The Global Initiative for Economic, Social and Cultural Rights (GI-ESCR) launched a new report in December 2019 setting out a preliminary framework for human rights impact assessments to evaluate the consequences of private sector activity for the right to health. It “proposes a methodology of questions to draw upon when evaluating the influence and consequences of private actor involvement in the financing and delivery of health care while considering States’ human rights obligations.”
As reconfirmed by the report, the World Bank has long been criticised for its push to privatise health services, including through public-private partnerships, which have been “found to weaken the budgets of public health services” (see Observer Spring 2020, Spring 2017). IMF conditionality attached to loan programmmes have also negatively impacted the most vulnerable and undermined human rights, by reducing governments’ social services budget through imposed austerity measures and prioritisation of debt repayment (see Observer Autumn 2018, Winter 2015).
In 2018, the UN special rapporteur on extreme poverty and human rights condemned the widespread privatisation of public services as, “systematically eliminating human rights protections and further marginalising those living in poverty.” He called on development actors to, “reverse the presumption, now fully embraced by actors such as the World Bank, that privatization is the default setting and that the role of the public sector is that of a last-resort actor that does what no one else can or wants to do” (see Observer Winter 2018).
The GI-ESCR report goes beyond more generalised criticisms of how privatisation can make health services more expensive and less accessible, without improving the quality of provision (see Observer Spring 2017). It sets out a human rights framework to assess the harm private sector projects cause and the obligations of states to prevent these harms under international human rights law.