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

World Needs New Economic Platform to Fight COVID-19

The World Needs A New Economic Platform to Fight COVID-19

Lawrence Freeman

April 5, 2020

Today April 5, the total cases of COVID-19-(coronavirus) in Africa are 8,536, deaths 360, and recoveries 710. On March 30, one week ago, the total cases were 4760, deaths 146, and recoveries 355. The diagram above shows the increased rate of the spread of COVID-19 across the African continent. In my March 30 article, New Economic Order Required to Combat COVID-19 in Africa, I concluded with a call for a New Just Economic Order, if humankind is going to effectively conquer the current pandemic.

We have come to a moment in the evolution of our civilization that we must acknowledge the failures of the present political-financial system. The Western-advanced sector nations, lacking an in depth and over-supplied health infrastructure have found themselves utterly unprepared to deal with the latest and most deadly zoonotic virus, COVID-19. The G-7 nations with a population of 750 million, and 39% ($34 trillion) of the world’s GDP are grabbling to muster the resources and capacity to defeat the coronavirus, while 90% of the world’s 7.5 billion people live with a frail health infrastructure, or none at all.

We have witnessed an increasing number of new zoonotic viruses (SARS, MERS, Swine Flu, HIV/AIDS) over recent decades. Humanity will only successfully defend itself by launching a global upgrading of healthcare including new scientific research into how human immune systems can become less susceptible to viruses that originate in animals.

Inadequate healthcare and impoverished living conditions in the developing sector cannot continue. It is a crime that has been perpetuated for decades, and the very survival of humanity screams out for a revolution in our thinking and practices. Ethiopian Prime Minister, Abiy Ahmed, stated eloquently the link between Africa and the advanced sector in this current crisis: “Advanced economies are unveiling unprecedented economic stimulus packages. African countries, by contrast, lack the wherewithal to make similarly meaningful interventions. Yet if the virus is not defeated in Africa, it will only bounce back to the rest of the world.”  (emphasis added)  PM Abiy “If Covid-19 is not beaten in Africa it will return to haunt us all” .The virus can only be overcome in Africa, and the rest of the developing sector, if we launch a new economic system, one that values human life above servicing debt and avariciousness.

Perilous Conditions in Africa

Dr. John Nkengasong, head of the Africa Centers for Disease Control and Prevention (CDC), said that COVID-19 “is an existential threat to our continent.” The Africa CDC and the World Health Organization (WHO) do not know the actual number of Africans infected with the virus, due to a lack of ability to test the population. Nor do they have an accurate count of the number of ventilators available in each African nation. Over a month since the appearance of the coronavirus on the continent, experts estimate that Africa is at the early phase of its proliferation.

The United Nations World Food Program warned that “the coronavirus pandemic threatens to cause food shortages for hundreds of millions of people especially in Africa,” according to Naharnet. “For many poor countries, the economic consequences will be more devastating than the disease itself.” Pandemic Threatens Food In Import Reliant States

An article published by Quartz, Africa Has About One Doctor for Every 5000 People cites a report by the (WHO), that Africa in 2013 “had a deficit of estimated 1.8 million healthcare worker that is projected to rise 4.3 million by 2035.”  One reason, according to the article is that: “Currently, there are only 170 medical schools serving the 47 countries of sub-Saharan Africa. Of those countries, 6 have no medical schools, and 20 have only one medical school.”

Statistics for the number of doctors per 1,000 population for African nations are horrifying. Physicians Per 1,000 People. When Compared to the figures for advanced sector nations that are now “hot spots” for COVID-19 to those of Africa, where the incidence of the virus is weeks behind Europe and the United States, Africa’s potential death rate is frightening.

Examine these estimates: U.S. has 2.3 doctors for 1,000 people, Spain 3.2, Italy 4.2, and South Korea 1.8. The average for sub-Saharan Africa (SSA) has an absurdly low 0.21 doctors for 1,000 people. Twenty SSA nations have .08 doctors or less to treat 1,000 of their citizens, with several at levels of 0.03 and 0.02 doctors. Two orders of magnitude less physicians than the nations that today are experiencing the highest mortality rates.

Governor Cuomo of New York, and Mayor de Blasio of New York City beg every day for more healthcare professionals, ventilators and PPEs (Personal Protective Equipment) to deal with the overload of coronavirus cases, Imagine what the potential death rate of Africa’s almost 1.5 billion population could be when one factors in extreme levels of poverty, weakened immune systems, and malnourishment, all prevalent on the African continent.

(Courtesy of SlideShare)

UNCTAD’s $2.5 Trillion Strategy

The March 30, 2020, statement by the United Nations Conference on Trade and DevelopmentUNCTADUN Calls for $2.5 Trillion Coronavirus Crisis Package for Developing Countries  is excerpted below.

“The consequences of a combined health pandemic and a global recession will be catastrophic for many developing countries and halt their progress towards the Sustainable Development Goals.”

UNCTAD’S strategy includes:

  • $1 trillion of debts owed by developing countries should be cancelled this year
  • $500 billion needed to fund a Marshall Plan for health recovery and dispersed as grants

Credit for a New Economic Order

Debt cancellation, and a Marshall Plan to build up health infrastructure for the developing sector nations are crucial for the survival of emerging nations. However, to break from the old political-financial system that has failed us, and to create a new economic platform, we must create credit for physical economic growth.

What is missing from UNCTAD’s proposal, and what is absent from all United Nations strategies, is the understanding of the importance of establishing a mechanism for the creation of credit. Following in the footsteps of President George Washington and his brilliant Secretary of the Treasury, Alexander Hamilton, we should establish a National Credit Bank. Nations Must Study Alexander Hamilton’s Principles of Political Economy. Wisely, the US Constitution provides for the federal government, not the states, to issue public credit to promote the general welfare.

Credit for production and infrastructure, unlike mere money, is the sine qua non for any healthy economy. This is not the same as printing trillions of dollars of money to bail out an over extended monetary system with a bubble of over one quadrillion of dollars in debt and derivatives.

Debts of developing sector nations must be cancelled to clear the decks for the issuance of new credit directed to fostering industrialized economies with healthy agricultural and manufacturing sectors. Extended credit with low interest rates must be issued for long term investments in vital construction of infrastructure. This is a life and death matter for the very survival of African nations.

Every government is obliged to create a national bank for the sole purpose of generating physical economic growth critical for the security and future health of that nation. Instead of relying on the present global financial institutions that dictate loan agreements at unnecessarily high interest rates coupled with arduous conditionalities we should create a new global economic system. One founded on the principles that promote the true shared common good for all nations and all peoples. Under this new system sovereignty is inviolate, and trade and credit agreements are premised on improving the material conditions of life for the people of those nations. All political and economic relationships between nations should be to benefit the general welfare of its citizenry.

Human beings are sacred, financial systems are not. We can and should craft new monetary systems to advance progress, not monetary profits. President Franklin Roosevelt created the Bretton Woods System, with the intention of uplifting the planet from the misery of World War II. He had magnificent ideas for promoting economic growth around the world, including greening the deserts of Africa.  Sadly, after his death, Bretton Woods was perverted, and became the opposite of what he intended.

While we must fight this deadly virus with all the resources that governments can assemble, we need to also think to the future; the creation of a more advanced economic platform. It is up to us create a new architype of relationships among sovereign nation states to transform the world out of the ashes of its present decayed state. Let us call this new paradigm by its proper name–A New Just World Economic Order

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