World Bank policies might soon force many civil society organizations (CSO) in middle-income countries (MICs) to close as international donors transition their support to a much smaller pool of least-developed countries. At the same time, patients in MICs with life-threatening diseases like HIV and tuberculosis are forced to pay up to 10 times more for medicines than patients in low-income countries, even though the difference in daily income between the two groups can be as little as $1.
AIDS Healthcare Foundation (AHF) delegates persistently highlighted these troubling realities at the World Bank Civil Society Policy Forum (CSPF), which was held in Washington on Oct. 10-13.
The advocates pressed the World Bank to change how it defines MICs as part of the AHF-led “Raise the MIC” advocacy campaign. Evidence is mounting that the World Bank’s approach to categorizing countries by income level is having an opposite effect to the institution’s stated mission of ending poverty. MICs are now home to 75% of the world’s poor and two-thirds of all people living with HIV.
During several panel sessions at the Forum, including a town hall meeting with World Bank President Jim Kim and International Monetary Fund President Christine Lagard, AHF staffers publically criticized the World Bank for abandoning MICs.
“Jim Kim’s response was basically that there will never be enough donor funding, and under the current model some MICs will only fund HIV/AIDS work if there is external money for it. Because of this, the World Bank is trying to transition them from a supply-driven to a demand-driven response, where developing countries shoulder most of the expense,” said AHF Associate Director of Global Policy Denys Nazarov. “Of course, this totally ignores the fact that in the post-transition space, many governments will not fund anything beyond clinical services, such as vital work with marginalized groups like men who have sex with men and injective drug users. It seems incomprehensible that the global health community is setting ambitious targets like ending AIDS by 2030 and achieving Universal Health Coverage, while the donors are retreating on funding commitments across the world in a major way.”
The outpouring of dissatisfaction with the World Bank culminated in a “Raise the MIC” protest in front of Bank headquarters on Oct. 13. The lunchtime demonstration organized by AHF drew a crowd of over 50 advocates who paced the sidewalk immediately opposite the World Bank’s barricaded entrance chanting and calling on Jim Kim to “do the right thing – raise the MIC now!” To top off the conspicuously loud procession adorned with picket signs and spurred on by a pair of megaphones, advocates brought a giant effigy of Jim Kim to the protest.
Inside the World Bank, AHF co-hosted a panel during the CSPF where several speakers shared their first-hand experiences the detrimental MIC status has on countries in Central and Eastern Europe, Latin America and Southeast Asia. About 25 forum delegates attended the 90-minute session, which concluded with questions from the audience and an AHF invitation for everyone to attend the demonstration.
The World Bank will reconvene in April 2018 for the Spring Meetings. In the interim, AHF fights on urging the World Bank to do the right thing for poor people around the world.