AIDS care and Treatment in Sub- Saharan Africa; Implementation Ethis

Kesaobaka Modukanele

Global HIV/AIDS

Blog Post for Tuesday November, 17 2009

The impact of the IMF on health care in developing countries.

Along with the obvious geographical boundaries that separate the world today, there exist other boundaries: ‘First world’ and ‘Third world’; ‘Developed’ and ‘Developing’ etc. What bothers me the most, is the idea of a ‘developing world’, which implies that these countries are progressively improving, or rising to reach some basic level of ‘development’. However, with regards to global health – hope of somewhat improving the situation of ‘developing’ countries is based on falsities. The fate of these countries lies almost entirely on the organizations like the International Monetary Fund, whose concerns may sound genuine, but their actual policies are contradictory. For example, although “The IMF acknowledges that poverty reduction is itself a necessary condition for economic growth, and that investments in health and education are crucial to the reduction of poverty”, they insist that in order for ‘developing’ countries to receive aid from bilateral and multilateral donors, or have access to private investment by foreign entities that could help improve access to treatment of diseases like HIV/AIDS, these countries would have to keep their inflation rates low. To these governments, lowering inflation rates restricts national spending in the health sector. In this way, there is a clear shift in the country’s authority to govern its own economy, and in essence, be forced to rely completely on loans from the IMF. Furthermore, while the IMF compels the countries to lower their inflation rates by means of reducing health care expenditure, they also expect them to increase their “absorptive capacity”. This “absorptive capacity” apparently indicates that whatever AIDS treatment program the IMF would be funding will be sustainable. However, increasing absorptive capacity can only be achieved by a substantial amount of spending on health care, which in turn increases inflation! Such policies make me question what the motives of placing such a policy was –as they restricts these countries from making national efforts against diseases through health expenditure. The case of a Botswana is a good example of how this policy makes it difficult to combat HIV/AIDS. Because they complied with all the regulations of the IMF, they struggle to implement programs because of restricted health expenditure, such as hiring sufficient health personnel. Zambia faced a similar issue. By trying to become proactive at improving the national health care and discouraging doctors from leaving the country through monetary incentives, their increased expenditure lead to the IMF suspending them from funding! To me this is a control issue! It is one of the reasons that the term ‘developing’ is deceptive – a word that brings false hope that at some point developing countries will become developed and self sustaining, while organizations like the IMF impose policies that prevent self sustenance and innovation, but rather encourage dependence. Such organizations, whose policies are mostly determined by the leading industrialized countries, the G7 –limit the development of these so-called ‘developing’ countries simply because wealth is concentrated in the hands of the elitist countries only, and decisions that are made do not assimilate the interests of the developing countries.