Oxfam Reveals How Rich Nations Are Helping For-Profit Health Industry Exploit Poor Patients

An Oxfam investigation published Monday reveals how development finance institutions controlled by the governments of France, the United Kingdom, Germany, and other rich nations have funded private healthcare corporations that are systematically abusing patients in the Global South, driving up prices, denying emergency care, and even imprisoning people who fail to pay their bills.

The humanitarian group's new report, titled Sick Development, found that 56% of healthcare investments that European development finance institutions (DFIs) made in Global South nations such as India, Kenya, and Nigeria between 2010 and 2022 went to private corporations.

Since 2010, the report notes, the U.K.'s British International Investment (BII), Germany's Deutsche Investitions-und Entwicklungsgesellschaft (DEG), the European Union's European Investment Bank (EIB), and France's Proparco have "invested at least $2.4 billion in health, both directly and indirectly via health-specific financial intermediaries (FIs). They invested a further $3.2 billion in multi-sector FIs, which invest in health among other sectors."

Oxfam raised concern that "at least 81% of the European DFI health investments" that it identified over the course of the investigation "made indirectly via a complex, unaccountable and often invisible web of tax-avoiding FIs, mostly private equity funds."

"These out-of-sight investments are mostly undisclosed and certainly unscrutinized," Oxfam lamented.

What the group was able to glean after following the money is alarming.

"One of the leading private hospital chains in Kenya, the Nairobi Women's Hospital (NWH), regularly imprisoned patients until their bills were paid," the report notes. "One newborn baby was reportedly held for at least three months, and a schoolboy for 11 months. Bodies of those who have died have been held for up to two years."

Oxfam found that Nairobi Women's Hospital has been funded by BII, Proparco, DEG, and the U.S.-dominated World Bank's International Finance Corporation (IFC).

The group also cited interviews with patients who said they were barred from using government-issued health insurance cards at the privately run Narayana and CARE hospitals in India, leaving them with exorbitant bills.

India's private healthcare sector is currently worth around $236 billion, thanks in part to investments from the World Bank's IFC.

Additionally, Oxfam found that private healthcare providers funded by major public development institutions used the Covid-19 pandemic as an opportunity to jack up prices and pad their bottom lines.

"During the pandemic in Uganda, Nakasero Hospital in Kampala reportedly charged $1,900 per day for a Covid-19 bed in intensive care. The bill for one patient who died from the virus at TMR Hospital came to an extraordinary $116,000," the report says. "Nakasero Hospital is funded by France's Proparco, the E.U.'s EIB, and the World Bank's IFC. TMR Hospital is supported by the U.K.'s BII and France's Proparco."

"The big winners are the super-rich investors and owners of healthcare corporations, and the losers being the masses facing rising poverty, sickness, discrimination, and human rights abuses."

Anna Marriott, Oxfam International's health policy lead, said Monday that massive infusions of public funds into private hospitals and other healthcare corporations in developing nations "has proved to be an evidence-free, rich country bankers' guide to global healthcare—a free-for-all of private greed over public good—where the big winners are the super-rich investors and owners of healthcare corporations, and the losers being the masses facing rising poverty, sickness, discrimination, and human rights abuses."

Among the winners highlighted in Oxfam's report are the billionaire brothers Malvinder and Shivinder Singh, who founded one of India's largest corporate hospital chains, and billionaire Jorge Moll Filho, president of the Brazilian hospital chain Rede D'Or.

"Half the world's population can't get essential healthcare," said Marriott. "Every second, sixty people are plunged into poverty by medical bills. Donor countries and development banks have long promised that they can drive down healthcare costs for people living in poverty by investing taxpayers' money into the private sector. Instead, costs are rocketing up and causing harm."

The report calls on all development finance institutions to immediately halt all direct and indirect funding for private healthcare providers in the Global South and take steps to "remedy any harms resulting from their investments including human and patient rights violations identified."

"It is more urgent than ever that governments stop this dangerous diversion of public funds to private healthcare and instead deliver on aid and other public funding promises in order to strengthen public healthcare systems that can deliver for everybody," Marriott said. "Global South governments should also step up and be more assertive in directing foreign public investments into better health outcomes for their people."