Ebola-stricken West African nations have faced under-funded, short staffed and poorly prepared health care systems due in part to policies backed by the International Monetary Fund (IMF), it has been claimed.
Researchers from Cambridge University’s department of sociology, joined by colleagues from Oxford University and the London School of Hygiene and Tropical Medicine, examined links between the IMF and the rapid spread of the disease.
In research published in the Lancet Global Health journal, they said IMF programmes over the years have imposed heavy constraints on the development of effective health systems in Guinea, Liberia and Sierra Leone – the cradle of the Ebola outbreak that has killed more than 6,800 since March.
Economic policy reforms advocated by the IMF have undermined the capacity of health systems in these three nations – systems already fragile from legacies of conflict and state failure – to cope with infectious disease outbreaks and other such emergencies, they added.
“A major reason why the Ebola outbreak spread so rapidly was the weakness of health care systems in the region, and it would be unfortunate if underlying causes were overlooked,” said lead author and Cambridge sociologist Alexander Kentikelenis. “Policies advocated by the IMF have contributed to under-funded, insufficiently staffed, and poorly prepared health systems in the countries with Ebola outbreaks.”
The researchers said that by reviewing the policies enforced by the IMF before the outbreak – extracting information from the IMF lending programmes between 1990 and 2014 – they were able to examine the effects on the three countries, and identified three factors that led to the further weakening of health care.
One was that the IMF required economic reforms that reduced government spending, which researchers claimed absorbed funds that could be directed to meeting pressing health challenges, while another related to IMF caps on the public sector wage bill which impacts on the capacity to hire and adequately pay key health care workers.
The third factor was that the IMF campaigns for decentralised health care systems, which in practice makes it difficult to mobilise coordinated responses to outbreaks of deadly diseases such as Ebola.
In recent months, the IMF has announced £274million of funding to help combat Ebola in West Africa, leading IMF director Christine Lagarde to say it is “good to increase the fiscal deficit when it’s a matter of curing the people. The IMF doesn’t say that very often”.