Reviving the International Monetary Fund: concerns for the health of the poor.

Despite optimism about the potential for a "new economic order," the outcomes of the G20 summit of April 2009 do not deviate from the neoliberal path. The main outcome, the G20's commitment to the International Monetary Fund (IMF), does not change the lending practices and core economic assumptions of the IMF. Further, this new funding commitment will do little to help the poorest countries, as it is not available to them and comes with high interest. Institutions that more actively consider health, such as the World Bank and World Health Organization, may have failed to win resources and authority because they have not demonstrated how they could expand or modify their activities, and because of broader ideological debates pitting social protection against economic stimulus. Reforms in IMF practices and economic assumptions may provide some limited protection of health spending. These reforms can allow for inclusion of the benefits of health programs in economic forecasting, dismissal of the assumption that aid will be short-term, and removal of indirect limits on public sector health spending. These reforms in IMF practices are urgently needed, but fall short of making health and social protection an integral component of efforts promoting economic stability.