LAUSR

W ithin the social sciences, much of the common sense surrounding the behavior of international financial institutions (IFIs), such as the International Monetary Fund (IMF) and the World Bank (WB), follows a rather conventional line of thinking. It runs something like this: many governments across the world required international funding amid debt crises in the mid-to-late twentieth century. As a result, they requested help from the IMF and WB. In order to ensure that past and now future debts were repaid, these groups demanded cuts to public services, such as education, health, and state employment, in order to free up state funds for debt servicing. In the end, these cuts generated increased inequality and generally benefited only wealthy citizens and transnational corporations. There is, of course, much truth to this story. The IMF and WB did condition their loans based on austerity measures. States that received their assistance often did cut state employment and attempt to downsize state bureaucracies. Many countries did witness escalating rates of inequality throughout the mid-tolate twentieth century. When it comes to health care, however, this story fails to capture the empirical realities in many parts of Latin America. While some states did severely cut state funding for health and privatize their health systems, such as Chile under General Augusto Pinochet, other governments worked with these IFIs to pursue a much different health care path. In her excellent new book, Shiri Noy examines the role of the World Bank throughout Latin America during the most recent decades. At the general level, Noy first uses statistical techniques to demonstrate that WB efforts did not generate reductions in public health expenditures throughout Latin America. Her most important contribution, however, is to demonstrate how WB pursuits throughout many countries in Latin America have been contingent upon domestic institutions and domestic dynamics. Although the WB has, in fact, urged Latin American governments to utilize neoliberal measures, the WB has also generally pursued a goal of universal health care and has not uniformly promoted the