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Public Health News South Africa

IMF loans linked to higher TB death rates

IMF loans to the former Soviet Union and Central and Eastern European countries between 1992 and 2002 were linked to a rise in deaths from TB.

This is according to a study published in PLoS Medicine, which found that death rates from TB rose by 16.6%. In their analysis, David Stuckler (University of Cambridge, UK) and colleagues from Yale University, USA, also showed 13.9% increase in the number of new TB cases per year and a 13.2% increase in the total number of people with the disease per year - both of which are associated with IMF loans. Many of the countries in the study received their first IMF loans between 1992 and 2002.

Stuckler and colleagues analyzed health outcomes data collected by the World Health Organization (WHO), and IMF data from the World Bank's World Development Indicators. They developed models that were designed to test the relationship between TB outcomes and entry to (and exit from) IMF loan programmes. The models statistically controlled for possible confounding factors, such as the level of economic development, financial desperation, and HIV/AIDS, to name a few. Studying the mechanisms that drive the increase in TB death rates, the researchers found that IMF programmes are associated with an 8% decrease in government spending and a 7% decrease in the number of doctors per person. In addition, countries receiving loans had less coverage of the TB control strategy recommended by WHO called "directly observed treatment, short course" (DOTS). The reduction in TB control infrastructure made by countries receiving IMF loans could very well be a main part of the reason for the increase in TB death rates.

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