Michael J. Sharpston
Health has an obvious and fundamental influence on human welfare; and if the health of the bulk of the population in a developing country can be improved, this could well have a major impact on overall welfare distribution. This was the basis of the World Bank’s Health Sector policy paper released in 1975.
In recent years, two trends have tended to increase the Bank’s interest in health in developing countries. First, there has been a growing realization in the development community as a whole that gross national product (GNP) per capita alone is not an adequate measure of development and of its effect on human welfare. The result—both outside and inside the Bank—has been increased attention to income distribution and to the social sectors.
The second recent trend has been a growing awareness of the problems of pollution and of the ecological effects of man-made changes in the environment. In 1970 the World Bank Group established the Office of Environmental Affairs “… to review and evaluate every investment project from the standpoint of its potential effects on the environment.” Environmental concerns in Bank projects cover a wider field than human health, but health is often a major issue. For example, water resource projects, such as irrigation or hydroelectric schemes, can have an important effect upon the incidence of certain diseases, especially in a previously arid area, where new; breeding places for disease-carrying insects can be created. Thus both because of a desire to avoid health problems and because of an active interest in improving welfare, the Bank became increasingly involved in health considerations.