Suchergebnisse

Global health partnerships created to encourage funding efficiencies need to be approached with some caution, with claims for innovation and responsiveness to development needs based on untested assumptions around the potential of some partners to adapt their application, funding and evaluation procedures within these new structures. We examine this in the case of the Health Systems Funding Platform, which despite being set up some three years earlier, has stalled at the point of implementation of its key elements of collaboration. While much of the attention has been centred on the suspension of the Global Fund's Round 11, and what this might mean for health systems strengthening and the Platform more broadly, we argue that inadequate scrutiny has been made of the World Bank's contribution to this partnership, which might have been reasonably anticipated based on an historical analysis of development perspectives. Given the tensions being created by the apparent vulnerability of the health systems strengthening agenda, and the increasing rhetoric around the need for greater harmonization in development assistance, an examination of the positioning of the World Bank in this context is vital.

In 2008, India launched a flagship national health insurance programme, the Rashtriya Swasthya Bima Yojana (RSBY) for those living below the poverty line (BPL). 1 Using qualitative methods and thematic analysis, this exploratory study of poor women from three selected districts of West Bengal sought to gauge reasons for low registration and factors affecting choice of institutional healthcare among those who had registered for the RSBY. In particular, we sought to understand the underlying factors, if any, which affect judgements on institutional healthcare.

ABSTRACTThe global war on terror was used by the Bush administration and its allies to defend a US dominated geopolitical configuration. To this end, counter‐terrorism measures (CTMs) were introduced which strengthened the alignment of development aid with diplomacy and defence. The broad, adverse effects of CTMs on civil liberties and human rights are well documented. Despite the advent of a new US administration and a 'soft power' approach to international relations, the legacy of the war on terror remains embedded in the laws, policies and attitudes of many states and regimes that continue to enclose the lives of citizens. This article describes the experiences of civil society organizations (CSOs) as 'securitization' processes unfolded. Studies over two years involving some forty countries provide an on‐the‐ground view to probe the gains and losses of securitization, both for governments in the US‐led 'coalition of the willing' and for civil society in terms of the pressures emerging from a development‐for‐security agenda. The authors identify some of the perverse zero‐sum effects on governments of CTM philosophy and the means employed. Findings also show asymmetry between northern and southern CSOs in terms of their negative‐sum subordination, found in the definition of security and in the vulnerability to new risks involved in undertaking development work.

The recent volatility and uprisings in several countries of the Arab world have been interpreted by the West solely as a popular demand for political voice. However, in all the countries of the region, including those in which there is ongoing violent opposition, the underlying economic dysfunction speaks for itself. The legacy of joblessness, food riots, and hunger is commonplace and is most often related to structural reforms and austerity measures promoted by the IMF and World Bank. These have played a significant role in reinforcing the rich-poor divide over the past three decades, fostering inequality, suffering, social divisions, and discontent, which are often overlooked by Western observers. In Syria, the state introduced policies for the liberalization of the economy as early as 2000; these were formalized into the 10th Five-Year Plan (2006-2010). Economic liberalization has been supported by the European Union with technical support from the German Technical Cooperation agency (GTZ). Changes made to the health sector and the labor market include: the piloting of health insurance schemes to replace universal coverage, the charging of fees for health services in public hospitals, and job losses across the board. While the West views discontent in Syria largely as political, its own role in promoting economic reforms and social hardship has been largely missed. In large part, discontent in Syria and in the region as a whole are a part of a phenomenon that has repeatedly highlighted the failure of policies that aim at rapid commercialization with little consideration for pre-existing disparities in wealth and resources. This paper traces some of the proposed changes to the financing of health care and examines the implications for access and equity. re and examines teh implications for access and equity.

The systemic inadequacies of models of health systems propagated by the advocates of global health policies (GHPs) have fragmented health service systems, particularly in middle- and lower-income countries. GHPs are underpinned by economic interests and the need for control by the global elite, irrespective of people's health needs. The COVID-19 pandemic challenged the advocates of GHPs, leading to calls for a movement for "decolonisation" of global health. Much of this narrative on the "decolonisation" of GHPs critiques its northern knowledge base, and the power derived from it at individual, institutional and national levels. This, it argues, has led to an unequal exchange of knowledge, making it impossible to end decades of oppressive hegemony and to prevent inappropriate decision-making on GHPs. Despite these legitimate concerns, little in the literature on the decolonisation of GHPs extends beyond epistemological critiques. This article offers a radically different perspective. It is based on an understanding of the role of transnational capital in extracting wealth from the economies of low- and middle-income countries resulting in influencing and shaping public health policy and practice, including interactions between the environment and health. It mobilises historical evidence of distorted priorities underpinning GHPs and the damaging consequences for health services throughout the world.