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

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Marlee Tichenor ◽  
Janelle Winters ◽  
Katerini T. Storeng ◽  
Jesse Bump ◽  
Jean-Paul Gaudillière ◽  
...  

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.

2018 ◽  
Vol 3 ◽  
pp. 18 ◽  
Author(s):  
Janelle Winters ◽  
Genevie Fernandes ◽  
Lauren McGivern ◽  
Devi Sridhar

Background:Over the past decade gender mainstreaming has gained visibility at global health organisations. The World Bank, one of the largest funders of global health activities, released twoWorld Development Reportsshowcasing its gender policies, and recently announced a $1 billion initiative for women’s entrepreneurship. We summarise the development of the Bank’s gender policies and analyse its financing of gender projects in the health sector. This article is intended to provide background for future research on the Bank’s gender and global health portfolio.Methods:First, we constructed a timeline of the Bank’s gender policy development, through a review of published articles, grey literature, and Bank documents and reports. Second, we performed a health-focused analysis of publicly available Bank gender project databases, to track its financing of health sector projects with a gender ‘theme’ from 1985-2017.Results:The Bank’s gender policy developed through four major phases from 1972-2017: ‘women in development’ (WID), institutionalisation of WID, gender mainstreaming, and gender equality through ‘smart economics’. In the more inclusive Bank project database, projects with a gender theme comprised between 1.3% (1985-1989) and 6.2% (2010-2016) of all Bank commitments.  Most funding targeted middle-income countries and particular health themes, including communicable diseases and health systems. Major gender-related trust funds were absent from both databases. The Bank reports that 98% of its lending is ‘gender informed’, which indicates that the gender theme used in its publicly available project databases is poorly aligned with its criteria for gender informed projects.Conclusion:The Bank focused most of its health sector gender projects on women’s and girls’ issues. It is increasingly embracing private sector financing of its gender activities, which may impact its poverty alleviation agenda. Measuring the success of gender mainstreaming in global health will require the Bank to release more information about its gender indicators and projects.


Author(s):  
Guoqing Shi ◽  
Fangmei Yu ◽  
Chaogang Wang

AbstractWe are very pleased to contribute to this volume to express our appreciation for the collaboration with the community of social scientists, sociologists and anthropologists, working at the World Bank. Chinese social scientists joined forces with them on essential activities: development projects, research programs, academic conferences, training courses, and joint books. One of us, Guoqing Shi, has participated in the international symposium in Bieberstein, Germany, where this volume has originated.


2020 ◽  
Vol 17 (1) ◽  
pp. 75-104
Author(s):  
Henner Gött

Interactions between international organizations (‘IOs’) are a ubiquitous and multifaceted phenomenon in global governance, with labour governance being an important field of reference. Such inter-organizational interactions, defined as intended or accidental influence between IOs, can considerably affect the way in which the interacting IOs execute their respective mandates. Depending on the situation, inter-organizational interactions can increase IOs’ outreach and impact, but they can also dilute, divert or thwart their activities and their functioning. Against this background, it is surprising that international legal scholarship has so far shown little interest in the legal dimensions of inter-organizational interactions. In consequence, many central aspects of the law governing such interactions still lay obscure. This article argues that there is a need for international lawyers to examine the phenomenon and the legal implications of inter-organizational interactions in a systematic manner. Using interactions between the International Labour Organization and the UN, the International Maritime Organization, the World Bank and the European Court of Human Rights as examples, this article explores the phenomenon of inter-organizational interactions, extrapolates these interactions’ variety, impact and normative ambivalence, and develops a legal scholarly perspective on them. In doing so, the article expounds the research agenda for a systematic legal analysis of inter-organizational interactions in labour governance and beyond.


2018 ◽  
Vol 3 ◽  
pp. 103
Author(s):  
Manveer Rahi ◽  
Genevie Fernandes ◽  
Janelle Winters ◽  
Devi Sridhar

Background: Tuberculosis (TB) is among the leading contributors to global mortality and morbidity from infectious diseases and has had a major socioeconomic cost in recent history. The World Bank is a leading institution for global health governance and financing, but little research has concentrated on the role of the World Bank in global tuberculosis control. Methods: We tracked the development of the World Bank’s policies and associated financial flows for tuberculosis control. First, we performed a scoping review of both published and grey literature. Second, we used the Bank’s Projects & Operations database to construct a dataset of all World Bank projects with funding allocated to the “Tuberculosis” theme from 1986 to 2017.  Finally, we analysed the World Bank’s funding patterns alongside wider funding for tuberculosis using the Institute of Health Metrics and Evaluation’s Development Assistance for Health database. Results: We identified four periods in the World Bank’s involvement in global tuberculosis control, from the recognition of tuberculosis as a global health issue to the creation of a global coalition against tuberculosis. Between 1986 and 2017 the World Bank undertook 79 projects with financing from its core lending divisions with a tuberculosis control theme or focus. Within the 79 projects the Bank committed 19.6% of funding, or $0.9bn, towards tuberculosis control. The World Bank has been involved in increasingly vertical programming with a growing proportion of project funding invested into tuberculosis control over time. However, after the formation of private-public partnerships against tuberculosis in 2002 such as the Global Fund to Fight HIV/AIDS, TB and Malaria, the Bank’s core financing decreased and private-public partnerships provided increasing levels of substitutive financing for tuberculosis control. Conclusions: The World Bank has been pivotal in leading global financing, garnering advocacy and creating widespread coalition in the battle against tuberculosis control in recent decades.


2020 ◽  
Vol 4 ◽  
pp. 35
Author(s):  
Marlee Tichenor ◽  
Devi Sridhar

The global burden of disease study—which has been affiliated with the World Bank and the World Health Organisation (WHO) and is now housed in the Institute for Health Metrics and Evaluation (IHME)—has become a very important tool to global health governance since it was first published in the 1993 World Development Report. In this article, based on literature review of primary and secondary sources as well as field notes from public events, we present first a summary of the origins and evolution of the GBD over the past 25 years. We then analyse two illustrative examples of estimates and the ways in which they gloss over the assumptions and knowledge gaps in their production, highlighting the importance of historical context by country and by disease in the quality of health data. Finally, we delve into the question of the end users of these estimates and the tensions that lie at the heart of producing estimates of local, national, and global burdens of disease. These tensions bring to light the different institutional ethics and motivations of IHME, WHO, and the World Bank, and they draw our attention to the importance of estimate methodologies in representing problems and their solutions in global health. With the rise in the investment in and the power of global health estimates, the question of representing global health problems becomes ever more entangled in decisions made about how to adjust reported numbers and to evolving statistical science. Ultimately, more work needs to be done to create evidence that is relevant and meaningful on country and district levels, which means shifting resources and support for quantitative—and qualitative—data production, analysis, and synthesis to countries that are the targeted beneficiaries of such global health estimates.


2019 ◽  
Vol 4 ◽  
pp. 35 ◽  
Author(s):  
Marlee Tichenor ◽  
Devi Sridhar

The global burden of disease study—which has been affiliated with the World Bank and the World Health Organisation (WHO) and is now housed in the Institute for Health Metrics and Evaluation (IHME)—has become a very important tool to global health governance since it was first published in the 1993 World Development Report. In this article, based on literature review of primary and secondary sources as well as field notes from public events, we present first a summary of the origins and evolution of the GBD over the past 25 years. We then analyse two illustrative examples of estimates and the ways in which they gloss over the assumptions and knowledge gaps in their production, highlighting the importance of historical context by country and by disease in the quality of health data. Finally, we delve into the question of the end users of these estimates and the tensions that lie at the heart of producing estimates of local, national, and global burdens of disease. These tensions bring to light the different institutional ethics and motivations of IHME, WHO, and the World Bank, and they draw our attention to the importance of estimate methodologies in representing problems and their solutions in global health. With the rise in the investment in and the power of global health estimates, the question of representing global health problems becomes ever more entangled in decisions made about how to adjust reported numbers and to evolving statistical science. Ultimately, more work needs to be done to create evidence that is relevant and meaningful on country and district levels, which means shifting resources and support for quantitative—and qualitative—data production, analysis, and synthesis to countries that are the targeted beneficiaries of such global health estimates.


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