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The World Bank and pharmaceuticals.

T Falkenberg¹, G Tomson

¹Department of Public Health Science, Karolinska Institute, Stockholm, Sweden.

Health Policy and Planning

|March 24, 2000

Summary

The World Bank heavily finances pharmaceuticals in developing nations, but primarily for drug procurement, not policy or rational use. Improved focus on drug policy and research is recommended for better health outcomes and loan efficiency.

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Area of Science:

Global Health
Health Economics
Pharmaceutical Policy

Background:

The World Bank is a major funder of health in low and middle-income countries, with significant investment in pharmaceuticals.
Pharmaceuticals represent a substantial portion (20-50%) of government health budgets in developing countries.
Irrational drug use, driven by market failures, causes health problems and financial strain.

Purpose of the Study:

To analyze the World Bank's pharmaceutical sector activities and lending between 1989-1995.
To assess the allocation of World Bank funds within the pharmaceutical sector.
To identify areas for improving the World Bank's involvement in pharmaceutical policy and rational drug use.

Main Methods:

Analysis of 77 World Bank staff appraisal reports.
Examination of loan and credit commitments for pharmaceutical activities.
Assessment of collaboration with pharmaceutical expertise in project development.

Main Results:

The World Bank committed approximately US$1.3 billion to pharmaceutical activities (1989-1995), with US$1.05 billion for drug and equipment procurement.
Only 5% of pharmaceutical lending supported drug policy and rational use initiatives.
Less than 45% of projects involved pharmaceutical expertise in their development.

Conclusions:

The World Bank's pharmaceutical lending heavily favors procurement over policy development and rational drug use.
There is a significant opportunity for the World Bank to enhance its impact by promoting drug policy research and dialogue.
Leveraging its expertise and influence, the World Bank can foster more effective and rational pharmaceutical sector reforms.

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