Global health. The current scenario and future perspectives

50 neoliberal economic policies that benefitted the rich and wealthy and protected the economic interest of foreign investors. Other events were the oil shocks of 1973 and 1979 that benefited Mexico, Venezuela and Ecuador, net oil-exporting countries, and the recycling of petrodollars allowed for increased investment and economic activity in several countries in the 1970s. However, the recycling of petrodollars to Latin America also contributed to the accumulation of higher levels of external debt that forced costly adjustment policies in the 1980s (Solimano, 2021a, 2021b, 2023) 10 . External Debt Crisis, Adjustment and Neoliberalism The high external debt accumulated in the 1970s along with external and fiscal imbalances led to the external debt crisis in the 1980s, which reduced the region’s economic growth, accelerated inflation, contracted real wages and had serious effects on investment and employment. A report by UNICEF, a United Nations agency, titled “Adjustment with a Human Face,” documented the deterioration in health indicators of the population because of the adjustment policies adopted in Latin America during the 1980s, including the reduction of social spending in healthcare. In the 1980s, income inequality increased in Argentina, Brazil, Chile, Colombia, Peru and Paraguay, but decreased in Uruguay and Costa Rica (Cornia, 2015). International historical evidence shows that, in general, inequality tends to increase during and after economic crises (Solimano, 2020) and may decline in booming periods. In the following decade, the 1990s, inequality increased again and this time the trend was associated with the adoption of neoliberal economic reform policies known as the “Washington Consensus.” These reforms focused on macroeconomic stabilization (e.g., shock treatment), privatization of public assets and companies and, in several countries, also the privatization of the pension system (Solimano, 2021b, 2023) as well as deregulation and opening of trade and financial sectors to the outside world. At the same time, labor unions weakened while business associations became stronger. Informalization of the labor market increased, and wage and benefit gaps widened between managers and high-level administrative positions on one hand, and middle- level employees and shop-floor workers on the other. Prices of assets such as stocks, bonds and properties also surged and benefitted wealth holders. From the early 2000s, a post-neoliberal period of political change (the 10 The income Gini (average of 15 countries) went up from 0.503 in 1950 to 0.537 in 1990 and confirms the high levels of inequality in the Latin American region.