: The Limitations of the Poverty Reduction Strategy Paper Approach’, Canadian Journal of Development Studies, 28(2), 27–292.
Obansa, S. A. (2005) ‘Impact of Structural Adjustment Program on the Nicaraguan Economy’, Africa Update Newsletter, XII (2), 1–5.
Ortiz, I., J. Chai and M. Cumming (2011) Austerity Measures Threaten Children and Poor Households: Recent Evidence in Public Expenditure from 128 Developing Countries, Social and Economic Policy Paper (New York: UNICEF).
Ortiz, I. and M. Cumming (2013) The Age of Austerity: A Review of Public Recent Evidence in Pu bli c Exp en di tu re a n d A dju s tin en t Mea su res from 181 Cou n tri es (New York: IP D an d South Centre).
Peabody, J. W. (1996) ‘Economic Reform and Health Sector Policy: Lessons From Structural Adjustment Programs’, Social Science & Medicine, 43(5), 823–35.
Reeves, A., M. McKee, S. Basu and D. Stuckler (2013) ‘The Political Economy of Austerity and Healthcare: Cross-National Analysis of Expenditure Changes in 27 European Nations 1995–2011’, Health Policy, 115(1), 1–8.
Reubi, D. (2013) ‘Health Economists, Tobacco Control and International Development: On the Economisation of Global Health Beyond Neoliberal Structural Adjustment Policies’, BioSocieties, 8, 205–28.
Rowden, R. (2012) ‘Advocates of Global Health Aid Must Call for a New Development Model’, in T. Schrecker (ed.), The Ashgate Research Companion to the Globalization of Health (Famham: Ashgate), 229–44.
Ruckert, A. and R. Labonté (2012) “The Financial Crisis and Global Health: The International Monetär)’’ Fund’s Policy Response’, Health Promotion International, 28(3), 357–66.
SAPRIN — Structural Adjustment Participatory Review International Network (2003) The Policy Roots of Economic Crisis and Poverty (London: SAPRIN).
Shandra, C. L., J. M. Shandra and B. London (2012) ‘The International Monetär)’’ Fund, Structural Adjustment, and Infant Mortality: A Cross-National Analysis of Sub-Saharan Africa’, Journal of Poverty, 16, 194–219.
Simon, D. (2008) ‘Neoliberalism, Structural Adjustment and Poverty Reduction Strategies’, in V. Desai and R. B. Potter (eds.), The Companion to Development Studies (London: Routledge), 86–92.
Stiglitz, J. (1999) ‘More Instruments and Broader Goals: Moving Toward the Post-Washington Consensus’, Revista deEconomia Politica, 19(1), 94–120.
Stuckler, D. and S. Basu (2009) ‘The International Monetary Fund’s Effects on Global Health: Before and After the 2008 Financial Crisis’, International Journal of Health Services, 39(4), 771–81.
Stuckler, D. and M. McKee (2012) ‘There Is an Alternative: Public Health Professionals Must not Remain Silent at a Time of Financial Crisis’, The European Journal of Public Health, 22(1), 2–3.
Taylor, S. (2007) ‘Aid and Health’, Globalization and Health Knowledge Network Research Papers, at: http://www.globalhealthequity.ca/webfm_send/13, accessed 20 December 2013.
World Bank (1993). World Development Report 1993: Investing in Health (New York: Oxford University Press).
World Bank (2001). Poverty Reduction Strategy Paper Sourcebook (Washington, DC: The International Bank for Reconstruction/ World Bank).
World Bank (2005) Economic Growth in the 1990s: Learning from a Decade of Reform (Washington, DC: The International Bank for Reconstruction and Development/ World Bank).
World Bank and World Health Organization (2003). High-Level Forum on the Health Millennium Development Goals: Resources, Aid Effectiveness, and Harmonization, at: http://www.who.int/hdp/aid/hlf_resources.pdf?ua=l, accessed 18 January 2014.
WHO — World Health Organization (2004) PRSPs and Their Significance for Health: Second Synthesis Report, at: http://www.who.int/hdp/en/prsp.pdf, accessed 1 October 2013.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Copyright information
© 2015 Arne Ruckert, Ronald Labonté and Rylan H. Parker
About this chapter
Cite this chapter
Ruckert, A., Labonté, R., Parker, R.H. (2015). Global Healthcare Policy and the Austerity Agenda. In: Kuhlmann, E., Blank, R.H., Bourgeault, I.L., Wendt, C. (eds) The Palgrave International Handbook of Healthcare Policy and Governance. Palgrave Macmillan, London. https://doi.org/10.1057/9781137384935_3
Download citation
DOI: https://doi.org/10.1057/9781137384935_3
Publisher Name: Palgrave Macmillan, London
Print ISBN: 978-1-349-48112-5
Online ISBN: 978-1-137-38493-5
eBook Packages: Palgrave Social Sciences CollectionSocial Sciences (R0)