AMIT SEN GUPTA*
World Development Report 1993: Implications for Infrastructure Development in Health Care and the Pharmaceutical Industry
The World Development Report 1993 (WDR) is the most comprehensive document of the World Bank regarding the health sector as a whole, and, in that sense, embodies the basic understanding of the Bank towards this sector. In this paper I shall try to critically analyse the essential fom)ulations being made in this document, as well as attempt to project the implications of these formulations on the future development of health infrastructure in developing countries.
Before embarking on this task, however, it would be useful first to take a look at the specific juncture at which the World Bank has chosen to make its views on the health infrastructure public. Structural adjustment policies, now being enforced in the country, have been in force in many developing countries (mainly in Africa and South America) for a fairly long period—in many cases over a decade. Such policies thus need to be viewed in a global context, specifically in the context of the attempt by developed market economy countries to gain access to the growing markets of third world countries. These policies attempt to encapsulate the "free market" ideology as a guiding principle, and are designed to place the "market" in a central position of dominance, where it would act as the principal, if not the sole, arbitrator of all processes. At n global level such a position is extended to encompass the concept of "free trade"—a concept that has been captured in its full essence by the GATT treaty of 1994.
The World Bank has obviously had time to analyse the effect of its adjustment policies in the countries which implemented them since around 1980. One fact that obviously must have leapt to the eye was
Society for Economic and Social Studies, New Delhi.
Social Scientist, Vol. 22, Nos. 9-12, September-December 1994