Uneven health outcomes and political resistance under residual neoliberalism in Africa
Uneven health outcomes and political resistance under residual neoliberalism in Africa
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DOI：
10.2190/jy59-dtcm-fbwl-rcg4
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发表时间：
2003-01-01
影响因子：
3.4
通讯作者：
Dor, G
中科院分区：
文献类型：
--
作者：
Bond, P;Dor, G
20年来，非洲一直在执行与“新自由主义”宏观经济和微观发展模式有关的政策，非洲大陆的健康状况明显恶化。尽管这些政策自1990年代末以来受到质疑，但它们继续在非洲实施，特别是由世界银行和货币基金组织通过《减少贫穷战略文件》和重债穷国债务减免倡议在非洲实施。对卫生部门的财政拨款不足就是证据；与其他部门相比，对保健的概念化不够；与民间社会协商不足；持续执行成本回收和用户费用规定；通过尊重不必要的知识产权贸易条款来获取药品的失败战略；最重要的是，在减少非洲外债方面的明显不足。华盛顿金融机构和非洲社会之间力量平衡的一个反映是，在南非和尼日利亚政府的敦促下，通过了非洲发展新伙伴关系。虽然世界卫生组织帮助研究、宣传和批评与非洲卫生保健中持久的新自由主义有关的问题，但它也继续犯严重的错误，因为它仍然被锁在范式中。相反，非洲社会论坛正在发展的人权观点与反对公司全球化的更广泛的国际趋势是一致的。
Africa has suffered two decades of policy implementation associated with the "neoliberal" macroeconomic as well as micro-development paradigm, and the health status of this continent has deteriorated markedly. Notwithstanding the discrediting of such policies since the late 1990s, they continue to be applied in Africa, especially by the World Bank and IMF, through Poverty Reduction Strategy Papers and the Highly Indebted Poor Countries debt relief initiative. Evidence can be found in the inadequate fiscal allocations to the health sector; the inadequate conceptualization of health in relation to other sectors; insufficient consultation with civil society; ongoing implementation of cost-recovery and user-fee provisions; a failed strategy to access pharmaceutical products, by respecting unnecessary Trade in Intellectual Property Rights provisos; and, most importantly, glaring insufficiencies in reducing Africa's foreign debt. One reflection of the balance of forces between Washington financial agencies and African societies is the adoption of the New Partnership for Africa's Development at the urging of the South African and Nigerian governments. While the WHO has helped to research, publicize, and criticize the problems associated with durable neoliberalism in African health care, it also continues to make serious mistakes as it remains locked within the paradigm. A human rights perspective being developed by the African Social Forum is, in contrast, consistent with broader international trends in the opposition to corporate globalization.