UK government heeds requests to challenge the World Bank on user fees for healthcare

Today the UK Department for International Development (DFID) released a report ‘The UK and the World Bank 2009’, which assesses how the UK has worked with the World Bank over the past year. It is encouraging to see a strong message in the report that the World Bank needs to push forward reforms to make it more effective at supporting development.

The report discusses the 2009 Independent Evaluation Group (IEG) report on the World Bank’s Health, Nutrition and Population portfolio, which found that 76% of the World Bank’s programmes in this sector in Africa were failing. Disappointingly however, DFID seem satisfied with the World Bank’s assurances that they have responded positively to the report and improved their performance, whereas follow-up reports from the IEG have shown little if any improvement, and in some cases worse performance.

Despite this, there is positive news from DFID’s new report. Further improvements in the Bank’s health work are mentioned in DFID’s priorities for their work with the Bank in 2010, suggesting that they plan to put further pressure on the Bank to tackle this area.

Most promisingly, there is an explicit commitment to ‘press [the Bank] to issue stronger and clearer guidance to staff working with poor countries on the removal of health user fees.’ The World Bank’s current policy on charging user fees for basic healthcare – a major factor preventing poor people from accessing healthcare – is very unclear, and in the past they have regularly advised developing countries to implement user fees.

Because of the damage that this policy does to the health of poor people RESULTS has long been advocating against it. In September 2009 our grassroots advocates asked their MPs to write to DFID, asking them to push the World Bank to change and clarify its policy in this area. It is great to see that DFID have responded to this request and are committed to challenging the Bank in this area.

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