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FINANCE: Development Banks Lag on Sexual Health – Report

Emad Mekay

WASHINGTON, Jul 6 2007 (IPS) - Despite strong verbal commitments to reproductive and sexual health, the so-called multilateral development banks (MDBs) that lend to poor nations have spent relatively little money on such projects and, in some cases, have followed policies on the ground that in fact impeded women’s empowerment and improved public health, a new study charges.

The study by Gender Action, a Washington-based group that monitors the banks’ policies towards women and gender equality, examines both the quantity and quality of funding for reproductive health during a four-year period from 2003 to 2006 by MDBs that include the World Bank, African Development Bank, Asian Development Bank and Inter-American Development Bank, as well as the restrictive fiscal and monetary policies by the International Monetary Fund (IMF).

Along with the European Bank for Reconstruction and Development, they make up the five multilateral development banks that lend vast amounts of public funds to governments in developing countries under the mantra of alleviating poverty.

The 90-page study records a “profound decline” in World Bank spending and a shortage of other MDB support for reproductive health and HIV/AIDS. The ebbing of funds occurred despite the fact that these banks have pledged to help countries meet the so-called Millennium Development Goals (MDGs), a series of anti-poverty targets to be met by 2015 that was set by the United Nations in 2000 and approved by 189 member governments. The MDGs include the promotion of gender equality and empowerment of women.

The report estimates that the World Bank was the largest funder from 2003-2006 of both reproductive health and HIV/AIDS projects and components, approving a total of 7.5 billion dollars. Still, funding declined dramatically from 2.7 billion dollars for such projects in 2003 to only 1.5 billion in 2006.

This apparent backpedaling on commitments to reproductive health comes after the Washington-based bank was slammed two months ago by watchdog groups for attempts by senior conservative officials to water down bank policy on sexual- and reproductive-health programmes.

The World Bank did not respond to several IPS requests for comment.

Another regional lender, the African Development Bank, also fared poorly in the study on both counts.

Despite the painful HIV/AIDS pandemic affecting many African countries, the Tunisia-based lender gave a relatively small 44 million dollars for HIV/AIDS projects and components from 2003-2006 and 108 million dollars for reproductive health during the same time period. This is out of a total lending portfolio of 3.4 billion dollars just for 2006.

The Manila-headquartered Asian Development Bank’s investments in reproductive health and HIV/AIDS from 2003 to 2006 totaled 47.4 million dollars, with most of the money going to HIV/AIDS in the form of grants. Last year, the bank lent a total of 8.5 billion dollars for various development projects.

The Washington-based Inter-American Development Bank, which lends to Latin nations, provided a meagre three million dollars in loans and grants for reproductive health and HIV/AIDS during the same four years, out of a lending portfolio of 6.4 billion dollars last year.

The report also gave poor reviews to the quality of these banks’ programmes. It found that the MDBs current initiatives often lack gender rights projects and fail to describe actionable remedies.

The report berated the MDBs for focusing almost solely on demographic issues and maternal health rather than on reproductive and sexual health and rights.

“Compounding lack of gender sensitivity in MDB projects is their unsustainability caused by endemic MDB project shortcomings including short-term project duration and lack of funding for recurrent expenditures such as salaries for doctors and nurses,” it said.

The study echoes longstanding complaints about the IMF and the MDBs that the conditions they impose with their loans often undermine government funding for reproductive health and HIV/AIDS programmes.

“Health sector privatisation and user fees make reproductive health and HIV/AIDS services unaffordable to the poor,” it said.

The IMF was faulted for loan packages and economic policy advice that force most borrowing governments to place limits on public sector wages and reduce the number of doctors and nurses as part of its prescription to cut inflation and public expenditures.

The IMF and the MDBs also embrace the Western standards for intellectual property rights allowing for large hikes in the prices for life-saving medicines and medical supplies, especially for HIV/AIDS.

“For these reasons, MDB project descriptions that promise to sustainably increase access to reproductive health, HIV/AIDS and other services are misleading,” concludes the study.

In its 2007 annual report, the World Bank acknowledges that despite strong donor policy commitments to gender equality objectives, “implementation has been disappointing.”

It adds that the multilateral development banks have introduced systems to monitor progress on gender equality policies and that there has been “modest but steady progress.”

The African Development Bank, Inter-American Development Bank and World Bank have recently adopted Gender Action Plans to make their gender and sexual health policies more strategic and effective.

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