International financial institutions and human rights: implications for public health

Abstract

Serving as lender of last resort to countries experiencing unsustainable levels of public debt, international financial institutions have attracted intense controversy over the past decades, exemplified most recently by the popular discontent expressed in Eurozone countries following several rounds of austerity measures. In exchange for access to financial assistance, borrowing countries must settle on a list of often painful policy reforms that are aimed at balancing the budget. This practice has afforded international financial institutions substantial policy influence on governments throughout the world and in a wide array of policy areas of direct bearing on human rights. This article reviews the consequences of policy reforms mandated by international financial institutions on the enjoyment of human rights, focusing on the International Monetary Fund and World Bank. It finds that these reforms undermine the enjoyment of health rights, labour rights, and civil and political rights, all of which have deleterious implications for public health. The evidence suggests that for human rights commitments to be met, a fundamental reorientation of international financial institutions’ activities will be necessary.

Responding to the COVID-19 Pandemic in Developing Countries: Lessons from Selected Countries of the Global South

“…In recent decades, developed economies, through the IMF and World Bank, have used aid conditionalities to demand fiscal cuts and neoliberal health reforms, e.g., by imposing user fees in developing countries (Lister and Labonté 2009). Instead of improving efficiency, quality and coverage, these reforms have had deleterious implications for public health, besides exacerbating inequalities in access to health care (Stubbs and Kentikelenis 2017;Forstera et al 2019;Sobhani 2019).Their structural adjustment programmes in developing countries, particularly in Africa, have resulted in underinvestment in health care systems, causing them to be poorly prepared to respond to the Ebola epidemic (Nkwanga 2015). Besides IMF and World Bank programmes, such underinvestment was also due to compromised fiscal capacities and regressive fiscal priorities (Sanders et al 2015;Scott et al 2016).…”

Climate Change, Trade, and Global Food Security: A Global Assessment of Transboundary Climate Risks in Agricultural Commodity Flows

“…This suggests that the presence of adequate social safety nets is essential to protect disadvantaged groups and, therefore, to just transition outcomes. Indeed, evidence shows that without appropriate and effective social welfare measures and safeguards in place, structural adjustment programmes and deindustrialization processes negatively influence human and worker rights, such as rights to physical integrity, health rights, labour rights, and civil and political rights (Abouharb & Cingranelli, 2006;Peck, 2016;Stubbs & Kentikelenis, 2017).…”

Direito à saúde e austeridade fiscal: o caso brasileiro em perspectiva internacional

“…The International Monetary Fund (IMF) and the World Bank have been strongly criticized for imposing conditionalities on countries borrowing at times of economic crisis, considering that crises are already a burden in terms of risk of human rights violation, guaranteeing the right to access healthcare, work, and civil and political rights. The rationale of conditionalities on the stabilization pillars (reduction of the fiscal debt with an emphasis on reducing social spending), liberalization (elimination of trade barriers and financial capital), deregulation (repeal of regulation of economic activity) and privatization (sale of state-owned firms to the private sector) has generated significant difficulties for borrowers to protect and address these rights 17 .…”

“…They impose fiscal and institutional reforms on lending terms that result in actions such as targeting programs, cuts on social spending, structural adjustments for introducing tariffs and co-payments to use health services, deregulation of the health sector to increase private sector participation in service delivery and decentralization of fiscal and operational responsibilities to the subnational levels. The latter has seen greater problems of governance and local institutional fragility, undermining the guarantee of the right to healthcare 17 .…”