Interrogating the World Bank’s role in global health knowledge production, governance, and finance

Abstract

Background In the nearly half century since it began lending for population projects, the World Bank has become one of the largest financiers of global health projects and programs, a powerful voice in shaping health agendas in global governance spaces, and a mass producer of evidentiary knowledge for its preferred global health interventions. How can social scientists interrogate the role of the World Bank in shaping ‘global health’ in the current era? Main body As a group of historians, social scientists, and public health officials with experience studying the effects of the institution’s investment in health, we identify three challenges to this research. First, a future research agenda requires recognizing that the Bank is not a monolith, but rather has distinct inter-organizational groups that have shaped investment and discourse in complicated, and sometimes contradictory, ways. Second, we must consider how its influence on health policy and investment has changed significantly over time. Third, we must analyze its modes of engagement with other institutions within the global health landscape, and with the private sector. The unique relationships between Bank entities and countries that shape health policy, and the Bank’s position as a center of research, permit it to have a formative influence on health economics as applied to international development. Addressing these challenges, we propose a future research agenda for the Bank’s influence on global health through three overlapping objects of and domains for study: knowledge-based (shaping health policy knowledge), governance-based (shaping health governance), and finance-based (shaping health financing). We provide a review of case studies in each of these categories to inform this research agenda. Conclusions As the COVID-19 pandemic continues to rage, and as state and non-state actors work to build more inclusive and robust health systems around the world, it is more important than ever to consider how to best document and analyze the impacts of Bank’s financial and technical investments in the Global South.

Implementing Health Policy in Nigeria: The Basic Health Care Provision Fund as a Catalyst for Achieving Universal Health Coverage?

“…While in the 1970s, a fairer distribution of power and resources across the globe was seen as an integral part of efforts to improve people's health, more recent calls for UHC pay less attention to the social determinants of health and emphasize coverage with less focus on how services are provided (Cueto, 2004; Fischer, 2018; Sanders et al., 2019). Prominently, the World Bank has encouraged the introduction of market principles into healthcare systems, for example via its promotion of user fees in the 1980s and 1990s and, more recently, of public–private partnerships in health (Gorsky and Sirrs, 2023; Mladovsky, 2020; Sridhar et al., 2017; Tichenor et al., 2021). The emergence of dominant private sectors in national healthcare systems is thus linked to the continuous underfunding of public healthcare systems, and advances the fragmentation of service delivery (Fischer, 2018; Koivusalo and Mackintosh, 2005).…”