Structural adjustment : damages, reparations and pathways to non-recurrence
Hickel, Jason Edward (Universitat Autònoma de Barcelona. Departament de Ciència Política i de Dret Públic)
Keshavjee, Salmaan A. (Harvard Medical School)
Burkett, Maxine (University of Hawai'i)
Richardson, Eugene T. (Harvard Medical School)
Universitat Autònoma de Barcelona. Institut de Ciència i Tecnologia Ambientals

Date:	2026
Description:	7 pàg.
Abstract:	Beginning in the 1980s and 1990s, the International Monetary Fund (IMF) and the World Bank implemented neoliberal structural adjustment programmes (SAPs) across most countries in Asia, Africa and Latin America. SAPs imposed austerity, privatisation and economic deregulation and have been associated with severe negative impacts on human welfare, including (a) declining real wages and working-class consumption, (b) increased rates of poverty and basic-needs deprivation, (c) increased neonatal and maternal mortality and (d) reduced health system access. Structural adjustment also created conditions for increased financial outflows and drain from the global South through unequal exchange. This paper reviews evidence of these damages and proposes possible options for reparations and distributive justice. We argue that the IMF and the World Bank should be democratised and restructured-or otherwise replaced by alternative institutions-to prevent further harm.
Grants:	European Commission 101071647 Agencia Estatal de Investigación CEX2024-001506-M
Note:	Unidad de excelencia María de Maeztu CEX2024-001506-M
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Global health ; Health policies and all other topics ; Health services accessibility ; SDG 3 - good health and well-being
Published in:	BMJ Global Health, Vol. 11 (2026) , art. 017221, ISSN 2059-7908

DOI: 10.1136/bmjgh-2024-017221
PMID: 41871845

7 p, 392.1 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Experimental sciences > Institut de Ciència i Tecnologia Ambientals (ICTA)
Articles > Research articles
Articles > Published articles