By Andrew Jack in London
Published: April 30 2009 19:03 | Last updated: April 30 2009 19:03
A third of the World Bank’s support for health, nutrition and population programmes over the past decade has been unsatisfactory, the multilateral agency’s own evaluation unit concluded on Thursday.
Out of $17bn (€12.9bn, £11.5bn) in support to countries, only two-thirds had satisfactory outcomes, with many projects marred by inadequate risk assessment, weak monitoring and evaluation, and lack of accountability, said its Independent Evaluation Group.
”A weak start” also undermined $873m invested by the International Finance Corporation, its private sector arm, over the period 1997-2008, with ”important gaps” remaining despite a marked improvement.
The analysis was seized on by non-governmental organisations which have long criticised donors for supporting the World Bank, which they claim lacks adequate accountability and supports private sector solutions they believe are ineffective.
The evaluation stressed that the World Bank’s support had helped strengthen governments’ capacity, that it was often working in difficult environments and that it had ”a unique and substantial” ability to improve outcomes for the poor.
But it called for greater attention to reducing high fertility and malnutrition, a redoubling of efforts to help the poor, and greater moves to reinforce its accountability. It said evaluation was ”almost non-existent” and warned that ”excessive earmarking” of support for communicable diseases risked weakening health systems.
Oxfam, the development charity, said the evaluation undermined claims by the World Bank to be a leader in health provision for the poor and an emphasis on private sector solutions.
Emma Seery, head of essential services, said: ”This calls into question the UK government’s decision to make the World Bank a central part of their efforts to improve health services in poor countries when other players like the Global Fund are doing a much better job and saving millions of lives.”
Rachel Baggaley, head of HIV at Christian Aid, said: ”’The report states that 82 per cent of the World Bank’s free standing HIV projects in Africa were not successful. Compare this to the results of the Global Fund and it is very clear where the UK government should be putting its aid money.”
The World Bank said it agreed with many of the criticisms and had already made changes in a new strategy adopted in 2007. It added that health was a complex field, but that if people were suffering and dying, it did not have the option of delay.
It said it was tripling its commitment to the sector to $3bn in the current fiscal year, with a particular focus on strengthening health systems.
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