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Abstract
'The Deadly Ideas of Neoliberalism' explores the history of and current collision between two of the major global phenomena that have characterized the last 30 years: the spread of HIV/AIDS and other diseases of poverty and the ascendancy of neoliberal economic ideas. The book explains not only how IMF policies of restrictive spending have exacerbated public health problems in developing countries, in particular the HIV/AIDS crisis, but also how such issues cannot be resolved under these economic policies. It also suggests how mounting global frustration about this inability to adequately address HIV/AIDS will ultimately lead to challenges to the dominant neoliberal ideas, as other more effective economic ideas for increasing public spending are sought.
In stark, powerful terms, Rowden offers a unique and in-depth critique of development economics, the political economy dynamics of global foreign aid and health institutions, and how these seemingly abstract factors play out in the real world - from the highest levels of global institutions to African finance and health ministries to rural health outposts in the countryside of developing nations, and back again.
Rick Rowden worked in Washington DC for 9 years with advocacy NGOs engaged on foreign aid and development issues, including as senior policy analyst for the US office of ActionAid. He has travelled extensively and worked with policy makers, economists and advocacy NGOs across Africa, Asia, Latin America and Europe to critically analyze the macroeconomic policies of the International Monetary Fund (IMF) and their impact on health spending in developing countries. With an MA and BA in International Relations from San Francisco State University, he is an expert in North-South relations and how the global foreign aid, trade and finance systems impact economic development. Previously, he taught Global Studies at California State University, Monterey Bay and Political Science at Golden Gate University in San Francisco. Most recently, he was an Inter-Regional Advisor with the Globalization and Development Strategies Division of the United Nations Conference on Trade and Development (UNCTAD) in Geneva, Switzerland. Currently he is pursuing doctoral studies in economics.
'This book is an extraordinary achievement. It includes a careful study of the political economy of HIV/AIDS and a clear explanation of the economic policies associated with neoliberalism and the IMF. Rowden shows that neoliberalism and IMF policies bear a significant responsibility for the limitations of health policies and budgets in the poor countries and, especially, for the insufficiencies of prevention and treatment of HIV/AIDS.'
Alfredo Saad Filho, School of Oriental and African Studies
'This book is a timely "wake-up call" that we must redouble our efforts to develop viable progressive economic alternatives to Neoliberalism. Despite the ideological fallout from the global financial crisis and recession, the main tenets of the Neoliberal economic paradigm retain decisive power to dictate public policies in developing countries and mould the consensus mindset of the international development community. The need to confront Neoliberalism is nowhere more critical than in the debate on how to expand national budgets and strengthen national capacities to stem the 'deadly' tide of global health crises such as HIV/AIDS.'
Terry McKinley, School of Oriental and African Studies
'For far too long, public health activists have allowed development discussions to be dominated by economists. Rick Rowden has written a highly accessible volume that clearly links economic policies to poor health outcomes in developing countries. His clarion call to health activists to get involved in economic debates is an urgent one. His message is clear, neoliberalism kills. Real health improvements will only come by confronting and ultimately changing neoliberal strategies that continue to have far too much influence in international policy circles.'
Howard Stein, University of Michigan
'Rick Rowden's 'The Deadly Ideas of Neoliberalism - How the IMF has Undermined Public Health and the Fight Against AIDS' is a masterful account of the little known link between ideologically distorted "mainstream" economic theories, IMF policies, and the deadly impact these can have on developing countries. An activist and an extremely well-read and informed student of economics, Rowden has woven a convincing and powerful tale of the human costs of bad theory and bad policy, especially in the area of public health and AIDs in the developing world. His is also an inspiring tale of how informed and dedicated activism can make a crucial difference to the lives of the least priveleged.'
Gerald Epstein, University of Massachusetts
'The Deadly Ideas of Neoliberalism provides a powerful, compelling analysis of the little-known impact of international financial institutions on countless people suffering without access to health services around the world. Rowden's passionate interrogation of the controversial macroeconomic policies embraced by the IMF is compelling and accessible, set against the high-stakes struggle for access to HIV treatment in developing countries. This book should be required reading at the IMF.'
Asia Russell, Health GAP (Global Access Project)
'The timing of Rowden’s superb book couldn’t be better. The global financial crisis has diminished support for health programs by wealthy countries and development organizations at the same time as developing countries are facing deep fiscal crises and severe pressure from the IMF to reduce spending. Rowden’s masterful work demonstrates the dangers associated with such policies, and provides health advocates with the information, arguments and motivation they need to win the battle against policies that, quite literally, kill.'
Ilene Grabel, Josef Korbel, University of Denver
'Occasionally, a book comes along that gives you a slap; a book that says 'you used to care, but you've gotten lazy: WAKE UP!' Rick Rowden's book is one of those books – a passionate, irresistible critique of neoliberal economics that enrages and educates in equal measure. Rowden has shown us why the IMF is bad for our health; the challenge now is for us to do something about it.'
Andrew Harmer, London School of Hygiene and Tropical Medicine
'This book is a welcome and timely rallying call, especially to health activists and development NGOs, to confront and challenge the IMF and question "its specific definition of macro-economic stability".'
Red Pepper
'Extensively researched and well written ... should be read by all who are interested in global health and in HIV/AIDS'
Soloman R. Benatar, Emeritus Professor of Medicine,University of Cape Town
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
About the author | ii | ||
Acknowledgements | vi | ||
Introduction | 1 | ||
Part One | Emergence of HIV/AIDS and the Global Response | 7 | ||
Introduction | 9 | ||
1 | The History of Global Funding to Fight HIV/AIDS | 13 | ||
2 | The Impact of the AIDS Response on Public Health Systems | 25 | ||
3 | The Shortage of Healthcare Workers and the ‘Brain Drain’ Problem | 29 | ||
The ‘brain drain’ problem | 33 | ||
4 | The Debate over ‘Vertical’ versus ‘Horizontal’ Donor Aid | 38 | ||
5 | Different Types of Health Systems, Different Types of Financing | 40 | ||
Hitting a wall: why can’t public health finance be increased? | 46 | ||
Part Two | The Neoliberal Development Model | 49 | ||
Introduction | 51 | ||
6 | The Reagan Revolution, Structural Adjustment and The Washington Consensus | 53 | ||
Origins of the IMF and the World Bank: the Bretton Woods conference of 1944 | 53 | ||
1950 to 1980: decolonization | 56 | ||
The 1980s: the Reagan Revolution and neoliberalism | 62 | ||
The debt crisis, structural adjustment programmes and the Washington Consensus policies | 65 | ||
7 | Neoliberal Theory and its Policies | 71 | ||
8 | The Consequences for Development | 78 | ||
Monetarism and its consequences | 96 | ||
Financial liberalization and its consequences | 107 | ||
Central bank independence (CBI) | 113 | ||
Anti-deficit radicalism and its consequences | 114 | ||
Trade liberalization and its consequences | 120 | ||
Labour flexibility and its consequences | 125 | ||
Consequences for agriculture and food security | 134 | ||
The consequences for development | 137 | ||
Part Three | Consequences for Health | 142 | ||
Introduction | 143 | ||
9 | The Demise of Public Health and the Rise of Neoliberalism | 144 | ||
10 | The Consequences for Health | 153 | ||
11 | Thirty Years Later: Coming Full Circle – Rediscovering Public Health | 160 | ||
12 | The IMF: Blocking Progress on Public Health | 170 | ||
The IMF’s wage-bill ceilings | 192 | ||
Health repression | 204 | ||
Conclusion: What is Development? | 207 | ||
Bibliography | 211 | ||
Index | 236 |