IMF Conditionalities Contribute to Shortage of Health Workers: Africa Suffers

A nurse in Uganda is giving a woman an injection

July 14, 2020

IMF Conditionalities Contribute to Shortage of Health Workers

Lawrence Freeman

As I have told my friends for many years, the International Monetary Fund (IMF) is incapable of helping nations grow their economies. I do not believe the IMF can point to any success story, where its policies led to improving the standard of living of the population. Their macro-monetarist ideology fails to understand the essential driver of real (not monetary) growth. Following IMF prescriptions usually results in more suffering for the victim nation.  For a more in depth analysis read my article from last year: Africa Needs Real Economic Growth, Not IMF Accountants.

The report cited by the ActionAid and Public Service International highlights the failure of the IMF:  IMF Told Countries Facing Critical Health Worker Shortages to Cut Public Sector Wages The statistics are revealing, but should not be shocking to those of us who study physical economics. Throughout its history we have seen the IMF insist on cuts to meet to macro-economic goal at the expense of the population. This report clearly pinpoints the effects of tying loans to cuts back in healthcare. Africa was suffering from an acute shortage of healthcare workers before the COVID-19 pandemic. Sub-Saharan Africa has the fewest physicians per 1,000 population and the lowest number of hospital beds per 1,000 population.

It was pointed out by Ethiopian Prime Minister, Abiy Ahmed, earlier this year, that   payments of debt service equaled or surpassed the amount of money nations spent on healthcare.  He wrote “In 2019, 64 countries, nearly half of them in sub-Saharan Africa, spent more on servicing external debt than on health. Ethiopia spends twice as much on paying off external debt as on health.

African nations, or any country for that matter, should not be subjected to this kind of treatment. Human life is real and precious. Debt is merely a financial accounting mechanism. There is no equivalence.

The COVID-19 pandemic has revealed the failure of the world globalized financial system, which has been become decoupled from the real economy. Genuine economic growth uses credit to promote human life. President Franklin Roosevelt’s Bretton Woods system, in its perverted form, came to an end on August 15, 1971. For the last fifty years, the City of London-Wall Street centered financial system has become more corrupt each decade, serving the interest of a tiny few. Now is the time to launch a New Bretton Woods, dedicated to improve the conditions of life for all people of all nations. I will be writing more on this subject in the future.

Below are excerpts from the cited report:

“New analysis by ActionAid and Public Services International (PSI) reveals how International Monetary Fund (IMF) austerity policies restricted critical public employment in the lead up to the Covid-19 crisis. (emphassis added)

“The analysis, released to mark UN Public Service Day (23 June), shows that every single low income country which received IMF advice to cut or freeze public employment in the past three years had already been identified by the World Health Organisation (WHO) as facing a critical health worker shortage.

“Key findings include:

  • Of the 57 countries last identified by the WHO as facing critical health worker shortages, 24 received advice from the IMF to cut or freeze public sector wages.
  • When countries are told to contain wage bills – it means fewer doctors, nurses and frontline workers in countries already desperately short of medics.
  • All but one of the 18 low-income countries advised by the IMF to cut or freeze public sector employment funding, are currently below the WHO’s recommended nurse-to-population threshold of 30 per 10,000.
  • The WHO predicts that these countries will experience a collective shortage of at least 695,000 nurses by 2030.

“ActionAid’s 2020 report Who Cares for the Future: Finance Gender-responsive Public Services exposed the detrimental IMF loan conditions and austerity measures which have pushed 78% of low-income countries to plan for zero increase in public sector wages.

“When countries are told to contain wage bills it means fewer doctors, nurses and front line health workers in countries already desperately short of medics. This was a dangerous practice even before the Covid-19 pandemic and is unthinkable now.”

Read the full report: IMF Told Countries Facing Critical Health Worker Shortages to Cut Public Sector Wages

Read my earlier posts: 

VIDEO: Africa’s Healthcare Infrastructure Requires a New Bretton Woods

World Needs New Economic Platform to Fight COVID-19

New Economic Order Required to Combat COVID-19 in Africa

Lawrence Freeman is a Political-Economic Analyst for Africa, who has been involved in the economic development policy of Africa for 30 years. He is the creator of the blog: lawrencefreemanafricaandtheworld.com

Ebola Crisis: How Many Africans Must Die Before the World Acts?

FILE – In this Sunday, Sept 9, 2018 file photo, a health worker sprays disinfectant on his colleague after working at an Ebola treatment center in Beni, eastern Congo. Top Red Cross official Emanuele Capobianco said Friday April 12, 2019, that he’s “more concerned than I have ever been” about the possible regional spread of the Ebola virus in Congo after a recent spike in cases. (AP Photo/Al-hadji Kudra Maliro, File)

Today is the one-year anniversary second eruption of Ebola in sub-Saharan Africa in five years. On August 1, 2018, an outbreak of Ebola was declared in the North Kivu province of the Democratic Republic of the Congo (DRC), when four cases of Ebola in town of Mangina were verified. After 426 cases of Ebola were confirmed, the World Health Organization-(WHO) on November 29, declared this to be the second largest outbreak of Ebola in history. The largest outbreak was from 2014-2016 in West Africa that caused 11,310 deaths.  By May 3, of this year over 1,000 human beings had perished from Ebola. As of June 4, the number of cases exceeded 2,000. Yet, it wasn’t until July 17, 2019, after more than 1600 people had died from this deadly disease that the WHO declared a “public health emergency of international concern”. This declaration by the WHO is far short of what is required to combat this killer disease. To date, there are 2,593 infected with Ebola and more than 1,770 have died, according to the The New Humanitarian on line journal.

The fear of Ebola spreading to the city of Goma, a transportation center with a population of 2 million, bordering Rwanda, was realized on July 14, with Goma’s first confirmed case. July 30, health officials confirmed a second case, unrelated to the first. However, on August 1, two additional cases were discovered, of relatives to the second deceased, thus establishing the transmission of Ebola in Goma itself, as reported by AP. Thursday, BBC News reported that the border between Goma and its neighbor Rwandan city, Gisenyi, was closed in response.  On June 11, Uganda reported the first of two deaths cause by Ebola.

The WHO should declare a full international health emergency, not “a matter of concern.” Although the WHO does not have the resources to fully combat this latest outbreak of Ebola, such a declaration would sound the alarm. This could mobilize international institutions like the World Bank, United Nations et al, along with forcing western nations to act.  However, for such an emergency declaration to be issued more Africans must die to meet the criteria of at least 20 deaths in several countries. For now, the world is watching, as Ebola murders more and more Africans. The government of the DRC should also be making appeals to the rest of the world, including Russia and China, who have indicated their willingness to help, if approached officially by the DRC.  A full scale emergency mobilization could potentially provide the impetus to expand the healthcare capacity of sub-Saharan Africa, which is urgently needed.

There is no time to waste. The population of the DRC exceeds 70 million, and it has one of the weakest infrastructure systems in the world. Is Africa, and the rest of the world willing to gamble with thousands, if not tens of thousands or more, lives?

The article below, by Debra Freeman, a public health specialist, provides a good overview of the Ebola crisis. She concludes:

“…stopping this latest outbreak and others like it requires more than vaccines and short-term measures…eradicating the threat of this most deadly of viruses, and others that may emerge in Africa, requires nothing less than an international crash-program mobilization to provide adequate economic conditions (sanitation, water, power, housing) along with the development and implementation of a first-class public health system.”

Read entire articleEbola: World Health Emergency