The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #62950

Nuria Homedes, MD, DrPH, University of Texas at El Paso, 632 Skydale, El Paso, TX 79912, 915 747 8508, nhomedes@utep.edu and Antonio Ugalde, PhD, Department of Sociology, University of Texas-Austin, 1802 Westridge, Austin, TX 78704.

There is growing awareness among observers that Latin American neoliberal health reforms have not achieved the intended goals. In the two countries (Chile and Colombia) that have fully implemented the reforms the systems have become more inequitable, inefficient and are costlier today than they were before the reforms. In the rest of Latin America, countries have implemented only components of the neoliberal reforms. In these countries the efforts have been economically and politically very costly, and evaluations confirm that they did not have a significant positive effect on equity, efficiency and improvement of health indicators.

This paper discusses the inadequacies of the policies included in the reforms and explains the reasons why they were selected over other policies that historically had been identified to be more adequate. The analysis suggests that the World Bank chose policies that benefited the US-based health industries (insurance companies and big-Pharma). Policies such as the protection of the health of the workers, the promotion of the adequate use of pharmaceuticals, and the enforcement of environmental standards were excluded because they would have had a negative impact on US industries. Quantitative data from some countries reveal that reforms have benefited the most affluent classes. The reforms weakened public health interventions, increased the indebtness of the countries, and placed in jeopardy needed changes.

The paper concludes that the transnational upper class utilizes the World Bank and other multilateral agencies to promote policies that benefit them.

The paper is based on field work, and extensive reviews of literature.

Learning Objectives:

• To understand anlytically the new configuration of social classes in the global economy and the consequences for health.
• To expand the knowledge of those who engage in advocacy through international social movements

Keywords: International Health, Social Justice

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: World Bank
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.