Imf Engagement On Health Spending Issues In Surveillance And Program Work

IMF country teams have become increasingly engaged on health spending issues in surveillance and program work, and more so since the COVID-19 pandemic. The primary objectives of health spending are to improve health outcomes and provide protection to households against high financial costs of health care. The Fund’s engagement on health spending issues is guided by an assessment of its macro-criticality, with the scope and purpose of engagement varying across countries and depending on whether it occurs in surveillance or program contexts. This technical note discusses how to assess the macro-criticality of health spending and reviews appropriate policy responses. The design and implementation of macro-critical health reforms often require specific sectoral knowledge and experience. Thus, this note emphasizes the importance of collaborating with development partners on health policy issues.

The International Monetary Fund (IMF) is increasingly involved in offering policy advice on public pension issues to member countries. Public pension spending is important from both fiscal and welfare perspectives. Pension policy and its reforms can have significant fiscal and distribution implications, can influence labor supply and labor demand decisions, and may impact consumption and savings behavior. This technical note provides guidance on assessing public pension systems’ macrocriticality, i.e., sustainability, adequacy, and efficiency; it also discusses the issues and policy trade-offs to be considered when designing responses aiming to address these dimensions of the pension system. The paper emphasizes the importance of taking a long-term, comprehensive perspective when evaluating public pension spending and providing policy advice. Where feasible, reforms should be gradual and transparent to allow individuals ample time to adjust their work and savings decisions and to facilitate consumption smoothing over their lifecycle to avoid poverty in old age. It is also important to ensure that pension systems’ design and reforms do not lead to undesirable impacts in other policy areas including general tax compliance, health insurance coverage, labor force participation among older workers, or labor market informality. The paper emphasizes the importance country-specific social and economic objectives and constraints, as well as political economy realities – factors that can determine whether a pension reform is a success or failure.

The International Monetary Fund’s engagement on social safety net (SSN) issues is likely to expand as member countries respond to growing challenges in the economic and fiscal landscape. SSNs play a crucial role in protecting households from poverty, promoting inclusive growth, and maintaining social stability. This technical note discusses (1) the different channels through which SSN spending may become macro-critical, (2) how to assess the importance of these channels, and (3) the types of policy responses that are appropriate and the trade-offs involved in choosing among them. To facilitate a more comprehensive assessment of SSN spending, the paper also examines the complementary role of labor market programs (for example, unemployment benefits and active labor market programs). The paper emphasizes the importance of early engagement and coordination with development partners with expertise on social safety nets and with different stakeholders when formulating policy advice.

This note provides general guidance on the operationalization of the strategy for IMF engagement on social spending. Social spending plays a critical role as a key lever for promoting inclusive growth, addressing inequality, protecting vulnerable groups during structural change and adjustment, smoothing consumption over the lifecycle, and stabilizing demand during economic shocks. Social spending policies have also been playing an important role in tackling the structural challenges associated with demographic shifts, gender inequality, technological advances, and climate change. This note builds on a series of notes on IMF engagement on specific social spending issues since the publication of the 2019 strategy paper and provides operational guidance on when and how to engage on social spending issues, in the context of surveillance, IMF-supported programs, and capacity development.

A recovery is underway, but the economic fallout from the global pandemic could be with us for years to come. With the crisis exacerbating prepandemic vulnerabilities, country prospects are diverging. Nearly half of emerging market and developing economies and some middle-income countries are now at risk of falling further behind, undoing much of the progress made toward achieving the UN Sustainable Development Goals.

This independent evaluation of the IMF’s role and performance in the determination and use of aid to low-income countries in sub-Saharan Africa is presented at a ground-level view. Country performance has improved in many sub-Saharan Africa countries over the period, and the report details the role of the IMF’s programs, as well as perceptions of that role. The report is an important contribution to following through on the IMF’s commitment to its Poverty Reduction Strategy and makes three main recommendations for improving the coherence—actual and perceived—of the IMF’s policies and actions relating to aid to sub-Saharan Africa going forward.

This note aims to provide guidance on the key principles and considerations underlying the design of Fund-supported programs. The note expands on the previous operational guidance notes on conditionality published over 2003-2014, incorporating lessons from the 2018-19 Review of Conditionality, and other recent key policy developments including the recommendation of the Management’s Implementation Plan in response to Independent Evaluation Office (IEO)’s report on growth and adjustment in IMF-supported programs. The note in particular highlights operational advice to (i) improve the realism of macroeconomic forecast in programs and fostering a more systematic analysis of contingency plans and risks; (ii) improve the focus, depth, implementation, and tailoring of structural conditions (SCs), with due consideration of growth effects; and (iii) help strengthen the ownership of country authorities. Designed as a comprehensive reference and primer on program design and conditionality in an accessible and transparent manner, the note refers in summary to a broad range of economic and policy considerations over the lifecycle of Fund-supported programs. As with all guidance notes, the relevant IMF Executive Board Decisions remain the primary legal authority on matters covered in this note.

This note discusses, through selected country case studies, how digital health records and telemedicine can improve delivery quality, access to underserved populations, and resource utilization in healthcare. In addition, it shows how digital disease surveillance tools can identify outbreaks and track the spread of diseases, while novel digital platforms can facilitate patent licensing and international pooled procurements for better drug access in developing countries. Ensuring safe and well-regulated collection and use of healthcare data, as well as facilitating standardization and interoperability of digital infrastructure in different sectors is critical for the success of these interventions.