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EDUCATION AND DEBATE: Martin McKee and Barbara McPake the devil is in the detail BMJ 2004; 329: 1175-1176 [Full text]

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evidence needed on ideologies

Colin HW Bullough   (29 November 2004)

evidence needed on ideologies 29 November 2004
Colin HW Bullough, Senior Clinical Research Fellow IMMPACT, University of Aberdeen, AB25 2ZL Send response to journal: Re: evidence needed on ideologies	McKee and McPake criticise Okuonzi (BMJ Vol 329, 2004, p1173-5) for drawing on ideology rather than evidence in his criticism of the World Bank instigated health care reforms in Uganda. But these 'reforms' guided as they are by market philosophy and market economic principles are themselves non-evidence-based ideologies. Okuonzi provides good evidence that they have failed in Uganda, and Monbiot (1) in a detailed analysis of International Monetary Fund (IMF) and World Bank (WB)policy shows that they have failed in most places where they have been implemented. In fact those countries that have been successful in raising themselves from poverty are those that have steadfastly refused to follow IMF and WB advice. McKee and McPake say 'this is an area where more evidence rather than ideology is needed'. I would prefer to see more evidence on the (effectiveness of the) ideologies. (1) Monbiot, George. The Age of Consent: a manifesto for a new world order. 2003, Flamingo Competing interests: None declared