Bad aid
•
Lesotho health budget and cost of PPP, 2007 -2013
During the World Bank spring meetings the Bank president Jim Yong Kim said that he would be taking a personal interest in the case. The Lesotho prime minister and minister of health also publicly expressed their concerns about the project in reaction to our report. South Africa’s Minister of Health even went on record saying that he expressed concerns at the time the hospital was opened and warned it would not work. Disappointingly, the IFC has yet to provide a comprehensive response to our critique of the PPP.
Given our experience in Lesotho, I would not recommend relying on the advice of the IFC, which in this case has not worked in the best interests of our nation. The World Bank Group should stop promoting this project as a success and something to be replicated across Africa. As a first step they should remove all misleading marketing materials on the Lesotho PPP from their website. My advice to other countries is don’t copy us. Rather study our example carefully and demand concrete evidence of the effectiveness and efficiency of PPPs before even considering this option.
On behalf of the many civil society organisations I work with, I call on the World Bank Group to finance a fully independent and transparent expert financial audit and broader review of the Lesotho health PPP, in partnership with the government of Lesotho. This should include a presentation of the full range of options available to the government to mitigate the negative impact this partnership is having on Lesotho’s wider health system.
Patients’ voices need to be represented in crafting a way forward. There has been virtually no participation of citizens in monitoring the PPP agreement. Privatisation of health care and other essential services should be discouraged. Advocates of PPPs should take a look at this case and realise that their interventions could undermine the role of state. Instead, the World Bank should work with local experts in order to have people who can protect the national interest. The World Bank should stop experimenting with new and complex initiatives that put poor countries on the brink of collapse, as this project has done in Lesotho.
by Lehlohonolo Chefa, Lesotho Consumer Protection Association (LCPA)
This article is an edited version of Lehlohonolo Chefa’s post for Oxfam’s From Poverty to Power blog on 17 April 2014
