World Bank set for historical change: does it matter to us?
For the first time in its 68 years of existence, World Bank will be headed either by a public health professional, or a political hawk or a non-American.
The World Bank, world’s biggest development lender, will rewrite its history when its new president is selected later this month.
For the first time in its 68 years of existence, it will be either a public health professional, and not an economist, banker or a political hawk; or a non-American, who will head it.
Either way, it will be a major departure from its hardcore tradition, whether it matters to the manner in which the World Bank (WB) functions or not.
Both developments are equally striking, although ultimately it will be America’s voting power and Europe’s consent to the American right, that will decide the presidentship.
Traditionally, America chooses its nominee to head the WB while an European gets to head the International Monetary Fund (IMF).
The two non-American candidates are very serious about their campaign for the job: Ngozi Okonjo-Iweala, a two-time finance minister of Nigeria; and José Antonio Ocampo, a former finance minister in Colombia and a professor of economics and public affairs at Columbia university.
Both of them are hardcore economists and public policy specialists with impressive career records, in the governments of their countries and in international development. While Ngozi worked in the World Bank, Jose Antonio held senior positions in the UN.
Of the two, Ngozi seems to have a leg up in the race. She has been widely featured in global media and is projecting herself as the symbol of the developing world’s right to head the organisation and lead a change in international development.
However, the most talked about is the third candidate, Jim Yong Kim, a Korean-American, and Obama’s nominee for the job. What stands him apart from the rest, including all those who headed the Bank till now, is that he is not an economist or a banker and not even a conventional development practitioner.
He is a public health specialist with impressive hands-on experience in developing countries and academics, who anchored his work in human development and poverty, and tried to change the equations of access and quality of health services.
That he is mostly spoken about as the associate of the legendary medical-anthropologist Paul Farmer and Partners in Health, an NGO, that they set up along with a few likeminded people including Ophelia Dahl, marks his distinctive and game-changer profile.
In his two decade-long work in developing countries, Jim Kim, as he is known in the international development circuit, successfully focussed on strengthening quality health services in resource-poor settings.
Along with Paul Farmer, he and the Partners in Health team pioneered a community-based health care model that responded to local needs instead of top-down solutions, which was later adopted by the WHO. The showcase example first came from Haiti and has been replicated in 40 countries.
Jim Kim subsequently joined the WHO, first as an advisor to the Director General, and then as the head of its HIV/AIDS Programme.
Strengthened by the global community experience, he set out on an ambitious goal of putting people living with HIV on life-saving anti-retroviral medication in poor countries. He audaciously said WHO would treat three million people living with HIV by 2005.
It was a super-ambitious target, when anti-retroviral drugs were extremely expensive and there was hardly any infrastructure to implement his idea in most parts of the poor world. The campaign was called "3 by 5".
"Kim is an ambitious visionary. He is sometimes audacious - most notably when he announced the campaign for '3 by 5' in 2001 when there was virtually nobody," said a senior UN official working in public health.
The "3 by 5" which was achieved in 2006, led to a cataclysmic change in the way the world looked at public health and service delivery. Everything was going against it, but Kim and his team at WHO literally rewrote everything: establishing universal standards, getting all stakeholders on board, setting up systems, procuring drugs, promoting treatment literacy, skills building...the list was endless.
Not surprisingly, the WB, then was among the biggest naysayers. Critics then charged that the WB, along with the US establishment, stood for the interests of big pharma.
The momentum Kim created led to a watershed in expanding lifesaving treatment for people living with HIV, even in the poorest countries. “Many people thought that the 3 by 5 target was both inappropriate and impossible - yet nothing has done more to turn around the global AIDS epidemic,” added the UN official.
Then, here is the catch. The World Bank is not about public health.
An organisation that claims to have modified some of its ways, following the worldwide criticism of its tied-assistance and structural adjustment programmes that landed many poor African and Latin American countries in deep economic trouble and debt traps, is still a typical, American style international development organisation.
It is about lending and telling the countries what is good for them although the contemporary development buzzwords such as inclusive growth and social protection are common in its lexicon now. In fact, this is more evident in Ngozi’s vision statement showing that she is the typical WB material.
“Three major challenges—creating jobs, investing in the human capital of the poor and building institutions—have to be pursued with vigour. Furthermore, the Bank also plays a key role in ensuring the efficient delivery of global public goods and in meshing its initiatives with the priorities of national and regional development programmes," she says in an article in Financial Times.
Sounds familiar, isn’t it?
This is Ngozi’s pitch for the presidentship and those familiar with international development can instantly identify that it is old wine in new bottle. This is vintage development-speak. With people like Ngozi, nothing will change, except for the nominal change of nationality and skin-colour.
Kim’s non-economist handicap might be Obama’s clever ploy to change the ways of the WB. International development experts think that the most important signal sent by this nomination is that the US wants a WB President with direct and extensive experience of fostering development amongst the poor. Kim and his colleagues have worked to promote health amongst the poor in a wide range of contexts and countries.
"His experience with poverty is what matters the most - not necessarily that the issue he worked on amongst the poor was health," says a senior UN official in New York.
Although diehard World Bank critics are not impressed, many believe that Obama has a plan.
First he picked up Indian-American Rajiv Shah, with predominant experience in food and agriculture, to head the USAID (US Agency for International Development). Now his choice for the WB president is a Korean-American with experience in public health amongst the poor.
Obama’s thinking definitely indicates a continuum.
But can a president really change the ways of the World Bank?
Although the Bank’s priorities are shaped by the interaction between its board and national governments, the president has several key roles including the use of "bully pulpit" for persevering with certain critical issues.
Obama’s choice has a clear, certain thinking behind it. It is likely that Jim Kim will pay more attention to public health and the intersection between health and development.
Does it really matter to us?
Yes; but then we also have to follow what Obama did: replace our policy hacks, who are mostly former WB and IMF employees and consultants, with sincere specialists, who really know what poverty and development mean to people and have results to show.
Not just blah blah and statistical trickery.
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