Sonny Callahan, the Chair of the Foreign Operations subcommittee of the House
Appropriations Committee, and Representative Nancy Pelosi, his Democratic
counterpart, disagree on a lot of issues.
they do agree that Congress should act to stop the International Monetary Fund
and the World Bank from keeping poor kids out of school in Africa.
United States House of Representatives, in the Foreign Operations appropriation,
passed legislation that would bar the International Monetary Fund and the World
Bank from imposing "user fees" on primary health care and education on
fees" are payments by families that the World Bank and the IMF pressure the
government in a poor country to impose for families to send their kids to
school, or to go to the hospital. These services had typically been publicly
financed. "User fees" are supposed to promote efficiency. Their
practical effect has been to deny access.
is particularly scandalous given the AIDS crisis in Africa. Some attention has
been focused on the need for more funding. But not nearly enough attention has
been paid to whether poor people have access to health care. For example, the
introduction of fees in a Nairobi clinic for sexually transmitted diseases
caused a 65% decrease in attendance for women. Yet it is well-known that failure
to treat STDs greatly increases the transmission of AIDS.
studies have shown that the imposition of user fees for school have led to
falling attendance rates. Attendance rates for girls have fallen even more.
Ghana education used to be free. After 10 years of IMF and World Bank imposed
user fees, two-thirds of rural families could not afford to send their children
to school consistently.
is a perverse disconnect here. In the U.S., there is a broad consensus across
the political spectrum in support of universal access to public education
through high school. Yet the IMF and the World Bank, institutions which get a
fifth of their funding from the U.S. taxpayer, impose "user fees" on
poor children in Africa. As the actress Valerie Harper pointed out, her daughter
goes to a public school for free – why would we keep kids out of school in
Africa because their parents can’t pay?
issue illustrates the ideological fanaticism of IMF and World Bank officials.
They continue to insist on their policy because their theoretical models
indicate that it would be more efficient to charge fees – exempting some of the
poorest – than to have education be free and fully financed by the government.
UNICEF has studied the track record of exemption schemes, and found that they
might hope that in light of this information, IMF and World Bank officials would
change their policies. But they haven’t, because practical effectiveness is less
important to them than conformity to their theories.
Clinton Administration, which has decisive influence over the IMF and the World
Bank when it wants to, could use its influence to pressure IMF and World Bank
officials for change.
far, however, the US Treasury department has failed to act. That’s why the
amendment introduced by Democratic Representative Jesse Jackson of Illinois to
the Foreign Operations appropriation, which passed with bipartisan support, is
Clinton Administration is now has two choices. It will have to pressure the IMF
and the World Bank to stop imposing user fees for primary health care and
education, or it will have to explain to Members of Congress why it unable or
unwilling to do so.
House of Representatives has also set an important precedent. In the past,
Congress has forced changes in IMF processes, requiring the publication of more
documents, for example. But with respect to specific IMF polices, it has limited
itself to exhortations which have proved ineffective. For the first time, the
House has demanded change of a specific IMF-World Bank "structural
adjustment" policy on the ground. If this effort succeeds, it could hasten
other reforms in the future.