IMF Survey: IMF Casts Doubts on TB Study
IMF News, July 23, 2008
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Bibliographic details
- Published: July 23, 2008
Overview
- The IMF cast doubts on a Cambridge University study that suggested IMF loans were linked to the spread of tuberculosis in eastern Europe and the former Soviet Union during the 1990s.
- The IMF's Research Department concluded that the study used a dubious methodology and that "the findings were not backed up by data."
- Contextual points cited in the article:
- IMF's membership: 185 members.
- Study sample: 21 transition countries from 1992 to 2002.
Research Department assessment
- Quoted assessment: "Severe methodological shortcomings limit the scope of these results and prevent any causal interpretation."
- Central critique: "This study does not take properly into account that countries implement IMF-supported reforms in times of economic distress."
- The IMF states that by not including the economic and political conditions that led countries to seek IMF assistance, "this study confuses the reasons for asking IMF assistance with the consequences of this assistance."
Key problems identified by the IMF
- Sample and period:
- 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.
- Failure to account for post-Soviet economic and social instability:
- "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."
- Uncorroborated conjecture on public health expenditure:
- The study speculates that IMF-supported programs are associated with lower public health expenditure, leading to higher TB incidence, but "this conjecture is not corroborated by data."
- IMF cites that "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)."
- Omitted control variables and dubious results:
- "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."
- The IMF notes "a number of dubious results, which cast doubt on the methodology used by the authors."
- Results contradicting established findings:
- The study reports that "TB-incidence increases with income growth and decreases with urbanization," which the IMF states "contradict previous studies that find that TB incidence increases with poverty and increases with urbanization."
- Overstated role of IMF programs:
- The IMF highlights that 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."
Noted contradictions with previous research
- The IMF emphasizes several contradictions between the Cambridge study's findings and prior epidemiological and economic studies:
- Directional relationships between TB incidence, income growth, poverty, and urbanization differ from earlier work.
- The IMF points to existing work and internal analyses (including WP/05/100) showing different patterns in health spending and outcomes for countries with Fund-supported programs.
Contact for comments
- Comments on the article should be sent to imfsurvey@imf.org
IMF Survey online — July 23, 2008