Why budget frameworks help HIV/AIDS relief
| Author | Jean-Louis Sarbib/Peter S. Heller |
| Position | World Bank/IMF |
| Pages | 169-175 |
Page 169
Does World Bank and IMF advice encourage governments in poor countries to restrict spending on HIV/AIDS in the name of fiscal righteousness? A recent article in a medical journal, The Lancet, claims so, but Jean-Louis Sarbib and Peter Heller, responding on behalf of the two institutions, beg to differ. They argue that the real issues that need to be addressed in the fight against AIDS are getting donors to live up to their commitments and helping recipient countries use additional money in the best way possible.
Page 175
In the May 21 issue of The Lancet, an international journal of medical science and practice, Ted Schrecker (University of Ottawa, Ontario, Canada) and Gorik Ooms (Médecins San Frontières, Brussels, Belgium) argued that government spending targets, created by the World Bank and the IMF under medium-term expenditure frameworks, prevent foreign aid from reaching HIV/AIDS programs in the world's poorest countries. They also suggested that "the international community has not taken seriously enough the acute need for new resources to assist health systems in the developing world, especially in sub-Saharan Africa." The World Bank-IMF rebuttal, to appear in the June 18 issue of The Lancet, follows.
It is disheartening to see your esteemed medical publication providing a forum for serious accusations about the International Monetary Fund (IMF) and the World Bank (May 21, p. 1821). For all of the strong rhetoric of the article, one fact stands out: Gorik Ooms and Ted Schrecker fail to cite a single instance in which Bank or Fund policies actually restricted spending on HIV/AIDS.
Take the example they offer of Mozambique, where, according to Ooms and Schrecker, officials were allegedly told in 2002 that their spending plans "might have been too ambitious."
The numbers tell a very different story. From 2001 to 2004, Mozambique's economy grew about 9 percent a year, after taking into account inflation. Meanwhile, the government's spending on health programs and HIV/AIDS programs grew exactly in line with that level of growth. That adds up to a substantial real increase in spending on HIV/AIDS every year.
Accordingly, the charges levelled by Ooms and Schrecker do not stand up to the experience of frontline practitioners.
A recent survey by the Center for Global Development, Washington, DC, USA-which drew 353...
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