Global Health Watch 1 in one file
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Global Health Watch 1 in one file

Global Health Watch 1 in one file Global Health Watch 1 in one file

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Holding to account | E2 Peoples Health Movement (2005). Defend UNICEF’s mission to defend children! PHM (http://www.saveunicef.org, accessed 14 March 2005). World Bank (2004). Rising to the challenges: the Millennium Development Goals for Health. Washington, World Bank. 298

E3 | The World Bank and the International Monetary Fund The World Bank and the International Monetary Fund were set up at a meeting of 43 countries in Bretton Woods, New Hampshire, US in July 1944. The reform of these ‘Bretton Woods institutions’ and the establishment of systems to hold them accountable to civil society are vital public health challenges. This chapter describes how they are managed and governed, within the broader political and economic context detailed in part A, and proposes reforms. What are the Bretton Woods institutions? The World Bank Group is the second largest public development institution in the world, lending around US$25 billion a year to reduce poverty and facilitate economic growth in developing countries. (Only the European Investment Bank is larger, but much of its lending is to European Union countries.) The World Bank was initially established to improve the capacity of countries to trade by lending money to war-ravaged countries for long-term reconstruction and development projects. It now exerts the single largest influence over policy-making through the conditions attached to its loans, and the research and advice it provides to governments. It has become a much bigger influence than the WHO in the health sector. The IMF also influences the health sector through its ability to dictate countries’ macroeconomic and fiscal policies. It was established to create a stable climate for international trade by harmonizing its country members’ monetary policies and maintaining exchange-rate stability. It was designed to provide temporary financial assistance to countries encountering difficulties with their balance of payments. Governance of the World Bank Group The World Bank Group comprises five institutions. The original institution was the International Bank for Reconstruction and Development, often simply known as the World Bank. Led by a president appointed by the US government, it employs nearly 10,000 staff including 4000 in its country offices. Its board of governors is largely ceremonial, while its executive directors are appointed civil servants who meet regularly in Washington, using voting power based on one dollar, one vote. The US holds 17% of the vote, giving it a veto over any decisions requiring a super-majority of 299

Hold<strong>in</strong>g to account | E2<br />

Peoples <strong>Health</strong> Movement (2005). Defend UNICEF’s mission to defend children! PHM<br />

(http://www.saveunicef.org, accessed 14 March 2005).<br />

World Bank (2004). Ris<strong>in</strong>g to the challenges: the Millennium Development Goals for<br />

<strong>Health</strong>. Wash<strong>in</strong>gton, World Bank.<br />

298

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