Back in January, I wrote a comment following Rick Rowden’s public launch at SOAS of his book “The Deadly Ideas of Neoliberalism: How the IMF has Undermined Public Health and the Fight Against AIDS”.  Today I open this blog to Rick who emailled me with the following response. I am still reading through Rick’s book and hope to come back to this issue very soon.

Dear peripheries:

Thanks you for covering the launch of my book at SOAS in London in January. I appreciate your attempt to review my book before reading it, which you concede, based on my limited remarks at the book launch and my attempts to answer questions in the limited time available. I hope that, to be fair, you will write another review after you have actually read the book.

For now, I would just take issue with a couple of points in your posting. You incorrectly presume I made the argument that the IMF policies cause AIDS. However, I did not make this argument, neither in my book nor in my remarks at SOAS. What I have argued is that IMF policies have undermined the public health systems and the ability of countries to have increased public investment as a percentage of GDP over the years that is necessary for building and maintaining the public health infrastructure, which has hurt countries’ ability to respond to the epidemic.

Additionally, my book is not just about AIDS, but also about public health more broadly.  Hence, your comment that “The point here is that if external economic policies dictated by the IMF certainly played a role in the overall economic development of a country, the argument that they directly affected the HIV epidemics is rather flimsy” is not fair because I was not arguing that IMF policies directly affected the HIV epidemics, but indirectly affected the ability of countries to finance health systems that could respond to them.

Furthermore, you point to some countries whose political leadership and social policies were effective at helping curb the epidemic and write, “In this context advocating alternative economic policies for the sake of advocating alternatives does not make great sense. Advocating policies that will deliver in the fight against HIV will, and these do not always have to be economic policies,” which I also contend is unfair because I did not argue that only economic policies are at issue. While many factors at are play in responding the epidemic, my book is about economic policies, but that does not mean I have argued that the only responses are economic ones. I did not say that only economic policies are at issue.

In previous my work with the NGO, ActionAid, over the years, I sought to bring together HIV/AIDS and public health advocates with macroeconomists to make the connections between health goals and the broader issues of economic development (or the lack thereof).  And by economic development, I expressly do not mean the “poverty reduction” and “poverty eradication” discourse of late, but the conventional notions in development economics of industrialization, building the domestic tax base and transitioning countries away from only producing primary agricultural commodities and extractive industries towards building manufacturing and services industries with increasing value-added over time, so that they are able to build a tax base and increasingly finance more of their own health budgets themselves, just as all of the industrialized countries have done.  The problem with health advocates is a tendency to stay in their health sector silos and not venture beyond into broader debates about development economics. The problem with IMF, World Bank and WTO policies is that they take away the policy tools and outlaw the practices that developing countries will need to industrialize and build the tax base. My book attempts to bring things two problems together.

I hope you will read it and then write another review on peripheries.

For a more recent back-and-forth between the IMF and myself, please see my letter to the IMF’s online magazine, “IMF Survey”, the IMF’s staff response, and my rebuttal to their response.

Sincerely,
Rick Rowden
Author, “The Deadly Ideas of Neoliberalism: How the IMF has Undermined Public Health and the Fight Against Aids” (London: Zed Books, 2009)

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