After World War 2 the International Monetary Fund (IMF) to help countries in financial difficulties by lending money to tide them over. Laudable idea to give countries stability.
Unfortunately the conditions of such loans are often very painful. A recent study has shown 21 countries lent money by the IMF see an increase in deaths due to Tuberculosis. Kind of a measure of the health care systems in such countries.
The conditions are usually a drastic reudction in government spending on things like health care. This says to me that IMF conditions, programmes and ideology experiments on countries not taking into account the overal bigger impacts. Loosing large numbers of citizens in poor countries due to reduced health care provision is bad for economies.
This could explain why the IMF is singulalry so unsuccesful helping poor countries succeed.
The countries in the study were all former Soviet block countries and the period analysed was from 1989 onwards after the fall of the Berlin wall. The basis for the claim was broadly that TB rates fell in countries in Eastern Europe and rose in Russia and the caucus republics. The authors highlight that those with the worst results were those with the larger IMF loans.
Unfortunately observing correlation in statistics does not make a good case for causation. Note for example the clear rise in global warming and fall in piracy over the last century. Global warming though is clearly not caused by there being less pirates.
In respect of causation, the most obvious hypothesis that authors and subsequent studies would need to disprove is that IMF loans tend to go to countries that are both most poor, and have the most problems with governance, both of which are issues that we would tend to associate with falling standards of health. Second isn’t the most likely cause of improved health outcomes in Eastern Europe the massive injection of funds and rising living standards caused by first the reintegration of East Germany and then the preparation and entry by many into the European Union’s acquis communitaire and single market. Not options open to the caucuses that remain in Russia’s sphere of influence…
Third the programme of the IMF is based on the Washington consensus of governance, based in turn on the common economic programmes of the world’s most successful and healthy countries. This consensus includes such unremarkable prescriptions as redirecting government spending from subsidies to primary health care, liberalising markets, privatising state industries, and respect for property rights. These are not prescriptions that tend to cause liberals much anxiety.
Further the IMF cannot operate without the consent of the country receiving aid. Governments not obliged to take their loans or follow the advice attached to it. Most criticism of the IMF then tends to come from revoluntionary socialist nations outside the IMF, and organisations that reject the notion that governments should be restrained by their own laws or that excess government power can have harmful consequences.
An objective study of TB rates would surely look at what policies are linked with high rates of TB not simply target the IMF… sadly, particularly given the political affiliations and modus operandi of the Public Library of Science, I see a political agenda here not science.
The research paper was produced by David Stuckler, Lawrence P. King and Sanjay Basu from Cambridge and Yale
Universities. They concluded “IMF economic reform programs are associated with significantly worsened tuberculosis incidence,
prevalence, and mortality rates in post-communist Eastern Eruopean and former Soviet countries, independenty of other
political, socioeconomic, demographic, and health changes in these countries.”
I don’t know if the PLoS have a political axe to grind but I don’t have any reasons to believe as you imply that the authors
have such an aze. Just accepting that as the west invents the IMF therefore whatever the outcomes of its programmes must
be good is naive and risks us missing a real opportunity to develop programmes that really help poor countries improve.
Further research is required to see if other health issues have been so significantly affected.