IMF Lending Conditions Curb Healthcare Investment in West Africa, Study Finds
A new study suggests that lending conditions imposed by the International Monetary Fund in West Africa squeeze “fiscal space” in nations such as Sierra Leone – preventing government investment in health systems and, in some cases, contributing to an exodus of medical talent from countries that need it most.
Researchers from the Universities of Cambridge, Oxford and the London School of Hygiene & Tropical Medicine analysed the IMF’s own primary documents to evaluate the relationship between IMF-mandated policy reforms – the conditions of loans – and government health spending in West African countries.
The team collected archival material, including IMF staff reports and government policy memoranda, to identify policy reforms in loan agreements between 1995 and 2014, extracting 8,344 reforms across 16 countries.
They found that for every additional IMF condition that is ‘binding’ – i.e. failure to implement means automatic loan suspension – government health expenditure per capita in the region is reduced by around 0.25%.