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On April 1, , Robert S. McNamara became president of the World Bank.
The Birth of Development: How the World Bank, Food And Agriculture Organization, And World Health Organization Have Changed the World, (New. The birth of development: how the World Bank, Food and Agriculture Organization, and World Health Organization changed the world, [ ].
During his long tenure ending June , he transformed the bank by moving poverty reduction to center stage. This shift began in the s, when orthodox views of development 35 —focusing on economic growth—were questioned, and studies found that physical capital played a smaller-than-expected role in economic growth. These development ideas made sense to McNamara. They both appealed to him personally and were consistent with his own personal history, prior loyalties, and experience with the US government and the private sector.
Moreover, internal bank studies and country mission reports revealed that hundreds of millions of people in developing countries were living in extreme poverty and lacking health clinics, primary and secondary schools, and safe drinking water. By , McNamara had established the Population Projects Department in the World Bank and continued to advocate population control in speeches and dialogue with governments. In June , he requested a health policy paper from bank staff. It also involved the private sector and nongovernmental organizations.
Onchocerciasis is caused by a parasitic worm and is spread by black flies that breed in fast-flowing water. The group determined they could stop flies from transmitting the disease by treating the water flow. The OCP also established a program of insecticide application to prevent the growth of black flies. Because the bank was not notably engaged in health issues at the time, its decision to tackle river blindness was a turning point. The program, which continued for some 30 years, protected an estimated 34 million people from river blindness and cleared nearly 25 million hectares of land for agricultural use.
In , the bank established a health department and a policy to consider funding stand-alone health projects, as well as health components in other projects. These efforts in the health arena were influenced by the growing recognition in academic and policymaking development discourse that the basic needs approach was essential to poverty reduction.
In his address to the annual general meeting of the board of governors in Manila, the Philippine Islands, he underscored the need to reexamine trickle-down economics and to focus on the unmet basic human needs of hundreds of millions of people in developing countries. Official recognition of this shift came most publicly in the World Development Report, which demonstrated that malnutrition and ill health were 2 of the worst symptoms of poverty and that both could be addressed by direct government action, with bank assistance. The report also suggested that improving health and nutrition would likely accelerate economic growth.
After a series of research papers suggested that health and education were directly productive, these findings were incorporated in the World Development Report, to argue for greater emphases on social sector lending. The program, which continued for 30 years, protected an estimated 34 million people from river blindness and cleared 25 million hectares of land for agricultural use. The bank translated development theory and research into action by creating the Population, Health, and Nutrition Department in October and allowing stand-alone health loans. A Health Sector Policy Paper was 1 of the first attempts to provide a rationale for stand-alone investments in the health sector.
In , the bank approved another nutrition loan—to the India Tamil Nadu Nutrition project.
A November bank report, Sub-Saharan Africa: From Crisis to Sustainable Growth , followed and called for doubling expenditures on human resource development. Its World Development Report, Other noteworthy early HNP activities included the first loan in to Tunisia to expand basic health services, the study Financing Health Services in Developing Countries: The World Development Report, was a watershed in international health, giving the World Bank greater exposure and legitimacy in the health sector.
The World Development Report, identified several major problems in international health systems, in particular, inefficient use of funds and human resources, inequitable access to basic heath care, and rising health care costs. As a result, the bank advocated several key recommendations for improving health: Although generally well received, the report was criticized for introducing disability-adjusted life years DALYs , for lacking a strong evidence base, and for promoting privatization.
Other areas of bank involvement in global health knowledge include training and seminars on HNP topics for policymakers in developing countries.
Over the past several years, the bank has produced country-specific HNP sector studies and staff appraisal reports and hundreds of country strategy documents on HNP topics, 75 including, for example, a study in Morocco on health financing and insurance. By far the most dramatic change in its role in global health has been its increased financial support for HNP through loans, credits, and grants.
The types of HNP activities pursued by the bank also have changed over the past several years. The World Bank also tried to tune into the international dialogue on the need to improve the effectiveness of development assistance through cooperation among agencies. A key lesson learned over the past decades is that institutions acting alone cannot meet complex HNP challenges. Thus, the bank has been working to strengthen its collaboration with other international organizations.
In Brazil, Uganda, and Ghana, it collaborated with other donors through its sector-wide approach programs, which aim to bring multiple donors together to fund an entire sector, develop comprehensive sector-wide policies, and pursue similar policy objectives. Sector-wide approach programs are an improvement on the previously fragmented approach of multiple donors funding ad hoc projects without coordination, but they have not been without controversy. However, the World Bank recognizes that it must do more to strengthen its partnerships with client countries, civil society, stakeholders, and other agencies.
Recently, it entered into collaborative agreements with WHO that will provide technical assistance for improving the design, supervision, and evaluation of bank-supported projects. The WHO and the World Bank are collaborating to advance international understanding of HNP issues, as was done, for example, through the recent Framework Convention for Tobacco Control, through which the bank worked with WHO to establish the evidence base on effective methods of curbing the prevalence and consumption of tobacco products. The World Bank and its policies are among the most hotly debated and highly criticized in the global development community.
With regard to health sector policies, key concerns involve user fees, structural adjustment, use of DALYs, and privatization. In its report on financing, the bank highlighted user fees as an instrument for mobilizing resources. However, empirical evidence demonstrates that user fees reduce the demand for both necessary and unnecessary care and that they disproportionately affect poor and sick people.
Evidence also suggests that such fees have not been overwhelmingly successful in raising revenue or enhancing efficiency. In its sector strategy, the bank claimed that it does not support user fees; however, it maintained that such fees are 1 tool for mobilizing resources. By contrast, critics prefer the bank to reject user fees entirely, a policy the World Bank has yet to pursue. This involved opening markets trade liberalization , reducing government expenditures in some cases for health , and privatizing state-owned enterprises.
Critics argue that such programs reduce health care spending and have deleterious health effects. The bank also was criticized for introducing DALYs to global health assessments. It described DALYs in the World Development Report, as a way to conceptualize and measure the global disease burden and to associate this burden with health and other social policies.
Critics argue that DALYs lack a sound theoretical framework and are inequitable because they value years saved for the able-bodied more than for the disabled, the middle-aged more than the young or old, and the currently ill more than those who will be ill tomorrow. Critics remain concerned with its use in global health, and the debate continues.
Insurance market failures, credit shortages, information asymmetries, and insufficiencies, in particular, can inhibit people from realizing economic benefits that accrue from collective risk reduction through risk pooling. The World Bank today is very different from the organization conceived at Bretton Woods in Its mission has changed from post-World War II reconstruction and development to worldwide poverty alleviation. Although the bank invested almost exclusively in physical infrastructure in its early days, its focus has broadened to include significantly more social sector lending.
Lessons learned from 50 years of development experience and theory suggest that economic growth, investments in infrastructure and physical capital, macroeconomic stability, liberalization, and privatization still matter, but that development is multifaceted and our understanding of it must be broad and inclusive.
A number of key elements, including economic growth and stability, a thriving private sector, investment in people and physical assets, a sustainable environment, and sound institutions and policies are necessary to promote prosperity, reduce poverty, and improve the human condition. Poor people require not only higher incomes but also security and empowerment, opportunities for education, jobs, health and nutrition, a clean and sustainable environment, a well-functioning judicial and legal system, civil and political liberties, and a rich cultural life.
Human Participant Protection No human participants were involved with this study. The author worked previously as a health economist in the health, nutrition, and population sector and as speechwriter to James D. Wolfensohn, president of the World Bank. National Center for Biotechnology Information , U. Am J Public Health.
Jennifer Prah Ruger , PhD. Find articles by Jennifer Prah Ruger. Box , New Haven, CT e-mail: Accepted August 25, This article has been cited by other articles in PMC. Abstract The World Bank began operations on June 25, Open in a separate window. The mission reported that expenditures to improve sanitation, education and public health should, without question, be given first priority in any program to increase the long-range growth and development of the Nicaraguan economy.
As long as you attribute the data sets to the source, publish your adapted database with ODbL license, and keep the dataset open don't use technical measures such as DRM to restrict access to the database. The datasets are also available as weekly exports. Published Universiteitsbibliotheek Gent Disclaimer. More from Amy L Sayward. Mon 17 Sep The birth of development: Kent State University Press, c New studies in U.
Includes bibliographical references p. The birth of development -- Constructing an international economic worldview -- The World Bank and development, -- The international economic diplomacy of the World Bank -- Food and agriculture in the international realm -- The limits of internationalism: World Bank History 20th century.