International News | World Bank Board Discusses Official's Attempt To Change Policy Promoting Family Planning In Madagascar, Los

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The World Bank Board of Directors reportedly met on Tuesday to discuss a bank official's attempts to change policy promoting family planning in Madagascar, the Los Angeles Times reports (Gaouette, Los Angeles Times, 4/19). According to the public interest group the Government Accountability Project, one of the bank's managing directors, Juan Jose Daboub, instructed several officials to delete all references to family planning from a proposal to curb poverty and disease in Madagascar. The proposal was a country assistance strategy, which is a long-term plan that outlines World Bank lending priorities. An internal e-mail made public by GAP -- dated March 8 and originally sent by Lilia Burunciuc, Madagascar country program coordinator -- said, "By the way, one of the requests received from the MD (Daboub) was to take out all references to family planning." It added, "We did that. However, this is a potential problem for us as the upcoming Health SWAP includes family planning measures in response to the government's strong request for help in this area." Three bank staff members confirmed the authenticity of the e-mail. GAP also obtained a draft document of the bank's Health, Nutrition and Population Strategy, which referred to family planning once in regard to a former bank program. The proposed HNP plan does not emphasize family planning or contraception as mentioned in the 1997 HNP plan, but it does say that bank-financed programs "will emphasize options for improving demand for reproductive health advice and services by strengthening female education, improving women's economic opportunities and reducing gender disparities." The 1997 HNP highlighted restrictions to family planning services as a primary health challenge. Some staff said the proposed changes were widely viewed as a divergence from previous bank policy of promoting contraception for HIV prevention (Kaiser Daily Women's Health Policy Report, 4/16).

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Bank staff members said the Madagascar plan has been finalized and worry that other country plans might have been altered as well. Daboub said he would send at least 11 country reports, including Benin, Chad and Cameroon, to the board before December. In an e-mail to colleagues he wrote, "I respect the freedom of our partner countries to decide" on family planning. Bea Edwards, international director at GAP, said that scaling back family planning funding "would have a tremendous impact because the World Bank is a major lender in the health sector, particularly in the poorest countries." Some women's health advocates said the situation is worrisome, the Times reports. "There's mismanagement" at the World Bank, Carmen Barroso, regional director for the International Planned Parenthood Federation, said, adding that bank President Paul Wolfowitz appointed Daboub, "who felt free to censor in line with his personal beliefs," into a high level position. The board is scheduled to meet Thursday to discuss various issues, including the changes, the Times reports (Los Angeles Times, 4/19).

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