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Clearing the global health fog: a systematic review of the evidence on integration of health systems and World Bank working paper ; no.
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Providing social services action one which will assist two in formulating policies three to reduce poverty four : doing this will take a very long time. But in the language of the Report, all these steps have contracted into a single policy, which seems to come into being all at once. All these ominous trends—and no one is responsible? Of course, the criteria according to which X would be treated differently from Y had been decided by someone. But prioritization concealed that. Why X and not Y? Because of prioritization.

Urbanization: An Environmental Force to be Reckoned With

In front of the word, one can no longer see—one can no longer even imagine — a concrete subject engaged in a decision. Levelling the playing field on global issues: no one will ever object to these words although, of course, no one will ever be able to say what they really mean, either. But World Bank Reports are not primarily about knowledge: they are about policy; and in policy, singularization suggests not a greater generality, but a stronger constraint.

There is only one way to do things: one development path; one type of management; one form of cooperation. World Bank policies change, as we have seen, but singularization does not: each new policy is the only possible one Figure 8. The transition from semantic clusters to grammatical structures—from the first to the second part of this essay—entails, so to speak, a certain loss of momentum: compared to the dramatic trajectories of Figures 1—6, with their five- or ten-fold increases, the mild incline of Figure 7 is hardly impressive.

Grammar is made of rules and repetition, and its politics is in step with longer cycles: structures, more than events.


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It defines, not a policy of the Bank, but the way in which every policy is put into words. It is the magic mirror in which the World Bank can gaze, and recognize itself as an institution. Two passages from the Report may help to explain:.

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There is greater emphasis on quality, responsiveness, and partnerships; on knowledge-sharing and client orientation; and on poverty reduction. The first passage—a grammatico-political monstrosity—is a small present to our patient readers; the second, more guarded, is also more indicative of the rhetoric in question. Knowledge-sharing has really nothing to do with client orientation; poverty reduction, nothing to do with either.

There is no reason they should appear together. The frequency of nouns in academic prose is usually just below 30 per cent; in World Bank Reports it has always been significantly higher, and has increased slowly and regularly over the years. Our agenda has included gender equality, food security, climate change and biodiversity, infrastructure investment, disaster prevention , financial innovation, and inclusion. Condensed, first of all: this is a brisk rhetoric, succinct, even a little impatient; the language of those who have a lot to say and no time to waste.

But one question remains. How could such a tortuous form of expression become a leading discourse on the contemporary world? The growing indifference to space and time is not just a matter of quantity. If one looks at the paragraphs in which the Reports are articulated, one detail leaps to the eye: their endings have completely changed. Here are some instances from A modern coffee-processing plant, financed by the Development Bank, was completed near Jimma, the centre of an important coffee-producing area.

Automatic telephone exchanges have been installed in Addis Ababa and Gondar, and manual exchanges in other towns. This has encouraged investment in industries such as metals and chemicals which are large consumers of power, and has led Norway to develop more generating capacity per head than any other country. Jimma, Addis Ababa, Gondar, Norway: in these sentences, a strong geographical specificity goes hand in hand with an equally strong sense of time.

This is true even in more complex cases, like this one from The temporality is complex, but its dimensions are clear: the past is the realm of results; the present, of decisions; the future, of prospects and possibilities. In recent years, though, this difference has been diluted. Here is a paragraph ending from Some other recent examples:. The Second Kecamatan Development Project is benefiting 25 to 30 million rural Indonesians by giving villagers tools for developing their own community.

The Bank significantly accelerated its efforts to help client countries cope with climate change while respecting another aspect of its core mission: promoting economic development and poverty reduction by helping provide modern energy to growing economies.


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  7. The Bank has accelerated —but only its efforts ; and all these efforts will do is— help ; and all those helped will do is— cope ; and the helping and coping will have to respect the promoting of the helping again! But there is no point in looking for the meaning of these passages in what they say: what really matters, here, is the proximity established between policy-making and the forms ending in -ing.

    An infinitely expanding present emerges, where policies are always in progress, but also only in progress. Many promises, and very few facts.

    The joint statement of purpose

    All change, and no achievement. All change, and no future. It appears in the general introduction of the Report, in a section on agricultural loans, and its language is so simple, it seems almost featureless: Many developing countries need to transform their agriculture. In addition, selling electricity back to the grid could generate revenue to conduct maintenance on these pumps — a good sign for the sustainability of the arrangement. What have we missed? Have you developed technology to tackle water problems? Tell us in the comments below. Join our community of development professionals and humanitarians.

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    Loading comments… Trouble loading? Most popular. Today one sees such cases only from third world countries. The lack of safe drinking water in India is being capitalized by industries manufacturing the bottled water and water filters. When the developed countries have started discouraging bottled water, we are seriously promoting it. Unless and until all our citizens have access to safe drinking water, distributed through pipes in each household, we can never claim to have achieved health care. The third major healthcare issue is poor waste management.

    Inadequate sanitation facilities and unhygienic surroundings pose a serious threat to our environment and health. On the world environment day, we in India should be discussing seriously on issues of waste management before we discuss global warming and ozone layer depletion.

    What does the World Bank actually do?

    All that we do on the world environment day is hold meetings and plant some trees, which are often forgotten after that day. We casually throw away all our waste and do not manage them properly, thus providing a breeding ground for the germs responsible for several communicable diseases like Malaria, Filariasis, Dengue, Leptospirosis, Typhoid and Dysenteries.


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    7. We also face other environmental issues like air and water pollution in the form of contamination of the atmospheric air with toxic gases, the water and food with toxins, bacteria and viruses. All these are signs of the absence of basic facilities in the society. There is an increasing threat to our environment from the careless dumping of electronic wastes containing heavy metals like Mercury, Cadmium and Lithium, which is the contribution of the unchecked and growing consumerism. The threat of ozone layer depletion, increasing levels of carbon dioxide and global warming are mainly caused by deforestation, but it is also linked to accumulating wastes and poor waste management.

      We should also realize that it is the increasing consumerism that generates more waste and promotes deforestation too. The fourth and probably one of the biggest and unrecognized global health problems is growing consumerism in every sphere of life including the disease care industry. Consumerism induces people to buy, eat or consume unwanted things or undergo unnecessary 6 procedures exposing them to overeating, physical inactivity, and stress, and finally into debt trap. The more we consume, the more will be the accumulation of waste around us, especially in a situation where there are no well-coordinated or well-organized waste management systems.

      People are deceived into buying and using most products because of lack of empowerment and the misleading advertisements promoted and propagated by celebrities. In the long run, this trend benefits only the manufacturers and suppliers of the products inside and outside the country, of whom probably USA is a major beneficiary and is presently the capital of consumerism. If we look carefully, we can conclude that consumerism and lack of empowerment are the root causes of several diseases like diabetes, liver diseases, hypertension, cancers and autoimmune diseases, and the consumerist forces then push people into the most expensive modalities of treatment, ignoring cheaper alternatives.

      As a nation, we have been ignoring health care for long and are literally manufacturing diseases. If the USA is the capital of consumerism, India is the capital of diseases like all kinds of infections including Tuberculosis and AIDS , lifestyle diseases like diabetes, hypertension, heart attacks, and cancers and even inherited diseases. Because of our careless attitude to health care we have ended up bearing the double burden of proliferating communicable diseases due to lack of basic health needs and the alarmingly high prevalence of noncommunicable disease due to ever growing consumerism, bad lifestyle and dietary habits acquired by imitating the bad trends in the USA.

      After manufacturing diseases in large numbers we now focus on socializing disease care facilities with a focus only on treatment and that too through specialist doctors and superspecialty hospitals imitating the worst disease care model in USA. We boast of the ultra-modern treatment facilities that we have, but conveniently forget the fact that we have not achieved anything in the area of basic health care needs, cost-effective basic medical care and have failed in providing human development and social security for all. To make matters worse, patients in India have the freedom to consult any doctor, bypassing all the conservative and cost-effective approaches, since we do not have a health policy and a referral system.

      We are wasting our resources by copying all the bad trends in the American 7 model of disease care and consumerism; at the same time we forget to emulate the good things in their basic health care.

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      Clearing the Global Health Fog (World Bank Working Papers)

      The trends in India have only helped USA to sell all their modern machines and costly medicines here. We now give priority to ultramodern treatment centers at the expense of genuine health care and basic disease care facilities. We must resolve to concentrate on ensuring availability of basic health needs for every individual as the first priority in order to reduce the disease burden as had already happened in the developed world , and to check the power of consumerist forces in all spheres of life including treatment of diseases.

      We must also remember that providing basic health care and basic disease care to all individuals is a human right or genuine health care is our right and that is the greatest health insurance to the people. We must not forget that health care and disease care are two separate issues, disease care facilities cannot sustain in the long run unless there is genuine health care and a low disease burden.