Debates on International Agencies SCALING UP GLOBAL SOCIAL HEALTH PROTECTION: PREREQUISITE REFORMS TO THE INTERNATIONAL MONETARY FUND

People living in low-income countries require protection from the economic and social impacts of global economic competition, yet, historically, the International Monetary Fund’s (IMF) fiscal austerity programs have weakened the potential for redistribution both within poor countries and between rich and poor countries. The current development paradigm’s focus on “sustainability ” is an obstacle to developing systems of global social protection and an impediment to future progress. Reforming IMF policy conditionality and democratizing the IMF’s decision-making processes will be necessary for offsetting growing inequalities in health financing among poor nations. Global capitalism and its inherent competition creates “winners ” and “losers,” both within a country and globally. In wealthy nations, those who lose the economic trading competition are buffered against the vagaries of competition and life by national social protection mechanisms. International Labour Office officials define these social protections as “income transfers (or benefits) in kind and in cash that a society affords to its individual members in order to: avoid or alleviate poverty; or assist them in coping with a series of life contin-gencies or risks;... or reduce or correct inequalities created through the primary (pre-transfer) income distribution ” (1; emphasis added). Between rich and poor nations, and within poor nations themselves, few such protective mechanisms exist (2). Bilateral and multilateral donors suc