Austerity‘s Toll on Health: Linking IMF Structural Adjustment Programs, Health Spending, and HIV

Austerity‘s Toll on Health: Linking IMF Structural Adjustment Programs, Health Spending, and HIV | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 20 February 2026 V1 Latest version Share on Austerity‘s Toll on Health: Linking IMF Structural Adjustment Programs, Health Spending, and HIV Authors : Seong Hun Yoo and YiYeon Kim 0000-0002-6615-9327 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.177158719.94170353/v1 194 views 56 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background : The current global debt crisis is expected to result in approximately 7.7 million AIDS-related deaths by 2030. While anecdotal evidence from countries such as Thailand and Greece suggests that IMF structural adjustment programs may increase HIV-related vulnerabilities, empirical research on this relationship remains limited. This study aims to systemically and empirically examine the impact of IMF structural adjustment programs (SAPs) on HIV and identifies the pathways through which these effects occur. Methodology : This study analyzes panel data from 121 developing countries between 1990 and 2017 using fixed-effects regression models with Driscoll and Kraay standard errors (DKSE). DKSE provides higher-order autocorrelation, serial correlation, and spatial dependency. Robustness checks indicate that correcting for serial correlation and cross-sectional dependence is necessary in the model. Results : While previous studies are divided on whether IMF programs increase or decrease public health spending, this study finds that a country’s adoption of an IMF structural adjustment program (SAP) significantly reduces public health spending, which in turn leads to higher rates of new HIV infections. Conclusion : The findings demonstrate that IMF structural adjustment program have consequences that extend beyond macroeconomic outcomes, affecting public health systems and HIV patients in borrowing countries. These results highlight the need for governments adopting IMF-mandated fiscal austerity to mitigate potential public health repercussions. Moreover, the study suggests that IMF structural adjustment may disproportionately affect marginalized populations, underscoring the need for future research on the distribution of health impacts. Supplementary Material File (austerity toll for submit.docx) Download 104.31 KB Information & Authors Information Version history V1 Version 1 20 February 2026 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords austerity measures hiv/aids prevalence imf structural adjustment programs (saps) public health expenditure social determinants of health Authors Affiliations Seong Hun Yoo Yonsei University - Mirae Campus View all articles by this author YiYeon Kim 0000-0002-6615-9327 [email protected] Kangwon National University View all articles by this author Metrics & Citations Metrics Article Usage 194 views 56 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Seong Hun Yoo, YiYeon Kim. Austerity‘s Toll on Health: Linking IMF Structural Adjustment Programs, Health Spending, and HIV. Authorea . 20 February 2026. DOI: https://doi.org/10.22541/au.177158719.94170353/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . 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