Batniji Rajaie
Global Economic Governance Programme, University College, Oxford, United Kingdom.
Int J Health Serv. 2009;39(4):783-7. doi: 10.2190/HS.39.4.k.
Despite optimism about the potential for a "new economic order," the outcomes of the G20 summit of April 2009 do not deviate from the neoliberal path. The main outcome, the G20's commitment to the International Monetary Fund (IMF), does not change the lending practices and core economic assumptions of the IMF. Further, this new funding commitment will do little to help the poorest countries, as it is not available to them and comes with high interest. Institutions that more actively consider health, such as the World Bank and World Health Organization, may have failed to win resources and authority because they have not demonstrated how they could expand or modify their activities, and because of broader ideological debates pitting social protection against economic stimulus. Reforms in IMF practices and economic assumptions may provide some limited protection of health spending. These reforms can allow for inclusion of the benefits of health programs in economic forecasting, dismissal of the assumption that aid will be short-term, and removal of indirect limits on public sector health spending. These reforms in IMF practices are urgently needed, but fall short of making health and social protection an integral component of efforts promoting economic stability.
尽管人们对“新经济秩序”的潜力持乐观态度，但2009年4月二十国集团（G20）峰会的成果并未偏离新自由主义道路。主要成果，即G20对国际货币基金组织（IMF）的承诺，并未改变IMF的贷款做法和核心经济假设。此外，这项新的资金承诺对最贫穷国家帮助不大，因为它们无法获得这笔资金，而且利率很高。世界银行和世界卫生组织等更积极考虑卫生问题的机构，可能未能赢得资源和权威，原因在于它们没有表明如何能够扩大或调整其活动，以及由于在社会保护与经济刺激之间展开的更广泛意识形态辩论。IMF做法和经济假设的改革可能会为卫生支出提供一些有限的保护。这些改革可以将卫生项目的效益纳入经济预测，摒弃援助将是短期的这一假设，并消除对公共部门卫生支出的间接限制。IMF做法的这些改革迫切需要，但仍不足以使卫生和社会保护成为促进经济稳定努力的一个组成部分。
