David Chivers

I'm happy to announce this new paper — we compile evidence on the extraordinary harms caused by IMF and World Bank structural adjustment programmes in the global South since the 1980s. The empirical record is devastating: documented negative impacts on wages, poverty, inequality, maternal mortality, infant mortality, healthcare access, etc. SAPs inflicted misery on the periphery in order to curtail their consumption, scupper independent development, and make labour and resources more cheaply available for the core. gh.bmj.com/content/11/Sup…

Regarding this piece on the social impacts of structural adjustment (jasonhickel.org/s/e017221full.…)... it is quite strange that some people have criticized it by saying it does not implement original statistical assessment to establish causality. Strange, because this is very clearly *not* a research paper. Nor is it a systematic review paper. It is simply a short analysis paper, clearly labelled as such, which is intended to "discuss topical issues" as per BMJ guidelines.  It is obviously beyond the remit of such a piece to undertake original statistical assessment, and indeed the piece makes no claim to such an undertaking. Instead, it provides citations to examples of previously published research that has explored the impact of SAPs on various social outcomes, including studies that *do* undertake to assess causal effect.  In other words, it is incorrect to claim there is no evidence on the causal effects of SAPs. There is such evidence, and we cite key examples, including studies that account for endogeneity and selection biases. This literature deserves to be better known.  For instance, see: -On poverty: link.springer.com/article/10.105… -On poverty and inequality: degruyterbrill.com/document/doi/1… -On child and maternal health: link.springer.com/article/10.118… -On child health: academic.oup.com/ije/article/48… -On health system access and neonatal mortality: sciencedirect.com/science/articl… -And there are many others we were forced to cut for brevity And yes, the piece also cites political economy research that does not rely on statistical analysis, because these are also recognized as valuable contributions to the literature.  Along these lines, I encourage everyone to read Mike Davis' masterpiece "Planet of Slums", which includes a chapter on SAPs. As for the figures, none of them claim to demonstrate causality.  They are included purely as illustrations of broad trends in social indicators during the adjustment period - social indicators that are assessed by the studies we cite. Someone asked about using 1980 as the starting point for liberalization.  This is common convention: Chang, Pollin, Weisbrot, Baker, Rosnick and others use 1980 to generally distinguish between the developmentalist and neoliberal periods.   In Sub-Saharan Africa, for the majority of countries that were SAPed, comprising most of regional GDP, 1980 was the year immediately prior to first implementation.  Most of the rest first implemented in 1982 and 1983, and of course any assessment of effects should assess interventions on a country-specific basis. As for India's 1981 loan, the IMF insisted on adjustment conditions, the Indian government said they could not accept externally imposed conditions, so it was agreed they would implement "homegrown conditionality", with policies generally aligned with IMF preferences.  The policies affected food prices, which is why we see an increase in BNPL poverty. As for China, their agreement with the World Bank was signed in 1988 and implemented in 1990.  While healthcare and some other sectors began to be liberalized earlier, in the 1980s, the BNPL basket was not substantially affected until 1990. As for the question of national income, researchers have found liberalization had a negative impact on growth in non-manufacturing regions, which is evident in the case of LatAm and SSA, but this does not apply in regions with higher manufacturing. Regarding Kenya, we see an increase in infant mortality after 1986, and the same pattern in child mortality.  We note that some of this is attributable to HIV (and cite research showing that this pathway too is exacerbated by SAPs), but we also know from work by IRD and CERDI researchers that, in Kenya, HIV is responsible for a minor share of the change in the child mortality trend.  Even removing HIV, there is increasing child mortality after 1986 compared to the pre-SAP trend.  Several studies indicate that adjustment was associated with increased child deaths in Sub-Saharan Africa. In sum, existing research provides valuable information on the social harms related to structural adjustment.  And this should not be surprising; after all, we know there were mass protests and riots across much of the South during the adjustment period. They were literally called "IMF riots".  People don't riot for no reason, they riot because they are desperate. The IMF and WB themselves recognized this, and relaxed some of their more extreme conditions. Why care about all this? Because every man who was impoverished by these policies is my brother, every mother who died needlessly during childbirth is my sister. Nothing will shake my conviction in that fact.

I'm happy to announce this new paper — we compile evidence on the extraordinary harms caused by IMF and World Bank structural adjustment programmes in the global South since the 1980s. The empirical record is devastating: documented negative impacts on wages, poverty, inequality, maternal mortality, infant mortality, healthcare access, etc. SAPs inflicted misery on the periphery in order to curtail their consumption, scupper independent development, and make labour and resources more cheaply available for the core. gh.bmj.com/content/11/Sup…