Richer countries have exerted power over others for many years, going back to the late 1800s and the “Scramble for Africa”. But even post colonialism, powerful countries have continued to exert an influence on less powerful ones.
Free trade, privatisation and lack of spending on health and education – in other words, neoliberal policies – haven’t always been the choice of poor countries. In many cases, they were effectively forced onto them through a process known as ‘structural adjustment’. In the 1980s the International Monetary Fund and the World Bank, headed by Europeans and North Americans lent money to many poor countries on condition that they pursued a rigid track of neoliberal policies. These including privatizing services, cutting regulation, opening markets to foreign trade and slashing government spending on health and education.
This was a disaster. It drove poor economic performance and increased poverty in the Global South destroyed the provision of health services; and propelled inequalities, resulting in poor health for the most impoverished. It also generated a mantra which posits an individual’s lifestyle as the cause of poor health, deflecting attention from wider political, economic and social causes.
The results were devastating. An extensive multi-country report by a global civil-society network published in 2002 reviewed the impacts of structural adjustment across a wide range of countries. It found a worsening of poverty and inequality with the greatest impacts on the poorest, especially women. A 1996 paper by World Bank and US Treasury Department economists calculated that over ½ million child deaths in the Global South in the year 1990 were a result of poor economic performance in the 1980s -the height of structural adjustment
Neoliberal policies are like a radical experiment with developing countries used as guinea pigs
– Rick Rowden
But this period is not confined to history. International financial institutions and powerful countries still exert power over others today. This can be covert such as providing ‘technical advice’ or aid projects that encourage privatisation or opening up economies to foreign investment, or overt such trade agreements between countries which force less powerful countries to accept conditions such as reduced regulation.
Because neoliberalism is so firmly embedded in many cultures that alternative voices often do not even feature in debates about tackling poverty and inequality.
Despite this, in many places around the world people are pushing back. There is evidence of a different track, where people are pursuing alternative policies that improve people’s health, strengthen public health systems, reduce inequality and improve people’s lives.
Read more about this in our report on alternative approaches to health and wellbeing.