Victory: U.S. Congress acts against structural adjustment

-------- Original Message --------
Subject: (50 Years) Victory: U.S. Congress acts against structural
adjustment
Date: Fri, 14 Jul 2000 18:51:01 -0400
From: Soren <Soren@afgj.org>
To: "'stop-wb-imf@50years.org'" <stop-wb-imf@50years.org>

The U.S. House of Representatives yesterday passed its foreign
operations
appropriations bill.  After much debate, the bill included nearly the
full
amount President Clinton requested for the joint IMF/World Bank "debt
relief" program, the Heavily Indebted Poor Countries (HIPC) Initiative.

The 50 Years Is Enough Network is very pleased to report that the bill
also
contained a provision that represents the first attempt by Congress to
use
its leverage over the IMF and World Bank to stop some of the worst
aspects
of structural adjustment: the imposition of user fees for primary health
and
education.   The House bill still has to be reconciled with the Senate
version, so it's not yet law -- but it has cleared some of the most
difficult hurdles.

50 Years has long objected to the HIPC program's linkage of debt relief
to
structural adjustment programs (SAPs).  We did not oppose the
appropriation
included in yesterday's legislation, but we remain committed to working
for
debt cancellation that frees countries from the shackles of IMF/World
Bank
demands.  The user fee provision is a modest first step in that
direction.
It does not satisfy the need for a complete divorce from structural
adjustment, but it can contribute to saving and improving lives.  It is
also
a significant first penetration of the seemingly-invincible armor SAPs
have
been accorded by the IMF, the World Bank, and the powerful governments
that
control them.

We will also continue to advocate for debt cancellation that requires
the
international financial institutions to write off debts rather than
demand
that Northern countries pay them off with their taxpayers' money, as is
the
case with the HIPC program.

The press release below was sent out today, and tells the rest of the
story.
Please note the information about the effects of user fees at the end of
the
press release.

If you're as happy about this provision on user fees as we are, why not
take
a moment and send a note of thanks to the Reps. who helped make this a
reality -- Jesse Jackson, Jr. and Nancy Pelosi.  (This would be
particularly
good if you live around Chicago or San Francisco, their respective
hometowns.)  Notes of appreciation signal to Reps that the issue indeed
has
support, and that sympathetic people want to see the final legislation
include this provision.  That encourages them to work for final passage.
Rep. Jackson's fax is 202/225-0899 and Rep. Pelosi's is 202/225-8259 --
or
you can send them regular mail at U.S. House of Representatives /
Washington, DC  20515.  

Thanks!

Soren Ambrose
50 Years Is Enough Network

======================================

July 14, 2000

Contact:  Soren Ambrose - 50 Years Is Enough Network - 202/544-9355
           Joanne Carter - Results - 202/783-7100

HOUSE VOTE OPPOSES IMF & WORLD BANK ON 
"USER FEES" FOR EDUCATION AND HEALTH IN POOREST COUNTRIES
Actress Valerie Harper calls IMF/World Bank policies a "terrible
tragedy"

In a landmark move, the U.S. House of Representatives on Thursday
approved a
measure to pressure the International Monetary Fund (IMF) and World Bank
to
stop requiring that impoverished countries charge "user fees" for access
to
primary health services and primary education.  

The anti-user fees measure is included in the Foreign Operations
appropriations bill approved Thursday by the full House.  It was
originally
introduced as an amendment in committee by Rep. Jesse Jackson, Jr.
(D-IL), a
staunch advocate for debt cancellation and economic justice for
impoverished
people around the world. This House action represents the first time
that
Congress has required the IMF and World Bank to change the specific
conditions they impose in borrowing countries.

User fees, charges imposed for using a health clinic or attending
school,
have led to increased illness, suffering and death when people cannot
pay
for health services, and decreased school enrollments when poor families
can
no longer afford to send their children to school. In a tragic example
in
Zambia quoted by UNICEF, a researcher observed a 14 year boy with acute
malaria turned away from a health clinic for want of a 33 cent
registration
fee. According to the report, "within 2 hours, the boy was brought back
dead."

The requirement that the world's most impoverished countries charge fees
for
primary health and education has long been one of the most controversial
features of the austerity programs mandated by the IMF and World Bank.
Advocates for the abolition of the fees point to scores of studies which
demonstrate that their imposition forces a society's most impoverished
families to deny their children basic education and their sick and dying
health care. [See end of press release for examples of research
findings.]

Although James Wolfensohn, President of the World Bank, has contended in
addressing members of Congress that the Bank has abandoned user fee
requirements, current documents, such as the program for Tanzania linked
to
the granting of limited debt relief, contradict his stance.  

Under the provision adopted by the House, beginning in 2002, U.S.
funding
would be provided only when the heads of the World Bank and IMF certify
their institutions "will not include user fees or service charges
through
'community financing,' 'cost sharing, ' 'cost recovery,' or any other
mechanism for primary education or primary healthcare, including
prevention
and treatment efforts for AIDS, malaria, tuberculosis, and infant,
child,
and maternal well-being" in any of their programs. 

Actress Valerie Harper, a RESULTS Board member and one of the leading
advocates of abolishing user fees, argued to members of Congress that
charging the world's most impoverished people for the basic health and
education was a "terrible tragedy."  She pointed out, "I live in one of
wealthiest areas of the wealthiest country in the world, and my daughter
can
attend Beverly Hills High School for free.  Meanwhile, women in the
poorest
countries of sub-Saharan Africa are told they have to come up with hard
cash
to send their kids to first grade or see a doctor at a clinic.  We must
not
accept this." 

Njoki Njoroge Njehu, a Kenyan who directs the 50 Years Is Enough
Network, a
coalition of U.S. groups opposing IMF and World Bank policies, said,
"This
significant step by the House brings closer the day when people
throughout
the Global South will be able to decide on their own priorities.  We do
not
want to raise another generation on promises from the IMF and World Bank
that the sacrifice of their education and health will be 'short-term
pain
for long-term gain.'"

*  *  *  * *  *  *  * *  *  *  *

Recent studies have revealed some of the damage done by user fees
imposed by
IMF/World Bank structural adjustment programs:

* In Kenya, introduction of a 33 cent fee for visit to outpatient health
centers led to a 52 percent reduction in outpatient visits. After the
fee
was suspended, visits rose 41 percent.  

* Introduction of user fees at rural clinics in Papua New Guinea led to
a
decline of about 30 percent in attendance, and although it subsequently
increased it never returned to pre-fee levels. Health workers also
reported
a reduction in completion rates for courses of treatment.

* In Dar es Salaam, Tanzania the three public district hospitals saw
attendance drop by 53.4% between the second and third quarters of 1994,
when
user fees were introduced.

* In Nicaragua, about a quarter of primary schoolchildren have not
enrolled
in primary school since charges for registration and a monthly stipend
were
introduced.

* In Niger, cost recovery measures implemented as part of a structural
adjustment program between 1986 and 1988 had the following results: 1) a
sharp decline in already very low primary school enrollment rates: these
went from 17% in 1978 to 28% in 1983 to 20% in 1988; 2) drop in
utilization
of preventative care services; 3) increased exclusion of the most
impoverished from care at Niamey Hospital, where outpatients who did not
pay
for care would wait an average of 24 days before seeking care while an
outpatient who did have to pay for care would wait an average of 51
days;
and 4) exemption systems that were applied to the benefit of urban,
military, and civil service families and not for the intended
beneficiaries
(the most impoverished).

* UNICEF reports that in Malawi, the elimination of modest school fees
and
uniform requirements in 1994 caused primary enrollment to increase by
about
50 percent virtually overnight - from 1.9 million to 2.9 million.  The
main
beneficiaries were girls.  Malawi has been able to maintain near full
enrollment since that time.


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