Investments by rich-country financiers in hospitals and private health care in developing nations of the South are ignoring and ruining poor people in need of health care, according to a new report by the international anti-poverty coalition Oxfam.
"Patients living in poverty in the global South are being bankrupted by private health care corporations backed by multi-billion-dollar investments from development finance institutions," said Anna Marriott, director of health policy at Oxfam International.
Bodies such as the World Bank's International Finance Corporation, the European Investment Bank, and agencies in Germany, France and the UK, invest public funds through the private sector to help foster economic development in the South and combat poverty, the Oxfam report said.
However, Ms Marriott said that "for decades, rich countries have been wedded to the theory that public funds can support the private sector to help low- and middle-income countries develop their health sectors."
That theory "has proven to be an evidence-free guide for rich country bankers on global health care - a free-for-all of private greed over the public good - where the big winners are super-rich investors and owners of health care corporations," she said. As a result, "the losers are the masses facing increasing poverty, disease, discrimination and human rights abuses," the Oxfam report stated.
According to the coalition, much of this investment of taxpayers' money goes to "dubious business, speculation and exploitation, health scandals and human rights abuses, all with little or no accountability."
"This includes private hospitals keeping patients such as prisoners or holding deceased relatives until bills are paid," said the document, which deplores "profiteering, including during the pandemic, and routine overcharging of patients into bankruptcy and poverty."
Other practices found include "denying treatment to those who cannot afford it - even in emergencies - and pricing services and medicines beyond the reach of most people in local communities." There are also entities and intermediaries "involved in tax cheating, price manipulation and medical malpractice leading to death."
Other grievances pernicious for the poor’s health include "failure to prevent human rights abuses, including organ trafficking by staff, and exploitative practices, for example by pressuring patients to undergo unnecessary and costly medical procedures."
To support its criticism, Oxfam analysed European financiers' investments in the thriving private health sectors of India, Kenya, Nigeria, Uganda and other countries in the South.
More than half (56%) of 358 health investments between 2010 and 2022 went to private healthcare corporations operating in low- and middle-income countries, with $2.4 billion that could be tracked, but Oxfam found at least 269 other health investments whose value is not disclosed. Most of these health investments (81%) are "slipping through the cracks", sub-invested through a network of financial intermediaries, 80% of them located in tax havens such as Mauritius, Jersey and the Cayman Islands.
There was little or no public accountability for these investments, and no evidence of whether they are improving access to health care for people living in poverty, especially women and girls.
There are extremes, from private hospital chains offering five-star hotel treatment for politicians, sports stars and celebrities, at elite prices, to people extorted, exploited or excluded on the basis of their inability to pay.
For example, in India, where the private health sector is worth $236 billion, financiers have invested $500 million in hospital chains owned by some of the richest billionaires.
The entities concerned "have not published a single evaluation of their health projects in India since they began more than 25 years ago; of 144 hospitals funded, only one is located in a rural area, and only 20 are in the 10 lowest ranked states on India's annual Health Index."
Oxfam reports cite profit margins of up to 1,737% on drugs, consumables and diagnostics in four large hospital complexes in the capital region of Delhi.
In Latin America, there is the case of the Siro-Lebanese Hospital in Brazil, which has investments from German and French development agencies (DEG and PROPARCO), and targets its services "mainly a wealthy elite including celebrities and Latin American presidents", according to Oxfam.
It recalls that it is a hospital that "has 500 security cameras, 250 electronic access controllers, 250 proximity sensors, and 100 guards and doctors trained to deal with the paparazzi."
In Africa, the Maputo Private Hospital in Mozambique, backed by multilateral funding during the pandemic, charged covid-19 patients a $6,000 deposit for oxygen and $10,000 for a ventilator.
Similarly, in Uganda, Nakasero Hospital reportedly charged $1,900 per day for a COVID intensive care bed, while TMR Hospital, with European funding like Nakasero, charged $116,000 for a patient who died of the virus.
"Half of the world's population cannot get essential medical care. Every second, 60 people are plunged into poverty because of medical bills," Marriott contrasted. Therefore, "it is more urgent than ever that (rich country) governments stop the dangerous diversion of public funds to private health care and instead deliver on aid and other funding promises to strengthen public health care systems that can provide services to all."
"Southern governments should also step up and be more assertive in directing foreign public investments towards better health outcomes for their people," he concluded.