The World Bank and world health: Under fire

This is the third in a series of six articles examining the World Bank's role in international health The World Bank is accustomed to criticism, and since the second world war few organisations have generated as much outcry. Most analysts, however, accept that the bank has conducted a successful campaign to improve its image over the past decade. Indeed, I was surprised during my meetings with health workers outside the bank that it attracted far less criticism than I had expected. None the less, reservations remain about the bank's approach, and this article discusses some of the most controversial aspects of the bank's policies. #### Summary points Critics of the World Bank argue that structural adjustment loans are a mechanism of forcing free market economics on countries through coercion. Countries with a debt crisis, whatever their other characteristics, agree to the bank's package of legal and economic reforms, and the bank agrees to lend them money. Argentina, Ecuador, and India have all either weakened their labour legislation or amended their land laws to qualify for an adjustment loan. India is reported to have changed 20 pieces of major legislation.1 #### Common criticisms of the World Bank