The World Bank promotes the private provision of basic services through interlocking conditions on aid and debt relief to poor countries. This appears to be driven more by the Bank’s internal targets than by evidence of what works in each country — for example, the Bank’s Private Sector Development Strategy aims for private sector participation in 40 per cent of its loans to the poorest countries. (page 9)Why 40 per cent? Why not 60 per cent, or 77.77 per cent? This is what happens when you get Mickey Mouse micro-targets. It probably took at least 10 minutes to think of 40 per cent. Probably the person who did so just looked up the current percentage, and added something plausible to it to come up with something nice and round. And why not? If anybody bothered monitoring the results of World Bank policies the meaninglessness of such figures might be challenged… but this is project management subordinated to ideology, not outcomes.
Later, discussing the rich countries’ recruitment of health workers from developing countries:
With the cost of training a general practice doctor [in Africa] estimated at $60 000 and that of training a medical auxiliary at $12 000, the African Union estimates that low-income countries subsidise high-income countries to the tune of $500 million a year through the loss of their health workers. (page 67)The rich countries put up import barriers to the few goods – agricultural, textiles, clothing and footwear – that offer the developing countries their best chance for prosperity. This helps impoverish people in Africa (or even kill them). But we then freely import their most valuable personnel to prop up our own health services. This is a destructive and self-reinforcing trend. The worse we make life for people in the third world, the more desperate they become to escape to the west. If successful, they become reluctant migrants; leaving their cultures and, in many cases, their families behind. The only long-term beneficiaries of these absurd policies are the people who are paid to make and administer them.