Page last updated at 00:39 GMT, Tuesday, 22 July 2008 01:39 UK

IMF funding 'fuelling TB deaths'

Tuberculosis bacteria
Drug resistant TB is a growing problem

Strict conditions on international loans have been blamed for thousands of extra tuberculosis deaths in eastern Europe, and former Soviet republics.

Analysts from Cambridge and Yale universities said they had led to less being spent on healthcare.

As a result TB in countries with International Monetary Fund loans rose sharply, they claimed.

A UK TB charity backed the Public Library of Science study findings - but the IMF firmly rejected them.

If we really want to create sustainable economic growth, we need first to ensure that we have taken care of people's most basic health needs
David Stuckler
Cambridge University

The resurgence of TB in eastern Europe and the former Soviet Union has caused widespread concern, particularly as it has coincided with an increase in the number of drug-resistant cases.

The IMF is an international organisation which aims to oversee the global financial system, and reduce instability by offering financial packages to governments.

In recent years, it has offered assistance to 21 countries in the region, in the form of loans offered in exchange for the meeting of strict economic targets.

The researchers claimed it was efforts to meet these targets that was undermining the fight against TB by drawing funding away from public health.

They looked at the timing of rises in the TB rate, and compared them with the timing of IMF intervention.

'Related rises'

They claimed a direct relationship could be seen - the start of the increases matched the starting point of IMF programmes, and continued rising as the programme continued.

This meant at least a 16.6% increase in deaths across the 21 countries, they said.

Without the IMF loans, they suggested, rates would have fallen by up to 10%, meaning at least 100,000 extra deaths.

Countries which accepted IMF loans averaged an 8% fall in government spending, a 7% drop in the number of doctors per head of population, and a fall in a method of TB treatment called "directly observed therapy", which is recommended by the World Health Organisation.

David Stuckler, one of the study's authors, said that the IMF "had its priorities backwards".

"If we really want to create sustainable economic growth, we need first to ensure that we have taken care of people's most basic health needs."

'Fully supported'

The IMF disputed the findings, saying that it always supported public spending on "critical social needs" such as healthcare and education.

A spokesman said: "I suppose anyone can try finding a rationale for anything. This is an example of that.

"Efforts to attack tuberculosis in sub-Saharan Africa are fully supported by the IMF.

"Our extensive array of published analysis is clear evidence that we are very sensitive to the important role of healthcare and personal well being.

"We also have contacts and relations with international bodies who are expert in the area of healthcare and disease prevention and control.

"This doesn't seem to register with the authors."

Paul Sommerfeld, from the charity TB Alert, said the findings were "unsurprising".

"It has long been evident that the surge of TB in ex-USSR countries through the 90s was an unforeseen and unwelcome result of the end of communism - because of the vast drop in public spending, including on public health, of which IMF policies are a contributory part."

However, he said that an over-reliance on expensive "sanatoria" for TB patients was another reason for problems in Russia.

Drive to curb drug-resistant TB
22 Jun 07 |  Health
Profile: IMF and World Bank
29 Mar 08 |  Country profiles

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