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WIPHN NEWS. 1994 Winter; 17:1.The World Bank has assumed first place in world health assistance and states that one reason for lending in health is that its presence in the health sector enables it to pressure governments to control population growth. The Bank believes that rapid population growth slows development, and to achieve its goal of lower birth rates in low-income countries, it recommends that governments provide an essential "clinical" package, which consists of perinatal and delivery care, family planning services, management of the sick child, treatment of tuberculosis, and case management of sexually transmitted diseases. "Clinical" in this context means services provided in a health clinic by nurses and midwives, not physicians. Sick children are the main beneficiaries of the package because it is assumed that families will limit the number of births only after child mortality falls. The treatment of tuberculosis is included to save the lives of children. The Bank has predicted that the AIDS epidemic will not result in negative population growth in Africa and has emphasized family planning services in the essential package. The World Bank seems to have made family planning the new, reductionist version of primary health care.