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Periodical article Periodical article Leiden University catalogue Leiden University catalogue WorldCat catalogue WorldCat
Title:Investing in Amnesia, or Fantasy and Forgetfulness in the World Bank's Approach to Healthcare Reform in Sub-Saharan Africa
Author:Epprecht, Marc
Periodical:Journal of Developing Areas
Geographic term:Subsaharan Africa
Subjects:World Bank
public health
Economics and Trade
international relations
Health and Nutrition
Abstract:The World Bank's 1993 'World Development Report', subtitled 'Investing in health', appeared to represent a significant rethinking of the monetarist dogma that has dominated international financial circles for the past two decades. It holds special significance for sub-Saharan Africa, the region where the current economic and health crises cry out most urgently for attention. If 'Investing in health' suggests hopeful strategies to avert that nightmare, a follow-up report called 'Better health in Africa' (1994) applies further balm to the pessimism. However, can one of the major architects of Africa's harrowing experience with the so-called free market really have converted? Can an organization that has ignored the recommendations of the WHO for the past 15 years really be embracing a vision of health for all? This paper argues that, although both reports contain many sensible, practical and useful recommendations, both 'Investing in health' and 'Better health in Africa' are profoundly, and dangerously idealistic. This idealism stems from self-flattering and self-serving premises about the political neutrality of Western biomedicine and about the rationality of Western thought in general. These premises can only be sustained by a rigorous refusal to consider the actual history and the lingering 'irrational' legacy of imperialist relationships. Notes, ref.