NCPA - National Center for Policy Analysis


January 20, 2006

Bill and Melinda Gates have been pouring billions into programs designed to help the health of residents in poor nations. To determine the return various projects generate, Gates helped finance a World Bank investigation into the efficiency of measures to improve the health of the world's poor.

The World Bank studied the results of programs meant to help the poor and found that even programs designed to reach poor people often end up instead helping the better-off.

According to the researchers:

  • In almost all of the more than 20 countries surveyed, the richest 20 percent of the population received more, or as much of, the government's subsidized maternal and child health care services as the poorest 20 percent.
  • Studies of Cote d'Ivoire, Ghana, Guinea, Kenya, Madagascar, South Africa and Tanzania all have shown that government spending on health favors upper-income groups.

The World Bank remains optimistic that such programs for the poor can be made to work. On the other hand, the World Bank was founded almost six decades ago and only now is releasing reports showing that some of the most promoted programs for the poor in the history of the world are more likely to benefit the rich, says author James Peron.

Source: James Peron, "The World Bank Gets Introspective," TSC Daily, January 9, 2006; and "Reaching the Poor with Health, Nutrition and Population Services: What Works, What Doesn't, and Why," edited by Davidson R. Gwatkin, Adam Wagstaff and Abdo S. Yazbeck, World Bank, December 2005.

For text:

For World Bank study:


Browse more articles on International Issues