By Mike Andrew
The World Health Organization (WHO) said on January 27 this year that it would streamline procedures to fight Ebola in the future. Surprising as it may sound, the IMF (International Monetary Fund) may have a bigger impact on disease control in the developing world than WHO does.
Austerity policies imposed by the IMF on several West African countries made the Ebola epidemic worse, according to a new study by British sociologists.
“A major reason why the Ebola outbreak spread so rapidly was the weakness of healthcare systems in the region, and it would be unfortunate if underlying causes were overlooked,” said Cambridge University sociologist and lead study author Alexander Kentikelenis.”
Policies advocated by the IMF have contributed to underfunded, insufficiently staffed, and poorly prepared health systems in the countries with Ebola outbreaks.”
Researchers at Cambridge examined policies enforced by the IMF before the Ebola outbreak, using information from IMF lending programs from 1990 to 2014, and analyzed their effects on West African countries.
The IMF required African countries to slash government spending and reduce public debt before they could be eligible for new financial assistance. IMF guidelines were “extremely strict, absorbing funds that could be directed to meeting pressing health challenges,” the study found.
In a December 22 interview with BBC News, Kentikelenis said that public sector wage caps meant countries could not hire heath staff and pay them adequately. The IMF’s emphasis on decentralized healthcare systems had also made it difficult to mobilize a nationwide response to health emergencies such as the Ebola outbreak, he added. Similar policies were also applied to European countries like Greece and Spain, with a similar reduction in services and capacity, but their healthcare systems were better funded and more developed to begin with.
A spokesman for the IMF said that the organization’s cost-cutting mandate did not specifically direct cuts to public health, so it was “completely untrue” that the spread of Ebola was a consequence of IMF policies.
Nevertheless, Cambridge sociologist Lawrence Kind, co-author of the study, said that officials from Guinea, Liberia, and Sierra Leone – the three countries hardest hit by the Ebola epidemic – met IMF economic goals, but did not allocate funds for healthcare needs.
“In 2013, just before the Ebola outbreak, the three countries met the IMF’s economic directives, yet all failed to raise their social spending despite pressing health needs,” Kind said. In November, an alliance of African mayors called on the IMF and the World Bank to cancel debts owed by countries affected by the Ebola outbreak. Guinea, Sierra Leone, and Liberia together owe approximately $370 million to the IMF, according to the faith-based activist network Jubilee USA. Of this, $55 million is due in two years or less. Meanwhile, World Bank numbers from 2012 show that Guinea pays approximately $45 million more per year on servicing its existing debt than it spends on public health.