  The International Monetary Fund (IMF) provides financial assistance to its
member-countries in economic turmoil, but requires at the same time that these
countries reform their public policies. In several contexts, these reforms are
at odds with population health. While researchers have empirically analyzed the
consequences of these reforms on health, no analysis exist on identifying fair
tradeoffs between consequences on population health and economic outcomes. Our
article analyzes and identifies the principles governing these tradeoffs.
First, this article reviews existing policy-evaluation studies, which show, on
balance, that IMF policies frequently cause adverse effects on child health and
material standards in the pursuit of macroeconmic improvement. Second, this
article discusses four theories in distributive ethics (maximization,
egalitarianianism, prioritarianiasm, and sufficientarianism) to identify which
is the most compatible with the core mission of the IMF, that is, improved
macroeconomics (Articles of Agreement) while at the same time balancing
consequences on health. Using a distributive-ethics analyses of IMF polices, we
argue that sufficientarianism is the most compatible theory. Third, this
article offer a qualitative rearticulation of the Articles of Agreement, and
formalize sufficientarian principles in the language of causal inference. We
also offer a framework on how to empirically measure, from observational data,
the extent that IMF policies trade off fairly between population health and
economic outcomes. We conclude with policy recommendations and suggestions for
future research.
