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<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif"><b><span lang="EN-US">OXFAM: </span>Stop
spending development funds on for-profit private healthcare<span></span></b></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif"><b>Providers</b><b><span> <span> </span></span></b><span style="font-size:10pt;color:rgb(132,151,176)" lang="EN-US"><a href="https://oi-files-d8-prod.s3.eu-west-2.amazonaws.com/s3fs-public/2024-06/Open%20Statement_%20Stop%20spending%20development%20funds%20on%20for-profit%20private%20healthcare%20providers.pdf" style="color:rgb(5,99,193);text-decoration:underline"><span style="color:rgb(73,161,250)">https://oi-files-d8-prod.s3.eu-west-2.amazonaws.com/s3fs-public/2024-06/Open%20Statement_%20Stop%20spending%20development%20funds%20on%20for-profit%20private%20healthcare%20providers.pdf</span></a>
<span></span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif"><span style="font-size:10pt;color:rgb(132,151,176)" lang="EN-US"><span> </span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">We, the undersigned, are calling for a stop to funding from
Development Finance Institutions to<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">private for-profit healthcare providers.<span lang="EN-US"> (list of signatories available in the ink
above)<span></span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif"><span lang="EN-US"><span> </span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">Mounting evidence shows that this funding is going to
expensive out-of-reach private hospitals and<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">clinics in low- and middle-income countries that are
widening healthcare inequalities, exacerbating<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">poverty and gender-based discrimination and violating human
rights. Far from advancing progress<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">towards Universal Health Coverage as governments have
committed, this form of development<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">finance is undermining it.<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">Research from organisations including Oxfam,1 Global Justice
Now,2 SATHI,3 Wemos,4 Akina<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">Mama wa Afrika,5 Center for Human Rights & Global Justice
at New York University and Hakijami,6<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">as well as from several academics,7 has found that
Development Finance Institutions (DFIs)<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">including the World Bank Group’s International Finance
Corporation, the European Investment<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">Bank, the UK’s British International Investment, France’s
Proparco and Germany’s DEG are<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">investing in private, for-profit healthcare providers in
low- and middle-income countries that are:8<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">● too expensive and out-of-reach for the majority of
ordinary citizens in countries where<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">they operate and are driving up catastrophic and
impoverishing out-of-pocket health<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">spending whilst increasing women’s unpaid care loads;<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">● violating patient rights, including reportedly denying
emergency care and even imprisoning<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">patients, including new-born babies and the bodies of the
deceased, for non-payment of<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">medical bills;<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">● prioritising profit at the expense of quality ethical
healthcare, demonstrated through cases<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">of both alleged and confirmed medical negligence, false
diagnosis, price rigging and<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">collusion, overcharging - including during the COVID-19
pandemic9 - and failure to prevent<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">other exploitation and abuse including alleged organ
trafficking;<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">● failing to reach geographical areas and populations with
the highest healthcare need and<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">least access, especially people on low-incomes and living in
poverty, notably women,<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">people living in rural areas, and other marginalised
population groups.<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">● reportedly exploiting and profiteering from government
health insurance and other publicly<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">subsidised financing schemes resulting in the diversion of
desperately needed public<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">budgets for health.<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">In a recent letter10 to the World Bank Group President, the
UN Special Rapporteur on the right to<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">health11 and the UN Independent Expert on foreign debt,
financing and human rights12 raised their<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">concern about the impact of IFC private health investments
on achieving UHC and questioned why<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">a full public account of abuse cases at IFC-funded hospitals
and clinics have not been addressed.<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">The DFI model of investing in private healthcare ignores the
dangerously inadequate regulation of<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">private healthcare providers in the countries where they
invest. Risks to patients, communities and<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">health systems are further exacerbated by the arms-length
DFI approach to investment, which is<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">both nontransparent and unaccountable.<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">Most DFI investments in private healthcare are made
indirectly via a complex web of tax-avoiding<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">financial intermediaries. These out-of-sight investments are
mostly undisclosed and certainly<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">unscrutinised.13 DFI governance and oversight of these
investments is wildly insufficient. Any<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">individual or community seeking remedy for harm related to
these investments faces the near-<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">impossible task of identifying DFI involvement.<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">DFIs are silent on the proven failures of commercialised
approaches to deliver equitable, gender-<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">responsive quality healthcare to those most in need.
Evidence demonstrates a clear correlation<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">globally that the higher the share of private financing for
health, the higher the rate of women’s<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">deaths;14 the greater the inequality in life expectancy
between rich and poor people;15 and the<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">higher the rate of COVID-19 infection and deaths during the
pandemic (after controlling for other<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">factors).16<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">The DFIs’ favoured model of investing in private healthcare
facilities via private equity funds also<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">neglects a growing global evidence base that private equity
ownership of healthcare and nursing<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">care facilities is associated with harmful impacts on costs
to patients or payers and mixed to<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">harmful impacts on quality and patient outcomes.17<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">DFI investments in private healthcare providers also fuel
the expansion of corporate healthcare<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">chains and augment their influence, jeopardising inclusive
healthcare now and into the future.18<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">Finally, as evidenced by Oxfam’s research, despite
multi-million dollar investments in private<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">healthcare facilities over the last fifteen years, the DFIs
they studied19 have published no evidence<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">over this period to back up their claims they are helping to
advance Universal Health Coverage.<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">Oxfam was unable to find any disclosed impact evaluation or
any substantiated impact data for the<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">healthcare investments in relation to healthcare access for
people on low incomes, or for women<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">and girls.20<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">The arms-length, unaccountable and opaque approach to
healthcare investing by both the DFIs<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">and the governments that own them is unsafe and
unacceptable. Using funds earmarked for<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">development on expensive, out-of-reach private healthcare in
contexts of extreme inequality with<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">inadequate regulation and no robust safeguards does not
fight health poverty or gender inequality<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">and goes against the principles of social justice.<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">We reject approaches that put profit before patients and
wealth before people’s health. We are<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">calling for:<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">● An end to new funding from development finance
institutions (DFIs) to for-profit commercial<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">private healthcare, including funding channelled via
commercial intermediaries such as<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">private equity funds;<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">● An independent and comprehensive evaluation into active
and historic DFIs healthcare<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">investments with emphasis on impacts on healthcare
inequality, impoverishment, gender,<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">and patient and worker rights;<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">● Action to remedy any harm resulting from these
investments;<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">● A redirection of government efforts to increase funding
for free, inclusive and equitable<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif">universal publicly delivered and financed healthcare.<span></span></p>
<p class="MsoNormal" style="margin:0cm;font-size:12pt;font-family:"Calibri",sans-serif"><span> </span></p>
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