Macroeconomic Justice for Healthy Communities

We advocate for investment in public sector health systems through macroeconomic justice, including international lending practices and trade agreements that embrace health as a human right.

Today, macroeconomic policies imposed as conditions on international lending constrain many developing countries and have a direct impact on people’s health. The long-term effects of these policies can severely impair a country’s ability to build effective health systems or respond to health emergencies.

Following the oil crisis in the 1970s and the initiation of aggressive lending by commercial banks, the developing world faced mounting debts. In response, International Financing Institutions (IFIs), such as the World Bank and the International Monetary Fund (IMF) began to implement strict conditions on their loans, underscoring privatization and deregulation, among other neoliberal principles. These structural adjustment programs (SAPs) included cuts to subsidies on basic food products, fuel, water and sanitation, public transportation and medicines, and often placed salary caps and hiring limits on the public sector, resulting in reduced ability to recruit and deploy health workers. 

Health systems in poor countries were hard hit by the reduction in public spending and by the increased debt and interest rates that came along with loans. In many countries, structural adjustment programs implemented fees in public hospitals and clinics that had previously offered care free of charge. These user fees reduced access to care, especially for the marginal communities. 

While there have been some improvements, macroeconomic policies continue to play a critical role in influencing what resources are available for ministries of health. The outbreak of several public health emergencies, such as Ebola, have underlined the urgent need for further reform and debt cancellation.

It is essential to understand the relationship between macroeconomic policy, trade, and health, as well as what we as concerned citizens can do to lift these crushing restrictions and allow governments to invest in their health system.

SPOTLIGHT

Trade & Public Health

International trade agreements, which are often negotiated in secret and without the presence of civil society at the table, often include policies that favor multinational corporations (such as pharmaceutical companies) at the expense of affordable, easy access to medications for the poor and most vulnerable people.

In 2019, HAI joined the Washington Fair Trade Coalition, and others to help organize an event commemorating the 20th anniversary of the “Battle for Seattle” WTO protests.  HAI led a session on Trade & Public Health

Sign ons & Resolutions

Op-Eds, News & Events

WHO WE FIGHT ALONGSIDE

Washington Fair Trade Coalition

HAI has partnered with the Washington Fair Trade Coalition on events and serves as a voice for Public Health in the coalition

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Community Alliance for Global Justice

CAGJ is a Seattle-based food and trade justice grassroots organization, and a committed advocacy partner of HAI.

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Explore the rest of HAI’s Advocacy Pillars

STRENGTHENING PUBLIC-SECTOR HEALTH SYSTEMS AND THE HEALTH WORKFORCE

USING PUBLIC HEALTH SOLUTIONS TO MEASURE THE HEALTH EFFECTS OF CONFLICT AND END WAR

MOVEMENT BUILDING FOR RACIAL, SOCIAL AND HEALTH JUSTICE

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HAI’s Transition 2021

HAI has transitioned our global operations and active programs to the local NGOs CSM (Mozambique) and HAMNASA (Timor-Leste). Learn more using the buttons below

Why Transition?

Learn about CSM

Learn about HAMNASA

Stand with HAI

Stand with HAI

Our Mission

Our mission is to promote policies and support programs that strengthen government primary health care and foster social, economic, and health equity for all. Our vision is a just world that promotes health and well-being, including universal access to quality health care.

Our History

Health Alliance International began in 1987 as a US-based international solidarity organization committed to supporting the public sector provision of health care for all.  Over 35 years, HAI conducted programs in 17 countries, with flagship programs in Mozambique, Côte d'Ivoire, and Timor-Leste.

Our Evolution

In line with HAI’s commitment to support and strengthen local public health leadership, as of October 2021, HAI fully transitioned global operations and active programs to locally-based, locally-led NGOs. Learn more about this shift toward local autonomy and equity in global health.

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