Typical street scene in Santa Ana, El Salvador. (Photo: iStock)
IMF Survey: IMF Casts Doubts on TB Study
July 23, 2008
- Study fails to take account of economic conditions when Soviet Union collapsed
- It contains a number of dubious results, casting doubt on methodology
- Several results contradict findings of previous studies
The IMF has poured cold water on a Cambridge University study suggesting that IMF loans were linked to the spread of tuberculosis in eastern Europe and the former Soviet Union during the 1990s, saying that the researchers used a dubious methodology and the findings were not backed up by data.
Flags of the IMF's 185 members. The IMF's membership rose rapidly with the collapse of the Soviet Union. (photo: IMF)
An examination of the study by economists in the Research Department of the International Monetary Fund called into question how the study was done.
"Severe methodological shortcomings limit the scope of these results and prevent any causal interpretation. The fundamental problem is that this study does not take properly into account that countries implement IMF-supported reforms in times of economic distress," the IMF's assessment said.
Key problems
The study finds that IMF programs are positively associated with the TB mortality rate for a sample of 21 transition countries from 1992 to 2002. According to the Research Department note, the main concerns with this study are the following:
• The authors do not take into account that the economic and social instability following the collapse of Soviet Union may have had a direct impact on TB incidence in the 21 transition economies considered in the study. Any analysis that seeks to estimate the impact of IMF-supported programs on economic or social outcomes should take into account the economic and political conditions that first led the country to agree to an IMF-supported program. By not including these conditions, this study confuses the reasons for asking IMF assistance with the consequences of this assistance.
• The study speculates that IMF-supported programs are associated with lower public health expenditure, leading to higher TB incidence. However, this conjecture is not corroborated by data. The average increase in health spending as a share of GDP is larger for countries with Fund-supported programs than in countries without such programs (http://www.imf.org/external/np/vc/2007/062907.htm and IMF's WP/05/100).
• The study has a number of dubious results, which cast doubt on the methodology used by the authors. The study does not take into account many other factors that should have a direct impact on TB incidence, including health expenditure, poverty, initial mortality, and migration. Other results of the study, including that TB-incidence increases with income growth and decreases with urbanization, contradict previous studies that find that TB incidence increases with poverty and increases with urbanization.
• Finally, the authors' finding that the only consistent factor impacting TB incidence is the presence of IMF-supported programs is in contrast with previous epidemiological studies on the incidence of TB.
Comments on this article should be sent to imfsurvey@imf.org