Structural adjustment: damages, reparations and pathways to non-recurrence

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Authors: Jason Hickel, Salmaan A. Keshavjee, MAXINE BURKETT, Eugene T Richardson
Cited by: 9
References: 34

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.

Fields of Study & Subjects

Human Rights and Development Poverty Education and Child Welfare Income and Inequality

Publication details

Journal / source
BMJ Global Health
Publisher
BMJ
Volume
11
Issue
Suppl 1
Pages
e017221–e017221
Publication date
1 March 2026
Language
EN