1,720,969 research outputs found
Austerity and health in Europe: disentangling the causal links
No full textAusterity and health in Europe: Disentangling the causal link
Governing and Measuring Health Security: The Global Push for Pandemic Preparedness Indicators.
Full text linkProviding collective solutions to global pandemics requires the coordination of information that is accurate and accountable. In recent years there has been a global push for reliable pandemic preparedness indicators. This push has come from U.S. foreign policy, the World Health Organization (WHO), NGOs, and private foundations. These actors want control over how data for preparedness indicators is collected, analysed, and promoted. Governments want to influence how they are assessed, using poor performance to attract attention and good performance to deflect blame. In this article we discuss how the push for pandemic preparedness indicators comes from the dual aims of repelling national risk, the spread of disease, while reducing global harm through stronger transnational governance arrangements. We delve into the development of indicators from the WHO and the privately-run Global Health Security Index, and examine how their claims to authority measure-up against standards of transparency, veracity, and accountability. We stress the importance of understanding how these indicators are composed. This is vital given the current drive to include social and governance metrics in revised efforts at data collection, as well as efforts to include pandemic preparedness indicators in how intergovernmental organizations, NGOs, donors, and funders devise health and development policies
Universal social protection: is it just talk?
No full textMany intergovernmental organizations (IGOs) now place a high priority on universal social protection as a means for achieving sustainable development. Is this shift toward universal social protection just talk, or does it signify a more substantial emphasis on welfare within development policy? We present a theoretical framework for understanding discursive changes in global policy as rebranding, fads, trends, or paradigm shifts. We then conduct a comparative, semi-structured review of official language related to social protection used by six key IGOs (International Labour Organization, International Monetary Fund, United Nations Children's Fund, United Nations Development Programme, World Bank, and World Health Organization) across five dimensions of social protection (labor market, health, family, housing, and education) before the introduction of the United Nations 2030 Agenda for Sustainable Development. Then, employing the framework, we analyze the findings of this review to determine the significance of the discursive shift toward universal social protection in the context of the 2030 Agenda. We document that, at present, universal social protection is an influential policy trend that has shaped how IGOs understand and act on social issues. These findings inform theoretical debates on the relationship between discursive and substantive policy change and contribute to a growing literature on transnational social protection. They also have implications for efforts across agencies and sectors to enhance social protection and achieve the Sustainable Development Goals
International financial institutions: forms, functions, and controversies
No full textHaving sizeable lending capacity and unparalleled epistemic power, international financial institutions (IFIs) are the world’s most powerful international organizations. One class of IFIs is primarily focused on lending for development projects, and commands portfolios of hundreds of millions of dollars that can transform infrastructure and social services in low- and middle-income countries. Another class is geared toward providing financial assistance to countries in economic crisis and has an active role in shaping their policy environments. Through these activities, IFIs alter the development trajectories of borrowing countries, for better or for worse. This article reviews these debates. We first map IFI forms and functions and examine their governance structures. Subsequently, we examine two of the leading controversies surrounding IFI activities: the problematic impact of these activities on social and environmental outcomes; and the charge that they impinge on developing countries’ policy sovereignty. We conclude by outlining fruitful directions for future research
Pump up the volume: from covert to overt politics in global governance
Full text linkRecent commentary on the state of multilateralism begins from an alarming premise: a popular backlash against globalization is underway. The prospects for multilateralism depend, by this account, on shielding global governance from the forces of mass politics. We challenge this conventional account to develop a novel conceptual framework for the mass politics of global governance and the role of contestation in resolving, rather than inciting, the present crisis of multilateralism. We distinguish between two modes of mass politics—covert and overt—and examine variation in (i) mass preferences, (ii) party strategies, and (iii) international organization between them. Building on this framework, we make the case for a shift from the current covert mode to a more overt politics of global governance that could make the multilateral system more effective, accountable, and legitimate. Concrete steps in this direction will accommodate broader political forces while defanging challenges from opportunistic political leaders. We conclude with an outline of pragmatic reforms to reinvigorate multilateralism for the post-pandemic era
The politics of the International Monetary Fund
No full textThe International Monetary Fund (IMF) is a key pillar of global economic governance. While its mandate stipulates neutrality with respect to the political, economic, and social objectives of its members, powerful states have repeatedly swayed the IMF to further their own interests, often at the expense of developing countries. This chapter reviews the politics of the IMF. First, we trace the evolution of the Fund's activities through its history, highlighting important interventions by powerful actors. Second, we introduce a framework, based on delegation theories, to explain how states and non-state actors impact the activities of the IMF. Third, we examine the practice of decision-making, including the agenda-setting power of the IMF's Managing Director and the ability of bureaucrats to influence operations. Fourth, we review IMF lending activities in borrowing countries vis-à-vis the Fund's stated goal of economic growth, its wider economic impact, and social consequences. Fifth, we discuss how the IMF, and its relationship with China, shapes the future of international development. We conclude by laying out areas for future research and discussing the implications for international cooperation
The International Monetary Fund’s interventions in food and agriculture: An analysis of loans and conditions
Full text linkThe mandate and competence of the International Monetary Fund (IMF) does not cover food and agriculture policies. While there is anecdotal evidence that the IMF engages in these policies regardless, the state-of-the-art lacks a systematic empirical foundation to identify the extent of its mission creep into these sectors. Based on a combination of machine and human coding, we present a comprehensive database on the IMF’s policy interventions in food and agriculture. Using new data on ‘conditionalities’—policies that governments must implement to access IMF credit—we assess to what extent the IMF has targeted these sectors for the period 1980 to 2014. Our analysis evaluates the agricultural content and ideological orientation of conditions according to whether they promote a developmental state, a night-watchman state, or neither. We find about 2% of all IMF conditions (1105 of 58,406) directly target food and agriculture issues. These are present in 43% of all IMF programs (332 of 781); and affect 100 countries (of the 131 countries that have had an IMF agreement). In addition, our analysis reveals that 59.2% of these conditions embody policy measures in line with night-watchman state policy preferences, 40.1% are model-neutral, and 0.7% developmental. Within the model-neutral category, 23.9% are conditions oriented towards building state capacity; 2.7% have a poverty reduction content; and 2.9% contain pro-environment policies. The IMF’s primary reason for targeting food and agriculture is to enforce fiscal discipline by removing subsidies, yet our analysis identifies that only 8% of these policies abolish subsidies. A more consistent explanation of the IMF’s interest in food and agriculture is its broader mission creep into development policy, and its deep-rooted pro-market ideology
How structural adjustment programs affect inequality: a disaggregated analysis of IMF conditionality, 1980–2014
Full text linkThis article highlights an important yet insufficiently understood international-level determinant of inequality in the developing world: structural adjustment programs by the International Monetary Fund (IMF). Studying a panel of 135 countries for the period 1980 to 2014, we examine income inequality using multivariate regression analysis corrected for non-random selection into both IMF programs and associated policy reforms (known as ‘conditionality’). We find that, overall, policy reforms mandated by the IMF increase income inequality in borrowing countries. We also test specific pathways linking IMF programs to inequality by disaggregating conditionality by issue area. Our analyses indicate adverse distributional consequences for four policy areas: fiscal policy reforms that restrain government expenditure, external sector reforms stipulating trade and capital account liberalization, financial sector reforms entailing inflation-control measures, and reforms that restrict external debt. These effects occur one year after the incidence of an IMF program, and persist in the medium term. Taken together, our findings suggest that the IMF’s recent attention to inequality neglects the multiple ways through which the organization’s own policy advice has contributed to inequality in the developing world
The IMF and government health expenditure: A response to Sanjeev Gupta.
No full textDo policy conditions attached to International Monetary Fund (IMF) lending programmes have an impact on government health expenditure in developing countries? Yes, according to a large body of literature (see Kentikelenis, 2017), and our recent article (Stubbs et al., 2017).
We systematically reviewed IMF loan agreements and staff reports to generate a database of “binding” conditions that could plausibly impact health expenditure. Our database offered an alternative to the IMF's own conditionality dataset, which has been widely criticized for inaccuracies and omissions (Arpac et al., 2008; IEO, 2007). Using cross-national models covering 16 West African countries between 1995 and 2014, we found that each additional binding IMF policy reform reduces government health expenditure per capita by 0.25% (95% CI -0.44 to −0.06). The mean number of binding conditions, at 25 per year, thus corresponds to a 6.21% reduction, on average, in government health spending per capita associated with IMF conditions.
To further test these findings, we performed a narrative review of these documents. They showed that IMF policy reforms reduce fiscal space for health investment, limit expansion of doctors and nurses, and undermine health system efficiency. It was clear that IMF programmes placed enormous pressure on already strained health systems, reducing health spending at times when economic crises placed more people in harm's way.
In the comment on our research paper, Sanjeev Gupta (2017), deputy director of the IMF's influential Fiscal Affairs Department, disagrees. Here we take each of his points in turn
Globalization and health equity: the impact of structural adjustment programs on developing countries
Full text linkAmong the many drivers of health inequities, this article focuses on important, yet insufficiently understood, international-level determinants: economic globalization and the organizations that spread market-oriented policies to the developing world. One such organization is the International Monetary Fund (IMF), which provides financial assistance to countries in economic trouble in exchange for policy reforms. Through its ‘structural adjustment programs,’ countries around the world have liberalized and deregulated their economies. We examine how policy reforms prescribed in structural adjustment programs explain variation in health equity between nations—approximated by health system access and neonatal mortality. Our empirical analysis uses an original dataset of IMF-mandated policy reforms for a panel of up to 137 developing countries between 1980 and 2014. We employ regression analysis to evaluate the relationship between these reforms and health equity, taking into account the non-random selection and design of IMF programs. We find that structural adjustment reforms lower health system access and increase neonatal mortality. Additional analyses show that labor market reforms drive these deleterious effects. Overall, our evidence suggests that structural adjustment programs endanger the attainment of Sustainable Development Goals in developing countries
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