Report on the IMF in Zambia: loan programme needs to better protect health services

14/10/2024 - News

Make Way Zambia

The International Monetary Fund (IMF) loan programme in Zambia, designed to restore economic stability, has imposed austerity measures that are severely restricting public budget for essential services and access to health, particularly for vulnerable groups. This is the key finding from Wemos’ latest research, developed together with the Make Way programme in Zambia. To restructure Zambia’s debt without jeopardizing social well-being, the government and the IMF should revise their approach to economic policies, ensuring social protections are in place to safeguard essential services.

The impacts of the IMF measures on access to essential services

Zambia is grappling with a severe economic crisis, marked by high inflation, rising poverty and an external debt burden of USD 14.5 billion in 2023. In an effort to stabilize the economy, Zambia secured a USD 1.7 billion loan from the IMF under the Extended Credit Facility (ECF). However, the austerity measures imposed by the IMF are exacerbating socio-economic inequalities and hindering access to quality healthcare.

The removal of subsidies and rising inflation have driven up the cost of living, making it harder for families to afford healthcare, transportation to clinics, and out-of-pocket expenses for essential medicines. Health facilities, especially in rural areas, face critical shortages of staff and essential supplies, including essential medicines.

The result is a sharp decline in household income and reduced access to essential health services, particularly in marginalized communities. Women, LGBTQIA+ persons and vulnerable populations are disproportionately affected, as they depend heavily on public health services that are becoming increasingly unaffordable and inaccessible.

Challenges of the health sector funding

While the health sector’s budget has nominally increased from 8% in 2022 to 11.8% in 2024, high inflation has reduced the real value of these investments, leaving the healthcare system underfunded and understaffed. In addition, Zambia’s heavy reliance on external funding for its health system also makes it vulnerable to shifting international priorities, which can undermine long-term health investments. These issues, coupled with high debt servicing costs, restrict the government’s ability to invest in the health system.

Therefore, despite the IMF’s goal of restoring fiscal stability, its austerity measures have intensified economic challenges. Its approach does not adequately consider the social impacts of its policies, leaving marginalized groups at greater risk of poor health outcomes and financial instability.

Recommendations for a healthy economic recovery

To enable the country to recover its economic stability while providing quality and accessible healthcare for all, the Zambian government and the IMF should address the social consequences of austerity measures. We outline 7 policy recommendations that prioritize social protection and health equity.

  1. The government of Zambia should continue its debt restructuring efforts to unlock funds for social services and improve debt sustainability.
  2. The government of Zambia and the IMF must ensure a meaningful, timely and inclusive civil society engagement in discussions around debt.
  3. In its analysis of the country’s debt sustainability, the IMF should consider external factors and crises in the recipient country. Its framework should include humanitarian and development needs along with GDP projections.
  4. The IMF should consider gendered effects of the conditionalities in their ECF programmes, and adapt these to ensure these do not increase poverty and inequality.
  5. The IMF should encourage progressive instead of regressive taxation, and focus on corporate taxes, wealth taxes and curbing illicit financial flows.
  6. The IMF should adjust social spending floors in ECF programmes to realistically meet country-specific needs, ensuring essential services are always protected.
  7. The IMF should measure the indirect effects their programmes have on access to essential services, particularly health, to mitigate potential negative effects.

The full version of the research on the IMF programme in Zambia will be published soon.

You can download our brochure with key findings and recommendations below.

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