The Austerity Decade 2010-20

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Abstract

In the wake of the financial, food and fuel crises, a fourth ‘F’ shockwave hit the global economy in 2010: fiscal adjustment. It would mark the onset of a prolonged period of budget cuts that is now projected to continue at least through 2020 in high-income and developing countries alike. This article: (i) examines International Monetary Fund (IMF) government spending projections for 187 countries from 2005 to 2020, indicating a decade of austerity from 2010 onwards; (ii) reviews 616 IMF country reports in 183 countries to identify the main adjustment measures; and (iii) discusses the negative impacts of austerity on jobs and welfare, pointing to alternative policies to identify fiscal space for equitable and sustainable development. Note that this analysis was done prior to COVID-19, and the estimates for 2019 and 2020 reflect pre-pandemic projections.

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Financial crisis, austerity, and health in Europe.

Marina Karanikolos, Marina Karanikolos, Johan P Mackenbach … (2013)

The financial crisis in Europe has posed major threats and opportunities to health. We trace the origins of the economic crisis in Europe and the responses of governments, examine the effect on health systems, and review the effects of previous economic downturns on health to predict the likely consequences for the present. We then compare our predictions with available evidence for the effects of the crisis on health. Whereas immediate rises in suicides and falls in road traffic deaths were anticipated, other consequences, such as HIV outbreaks, were not, and are better understood as products of state retrenchment. Greece, Spain, and Portugal adopted strict fiscal austerity; their economies continue to recede and strain on their health-care systems is growing. Suicides and outbreaks of infectious diseases are becoming more common in these countries, and budget cuts have restricted access to health care. By contrast, Iceland rejected austerity through a popular vote, and the financial crisis seems to have had few or no discernible effects on health. Although there are many potentially confounding differences between countries, our analysis suggests that, although recessions pose risks to health, the interaction of fiscal austerity with economic shocks and weak social protection is what ultimately seems to escalate health and social crises in Europe. Policy decisions about how to respond to economic crises have pronounced and unintended effects on public health, yet public health voices have remained largely silent during the economic crisis. Copyright © 2013 Elsevier Ltd. All rights reserved.

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Structural adjustment and health: A conceptual framework and evidence on pathways.

Alexander Kentikelenis (2017)

Economic reform programs designed by the International Monetary Fund and the World Bank-so-called 'structural adjustment programs'-have formed one of the most influential policy agendas of the past four decades. To gain access to financial support from these organizations, countries-often in economic crisis-have reduced public spending, limited the role of the state, and deregulated economic activity. This article identifies the multiple components of structural adjustment, and presents a conceptual framework linking them to health systems and outcomes. Based on a comprehensive review of the academic literature, the article identifies three main pathways through which structural adjustment affects health: policies directly targeting health systems; policies indirectly impacting health systems; and policies affecting the social determinants of health. The cogency of the framework is illustrated by revisiting Greece's recent experience with structural adjustment, drawing on original IMF reports and secondary literature. Overall, the framework offers a lens through which to analyze the health consequences of structural adjustment across time, space and levels of socioeconomic development, and can be utilized in ex ante health impact assessments of these policies.