Globalization, Health Sector Reform, Gender and ... - Ford Foundation

1. The InternationalContext of HealthSector Reform:“Globalization”Globalization has critical implications for issues which concernadvocates of reproductive health and women’s rights. Yet littleattention has been given to analyzing the link between global processesand reproductive health. Macroeconomic and sectoral strategiesand their implementation which are supported by the WorldBank and other donors have yet to fully reflect the findings ofacademic and policy research which shows that “liberalizationand integration processes have been asymmetric and uneven—across countries, classes and genders” (Grown et al., 2000). Inthis section, we look at the distinctive characteristics of globalizationin the current era and explore its relevance for women’s reproductivehealth and rights in the context of health sector reform.The concept of globalization is often linked to the rise in predominanceof Transnational Corporations (TNCs) and the associatedinternationalization of production, distribution and consumption.In terms of political economy frameworks, globalization islinked to the “Washington Consensus” of economic development,the cornerstone of which is the liberalization of markets underStructural Adjustment and Stabilization policies of the World Bankand the IMF. Liberalization policies call for the deregulation ofworld and domestic markets, while placing restrictions on individualcountry governments’ ability to control direct foreign investmentand to influence flows of imports and exports. Therefore,the counterpart of liberalization of markets is the impositionof rules which restrict a country’s ability to use government institutionsto protect its own industries (domestic pharmaceutical industries,for instance) and limit the government’s scope for interveningin markets in order to support national priorities.For the purposes of this paper, globalization is taken to mean theincreased integration of national economies stimulated by the liberalizationof trade and capital markets (foreign direct investmentand financial flows across national boundaries) and rapid technologicaladvances in international communication. In view of currentdebates about the role of the World Trade Organization (WTO)and the impact of trade liberalization, it is important to emphasizethat the expansion in international trade, per se, is not the definingfeature of “globalization.”What is “decisively new about the international economy in the late twentieth century” is the deregulationand integration of capital markets combined with profound technological advances whichhave facilitated the dramatic increase in the pace and decline in the cost of global transactions(Elson, 2000, p.92) and the corresponding restrictions on the scope for intervention by nationalgovernments.10