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[Progress report on a World Bank loan to China for a tuberculosis control project].

The progress of the World Bank loaned TB control project implemented from the second quarter of 1991 to the fourth quarter of 1993 was described in this paper. In the past three years, 737 counties of the 12 provinces with the population of 360 million has been covered by the project. Among 95176 new smear positive cases discovered, 93909 patients received free treatment of TB. The treatment coverage is 98.7%, of which 95% were treated under full course supervision. The smear conversion rate at two, three months of new smear positive TB patients are 83.4% and 90.6% respectively. The cohort analysis showed that the cure rate is 89.8%, which has reached the advanced level of the modern national tuberculosis control programme in the world.

Adolescent↗

The International Monetary Fund and World Bank in Africa: a "disastrous" record.

In their 60th anniversary year, the International Monetary Fund and World Bank will attempt to highlight their "assistance" to Africa. But in reality, since the 1970s, these institutions have gradually become the chief architects of policies that are responsible for the worst inequalities and the explosion of poverty in the world, especially in Africa. When they began to intervene on that continent in the late 1970s and early 1980s, their stated goal was to "accelerate development." But the actual record is just disastrous, as this article reveals.

Africa↗

The role of the World Bank in international health: renewed commitment and partnership.

During the course of the past ten years, the World Bank has become the single largest external financier of health activities in low and middle income countries and an important voice in national and international debates on health policy. This article highlights the Bank's new strategic direction in the health sector aimed at: improving health, nutrition, and population outcomes of the poor; enhancing the performance of health care systems; and securing sustainable health care financing. Millions of preventable deaths and treatable illnesses, together with health systems that are inefficient, inequitable and ineffective, have motivated expanded Bank support for the health sector in many of its client countries. The new policy directions and system-wide reforms observed in these countries are the result of both demand and supply factors. It is part of a general shift in the Bank's approach to development assistance, which sees systemic reform as a way to improve the impact and sustainability of investments in health. On the demand side, the Bank is trying to adapt to ongoing political, technological, economic, demographic, epidemiological and social pressures. On the supply side, the Bank's growing international experience and substantial financial resources are used to complement the development assistance provided by other organizations and the global effort to improve health and health systems in low and middle income countries.

Cost-Benefit Analysis↗

Achievement of the World Bank loan project on schistosomiasis control (1992-2000) in Hubei province and the challenge in the future.

Since the World Bank provided a loan for control of schistosomiasis in China, started from 1992, with the objective of a reduction of prevalence and intensity of the infection both in humans and animals by 40%, through mass chemotherapy in areas of high prevalence, and selective chemotherapy in areas with medium and low endemicity together with focal mollusciciding, the objective of morbidity control of the project has been reached in Hubei Province.

Animals↗

The World Bank's innovation market.

Large, tradition-bound organizations can make space for radical, low-cost (and therefore low-risk) innovations. Just ask executives at the World Bank. The story of this best practice begins in 1998, when a young new-products group at the international funding agency proposed holding an Innovation Marketplace to capture novel ideas within the Bank for alleviating poverty. The forum, which eventually was opened to external participants, let people informally present their antipoverty ideas to potential funding sources. Funders could move among hundreds of booths and evaluate proposals for, say, a program that would provide postdisaster reconstruction insurance in developing countries or a vaccination development initiative. The marketplace truncated the Bank's standard project-review processes, which often stretched to a year or more, and gave funders permission to make commitments in the tens of thousands of dollars, rather than in the tens of millions more typical of Bank-financed projects. The marketplace concept met with some skepticism at the beginning. Some senior executives at the Bank felt no group had the right to spend the agency's money without following its well-established resource allocations process. But the marketplace team believed an open process for allocating grants would produce more breakthrough ideas in the long run than a centralized one. In this article, the authors describe how the new-products team brainstormed to create a market for ideas, how it got senior management's support, and how it has expanded on the original concept for these innovation marketplaces. The program's success, they contend, offers hope both for the world's poor and for business leaders looking to find new ideas under the hard crust of corporate dogma, conformance, and bureaucracy.

Cooperative Behavior↗

Health and social security reforms in Latin America: the convergence of the World Health Organization, the World Bank, and transnational corporations.

International financial institutions have played an increasing role in the formation of social policy in Latin American countries over the last two decades, particularly in health and pension programs. World Bank loans and their attached policy conditions have promoted several social security reforms within a neoliberal framework that privileges the role of the market in the provision of health and pensions. Moreover, by endorsing the privatization of health services in Latin America, the World Health Organization has converged with these policies. The privatization of social security has benefited international corporations that become partners with local business elites. Thus the World Health Organization, international financial institutions, and transnational corporations have converged in the neoliberal reforms of social security in Latin America. Overall, the process represents a mechanism of resource transfer from labor to capital and sheds light on one of the ways in which neoliberalism may affect the health of Latin American populations.

Commerce↗

A fundamental shift in the approach to international health by WHO, UNICEF, and the World Bank: instances of the practice of "intellectual fascism" and totalitarianism in some Asian countries.

Navarro has used the term "intellectual fascism" to depict the intellectual situation in the McCarthy era. Intellectual fascism is now more malignant in the poor countries of the world. The Indian Subcontinent, China, and some other Asian countries provide the context. The struggles of the working class culminated in the Alma-Ata Declaration of self-reliance in health by the peoples of the world. To protect their commercial and political interests, retribution from the rich countries was sharp and swift, they "invented" Selective Primary Health Care and used WHO, UNICEF, the World Bank, and other agencies to let loose on poor countries a barrage of "international initiatives" as global programs on immunization, AIDS, and tuberculosis. These programs were astonishingly defective in concept, design, and implementation. The agencies refused to take note of such criticisms when they were published by others. They have been fascistic, ahistorical, grossly unscientific, and Goebbelsian propagandists. The conscience keepers of public health have mostly kept quiet.

Asia↗

The World Bank, the Monetary Fund, and poverty.

The debt crisis into which heavy borrowing, steeply rising interest rates, and a worldwide recession had plunged a number of developing countries in the late 1970s and 1980s was alleviated largely by policies and conditionalities imposed by the International Monetary Fund and the World Bank. These policies and conditions were meant to strengthen the export and financial markets of those countries, stabilize their currencies, and reduce the reach of their governments in their economies. However, they contributed to deepening poverty and structural crises, as the reports and data published by the international financial institutions themselves attest.

Developing Countries↗

[Analysis of short-term effects of short-course intermittent chemotherapies of the World Bank Loaned Project].

OBJECTIVE: To explore the characteristic features of sputum conversion during short-course intermittent chemotherapies and the measures of keeping high cure rates. METHODS: 1,350 smear positive pulmonary tuberculosis cases in the ten research pilot counties of Liaoning province from 1992 to 1993 were selected to receive short-course intermittent chemotherapies under full-course supervision. The project was supported by the World Bank. The sputum specimens of the cases were regularly examined. The effects of the chemotherapies and the measures of keeping high cure rate were evaluated according to the situation of sputum conversion. RESULTS: The cure rates of initial and relapse smear positive cases were 92.5% and 74.6% respectively. It is also found that the therapeutic effects were affected by the situation of sputum conversion at the end of intensive phase. The cure rate of the cases who failed in initial treatment and continued retreatment was only 54%, which was obviously lower than that of the other retreatment cases. CONCLUSION: Strengthening the treatment and management at the intensive phase can increase the cure rate. It is recommended that more rational regimens should be studied and provided to those who fail in initial treatment to improve the therapeutic effects.

Antibiotics, Antitubercular↗

Local participation, international politics, and the environment: the World Bank and the Grenada Dove.

The process of locating waste disposal sites in the Eastern Caribbean country of Grenada illustrates important lessons in the implementation of new international mandates to invite stakeholder participation in projects with environmental and social impacts. This case study analyzes the participatory methods and results of the World Bank-funded project in Grenada, including an unexpected shift in the policy agenda toward habitat protection for the elusive Grenada Dove, the national bird of Grenada. We conclude that the impact of new requirements for stakeholder inclusion by funding agencies such as the World Bank and Global Environmental Facility has been palpable, but mixed. As the catalysts of more participatory methods, funding agencies still must give more careful consideration to the methods by which their participatory requirements are implemented. In particular they must develop more effective knowledge of and relationships with a broader range of stakeholders than are routinely considered by existing methods, allow for and learn from unexpected contingencies, and be flexible as to project goals and methods.

Animals↗

[Cancer screening in Hungary: World Bank supported model programs].

Since 1995, a model cancer screening program has been in operation in Hungary, the overall purpose of which is to promote the establishment of effective and efficient screening programs by means of adapting the internationally agreed principles of organized screening to the needs and opportunities in Hungary. The establishment and operation of a national population-based cancer registration system is an other aim of the Program. The model program--financed partly from a loan from the World Bank, partly from local funds provided by the Government of Hungary--is to develop standard procedure for cervical, breast and colorectal screening and to end up with tested recommendations for introduction of organized screening of proved effectiveness, integrated into the health care system, on country-wide service bases in Hungary.

Female↗

Rural health and labour supplies: empirical evidence from the World Bank Assisted Agricultural Development Project in the Kwara State of Nigeria.

The efforts made in this study are in two areas. First, an effort has been made to determine whether there are any health or labour supply differences between ADP and non-ADP households. Second, an effort has also been made to determine whether differences in health, housing and nutrition, if any, have an effect on labour supply. All the efforts are attempts to focus research attention on the Nigeria's resource endowment factor and at the same time assess the impact of rural infrastructure capital and thus the World Bank Assisted Agricultural Development Projects (ADP) on the rural Nigerian residents and their industry. Using 175 households, 50 from the ADP and 125 from the non-ADP areas, the discriptive statistic indicates strong mean significant differences for the descriptors of nutrition, housing and state of health among the two sample categories. The discriminant function strongly discriminates between the two sample groups while the multiple regression analysis establishes a causal relationship between the discriptors of rural healthy days and labour supply for the two sample data sets. The policy implication of the study is that the implementation of the ADP particularly the Ilorin, leads to the improvement of quality of life and greater infusion of high quality labour into the rural agricultural industry. Higher productivity and increased farm family income and enhanced rural life which results is a useful virile circle necessary for laying the bedrock for the rural development.

Agriculture↗

Highlights on the World Bank Loan Schistosomiasis Control Program in China (1991-1998): a special focus on Hunan Province.

A region-wide sampling survey was conducted in 1995 in order to evaluate the current epidemiological status of schistosomiasis japonica in Hunan Province, China. A total of 45,590 humans and 3,726 domestic animals, from 52 villages, were examined parasitologically and/or serologically for current Schistosoma japonicum infections. In uncontrolled endemic areas (43 villages) the overall human prevalence of S. japonicum was 7.81% across the different geographical subtypes. The geometric mean intensity of infection was 17.71 eggs per gram (epg) among infected individuals and only 1.25 epg in the general population. The bovine prevalence, as determined by the hatching test, was 9.63% in the uncontrolled endemic villages. Only one sero-positive (by indirect hemagglutination assay) child was found among 1,072 children tested aged 10-14 years in the 9 endemic villages under effective control. No infection was confirmed by the Kato-Katz thick smear stool examination. When the results of this survey were compared to those seen at baseline (1989) an overall reduction of 45.65% was seen in the human prevalence but no significant change was apparent in the lake-beach ecotype. Additionally, there was more than a 60% reduction in the prevalence among bovines over the same sampling period. The results demonstrate that the World Bank Loan Schistosomiasis Program was successful in achieving its most basic objectives for this province - to reduce human and bovine infections by 40%.

Adolescent↗