Dear colleagues & friends,

Inclusion of the IFC-World Bank report “Healthy Partnerships: How Governments Can Engage the Private Sector to Improve Health in Africa” in our weekly newsletter of international health policies sparked some debate over the weekend. With this post, we hope to offer all of you an option to chip in.

7. World Bank report (press release ) – IFC-World Bank Report Calls for Government and Private Sector Partnership to Expand Africa’s Health Serviceshttp://go.worldbank.org/RCF0GXO2C0They do get a lot of flak at times, the boys and girls of the World Bank, but you can’t say they are a lazy bunch. A few weeks ago they released yet another report, this one calling for a government and private sector partnership to expand Africa’s Health Services. [you can read the report online on Issuu. Or download it here (PDF 176 pages, 26 MB !! Which begs the question: who the hell is their target audience ? )

After receiving the newsletter last Friday, Pierre De Paepe, a colleague of ours, currently based in Argentina, wrote: “ Los amigos del IMT que nos mandan el IHP News no tienen comentario alguno sobre este informe agresivo y nefasto, “casi que lo recomiendan”. Increible. “
Short translation : « our friends who sent it, do not have any comment on this report, which is aggressive and toxic; it’s as if they recommend it; incredible”.

Pierre De Paepe’s comment is perhaps a bit sharp, but it’s a comment the IHP newsletter (and/or our selection of documents) sometimes receives. So we think it deserves an in-depth answer. Wim Van Damme, the initiator of the newsletter, and David Hercot already gave the following replies:

Wim:

“We have selected the report for the IHP Newsletter, because we think it is “significant”, in the sense that we think it will be often referred to (cited and quoted); and that people working in our field should be aware of it. We often select reports we do not like, and circulate them. We encourage comments on the blog, especially from the South. So, we would very much welcome your comments “a voice from Argentina”…

I personally read the WB report only in some depth this weekend, and think it is generally quite weak, and of little practical help for policy makers. The reality that the private-for-profit sector is expanding fast in most countries in sSA is obvious for most observers. How public policy makers should deal with that reality is far less clear, and this report seems of little help. The mapping done by the WB consultants is relatively bizarre, I think, but many of the comments throughout the text are quite interesting and frank. The snapshots for each of the countries are very disappointing, and give little, if any insight in the PPF health sector. The recommendations at the end seem to bear very little links with the data and the findings from the report. The data tables at the end are mostly from WHR and other easily accessible sources, and do not add much insight to the well-known staggering proportions of THE that are OOP.”

Re our comment “… (PDF 176 pages, 26 MB !!) Which begs the question: who the hell is their target audience ?”
This is meant to be ironical (and ambiguous). It obviously refers to the 26Mb, which makes the report already difficult to download for many of us in the North – in other words, the document is thus “totally inaccessible” for 99% of the people in sub-Saharan Africa, including people in MoH in capital cities, probably even for most WB offices in Africa!

David:

We often discuss within the editorial team whether we should include some articles or not, and inevitably, the discussion tends to be fiercer for those for which “we do not fully agree” (to put it euphemistically) with the content. Recently, we also discussed whether we should take positions in the newsletter or refrain from doing so. We arrived at the following ‘modus vivendi ‘: we publish articles from all origins even if we disagree more or less with the content, if we think they are newsworthy and relevant (In this case we thought it is important to “know your enemy”). Further, as far as our practice of ‘us taking sides’ is concerned, we try to remain neutral to the extent possible, when describing the content of a specific document or paper in a few sentences. Yet, as we are human beings, at times, we don’t manage to refrain from making a comment (like the one I added here on the fact that they come up with a report of 26 MB, which for me illustrated that the authors are not very interested in the report being distributed in the developing world).

However, we strongly encourage replies and reactions from people on articles selected in the newsletter, just the way you did, Pierre. And we are happy to publish this comment, or any version you would like us to post as a standalone blog or as a comment to Friday’s newsletter, on our blog. We will also send your comment to another 160 Emerging Voices, and they can react as well. This just as a first step. In addition we propose to those interested to team up and help draft a more structured comment on the WB report which we could then try to publish in a more visible place – just like we did together with Irene Agyepong and Juliet Nabyonga on the Ghana Insurance, in TMIH. (doi:10.1111/j.1365-3156.2010.02639.x; volume 16 no 1 pp 105–109 january 2011).

Looking forward to more discussions. Thanks for your reaction.

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