Will markets be master or servant to health at the World Bank?

Abstract

In the 18 years since a six part series by Abbasi in The BMJ argued that the World Bank merits greater attention from the health community, the institution has received little scrutiny from global health scholars.1 This is despite its substantial and growing role in the health sector. A recently published series of articles by Sridhar and colleagues does much to fill this gap.2-6 The authors paint a detailed picture of the bank’s historical activities, growing investments, and considerable evolution in its approaches to health. They also critically analyse more recent developments. Whether considering the growth of health related trust funds at the bank,3 its role in universal health coverage,4 the recently launched global financing facility for women and children’s health,5 or the pandemic emergency financing facility,6 the series persistently grapples with two key questions: firstly, can the bank’s market oriented approach be consistent with health equity objectives such as the globally endorsed goal of universal health coverage? Secondly, how can the bank’s immense economic and intellectual power be appropriately governed?