[Ip-health] Yale University: TB spread linked to IMF Loans

[Riaz K Tayob]

CONTACT: Michael Greenwood 203- 737-5151 or michael.greenwood@yale.edu
      Bill Hathaway 203-432-1322 or william.hathaway@yale.edu
Embargoed for release: 8 PM ET July 21, 2008

High Tuberculosis Rates Linked to IMF Loan Programs


New Haven, Conn. - Loans to European and Asian countries from the
International Monetary Fund (IMF) are associated with significantly
higher tuberculosis rates and mortality, according to study published
Tuesday in PLoS Medicine and co-authored by a doctoral student at the
Yale School of Public Health.

The researchers examined 21 post-communist countries in Europe and the
former Soviet Union and found that IMF loan programs were associated
with a 16.6 percent increase in TB mortality.  Strict conditions placed
on IMF loans in those countries resulted in cuts to health and
education budgets when countries have to repay the loans, according to
Sanjay Basu, M.D, a PhD candidate at Yale, and his co-authors David
Stuckler and Lawrence King of Cambridge University in England.

The findings are particularly troubling because drug-resistant forms of
tuberculosis are spreading and more treatment is needed, the authors
said.

"There were significant declines in the number of doctors available to
treat tuberculosis,'' in countries receiving IMF loans, Basu said.
"Soon after the countries entered the IMF programs, there was a
significant rise in tuberculosis cases and deaths. The rates were
stable or improving beforehand. When countries left the IMF programs,
their rates of tuberculosis significantly improved."

The team examined over two decades of data and determined that loans
from the IMF-intended to help revive countries with stagnant
economies-have had the unintended consequence of increasing the
incidence, prevalence and mortality rates from the respiratory illness,
Basu said

IMF loans were significantly associated with large reductions in
government health expenditures, tuberculosis program coverage, and the
number of physicians per capita. Loans or aid packages from non-IMF
institutions were not associated with these reductions, or with higher
tuberculosis rates. Previous studies by other researchers also have
suggested that IMF loan programs have an influence on health care in
the recipient country.

To make the study comprehensive, they checked that the association
between the IMF programs and tuberculosis rates was not "confounded" by
other factors, such as changes to the political structures, economic
situations, or other variables that might affect tuberculosis rates.
The study also revealed that IMF programs were associated with reduced
reporting of tuberculosis cases, making their results conservative.

Citation: PLoS Medicine Vol. 5, Issue 7 (July 2008)

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Researchers found that tuberculosis mortality rates were higher
in post-communist countries receiving aid from the IMF.