The impact of IMF, World Bank
and neoliberal economic policies
on infant mortality
and increasing longevity in the Third World
Dollars and Sense magazine, July / August 2000,
In spite of the persistence of great inequality and poverty
in the world, throughout the last 50 years infant-mortality rates
have fallen and life expectancy has risen in almost all countries.
The gains in many low-income countries are especially impressive.
Yet these improvements were no greater in the 1980s and 1990s,
when neoliberalism gained dominance, than in earlier periods,
and they cannot be tied to the neoliberalism of the IMF and World
Public-health programs, such as inoculation against smallpox
and improvements in sanitation, are responsible for most of these
improvements. Yet these types of social programs are, to say the
least, not central elements in the neoliberal agenda, which encourages
government cutbacks and privatization. Of course, the neoliberals
justify their approach by arguing that their policies lead to
economic growth, which then leads to the expansion of social programs.
Neoliberal policies, however, have not greatly improved economic
growth, nor is there any automatic connection between economic
growth and improvements in infant-mortality rates and longevity.
Chile is one case that might lend support to the claims made
by supporters of the IMF and World Bank. In that country, where
neoliberal policies were imposed by the military dictatorship
in the mid-1970s, the infant-mortality rate fell from 77 per 1,000
live births in 1970 to 32 in 1980, to 16 in 1990, and to 11 in
1997. (Life expectancy data tell a similar tale, rising from 62.4
years in 1970 to 75.2 in 1997.) The substantial success of the
1970s, however, can hardly be attributed to the neoliberal model,
since free-market policies were not instituted until the latter
part of the decade and it takes time for economic policies to
produce health results. Also, the improvements occurred at least
in part because the dictatorship departed from its neoliberal
policies, establishing government prenatal and neonatal programs.
Nowhere else in Latin America can advocates of neoliberalism
find support for their claims, even though the governments in
the region have adopted neoliberal policies. For example, in Mexico,
Brazil, Argentina, and Peru, infant-mortality rates and longevity
figures have improved continuously, but no more than when "statist"
policies were in force. Indeed, in Mexico improvements in the
infant-mortality rate have slowed dramatically since 1990 -precisely
the years when neoliberal policies began having their impact on
Also, to date, no other country in Latin America has matched
the experience of Cuba. In 1997, the life expectancy in Cuba was
76 years and the infant-mortality rate was 7 per 1,000-the same
as in the U.S. Whatever one thinks of Cuban economic policies,
they can hardly be classified as neoliberal!
Outside of Latin America, it is hard to find evidence that
would support the IMF and World Bank on the basis of these social
indicators. On the one hand, there is the case of South Korea,
where a military dictatorship achieved great success with capitalist
development under a regime of strong state control of the economy.
The infant mortality rate fell from 46 in 1970 to 12 in 1990,
and life expectancy rose from 60 to 70. On the other hand, in
sub-Saharan Africa, where the IMF and World Bank have had major
roles in recent years, social indicators remain dismal and the
era of increased neoliberal influence has not been better than
earlier decades. Life expectancy rose from 44 years in 1970, to
48 in 1980, inched up to 50 in 1990 and then to 51 in 1997; the
infant-mortality rates for those years have been 137, 115, 100,
and 91. (Neoliberalism, it seems, has done little to counter the
Shifting attention to the wealthy capitalist countries, it
is interesting to compare the U.S. and Japan. In spite of Japan's
relative economic stagnation since the end of the 1980s, in 1997
life expectancy was 80 and the infant mortality rate was a remarkable
3.7 per l,000. In the U.S., where we talk about the great economic
expansion of the 1990s, the figures for 1997 were 76 for life
expectancy and 7.1 for infant mortality. There are many differences
between the two countries that could explain Japan's better social
indicators. Still, one economic fact is probably most relevant
here, as in other parts of the world: the distribution of income
in Japan is much less unequal than in the U.S.
IMF, World Bank, Structural