Article ID: CBB495638616

Disease in a Debt Crisis: Financing Global Health, Development and AIDS between WHO and World Bank, 1978–87 (2020)

unapi

This article examines how international organisations with mandates in health and development interpret global economic crises and respond to disease. It contributes the perspective of World Bank to emerging scholarship on the various factors leading to the decline of the World Health Organization (WHO) and its Health for All (HFA) mission during structural adjustment. It does so by telling a story of collaboration and conflict between WHO and World Bank’s Population, Health and Nutrition (PHN) Department following the ambitious Alma Ata Declaration in 1978 until the initial global AIDS response. As debt crises emerged in Latin America in the early 1980s, WHO tried to find a way forward for HFA. However, the African crisis of 1985 fractured the international community’s support, causing WHO and PHN to dialogue more closely regarding health sector financing. As AIDS became a global crisis, this culminated in their 1987 joint research on the disease’s macroeconomic and demographic impact. However, observing WHO’s continued hesitance regarding financing and its decision to act as a donor gatekeeper, the Bank ultimately opted to work separately in AIDS. Thus, the themes of the Alma Ata versus Selective Primary Health Care debate of the late 1970s continued throughout the 1980s into the early years of the global AIDS response: a perennial conflict of financing within resource constraints and the appropriate role of donors in the grand project of health and development.

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Authors & Contributors
Fee, Elizabeth
Cueto, Marcos
Brown, Theodore M.
Fernández Juárez, Gerardo
Carlo A Favero
Bollyky, Thomas J.
Concepts
Global health
Public health
Economics
Disease and diseases
Financial crises
AIDS (disease); HIV / AIDS
Time Periods
20th century, late
21st century
20th century
Places
Africa
Great Britain
Ethiopia
Uganda
Nigeria
United States
Institutions
World Health Organization (WHO)
World Bank
UNICEF
Bill and Melinda Gates Foundation
United Nations
Group of Twenty
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