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‘Unpleasant Accounting,’ Public Finance Trade-Offs Hold Some Responsibility For Poor Health Care In West Africa

Washington Post: Who has responsibility for Ebola? The IMF, the West, or unpleasant accounting?
Chris Blattman, associate professor of political science and international and public affairs at Columbia University

“…The idea that financial austerity kills is not unique to West Africa. Most of the world is suffering from austerity, and a lot of people hold the IMF and their ilk responsible. So this is an important question beyond the Ebola crisis. … In my mind, the real problem is the unpleasant accounting you face when you’re poor, have no tax revenues, and only so much aid. You need to spend less on something. … To sum up, I want to suggest a rule of thumb for any public finance question: When someone suggests ‘This country should spend more on X,’ the most important thing you can ask is the unpleasant accounting question: ‘Where should that money come from?’ More loans? More aid? Less spending on something else? The next thing you should do is take back the point I conceded, and ask whether spending equals results. Because of tradeoffs: money wasted on one thing is money not spent saving lives in other ways. Anything less doesn’t add up, IMF or not” (1/7).

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