The Western-dominated International Monetary Fund (IMF), whose credibility with some of its largest clients is eroding because of what they consider counter-productive economic policy advice, is facing renewed accusations that its prescriptions have compounded major health crises. 

Similar charges have been leveled at the IMF before. But these accusations come at a time when the IMF's standing is being challenged as developing countries increasingly see it as an institution that has catered only to its "masters" within the Group of Seven most industrialised nations at the expense of human health in poor nations. 

Already several countries, especially in Asia, have accumulated huge foreign currency reserves, while others like Brazil and Argentina paid off their debts to the public lender to fend off any future need for its loan packages. 

Now activists who have played a major role over the past decade in bringing the shortcomings of the IMF policies to light are vowing they will keep the heat on the IMF's controversial role till it is either drastically reformed or abolished altogether. 

They are targeting the Fund's record on health issues, especially how its policies have compounded problems like HIV/AIDS and shortages of health workers in developing countries. 

Dozens of campaigners organised demonstrations on the sidelines of the twice-a-year meetings of the IMF and the World Bank outside their headquarters here in Washington to protest the negative impacts of IMF austerity measures, originally designed to cut inflation and control spending, on health care in borrowing nations. 

As in previous years and to attract attention to their grievances, the activists staged a theatrical protest on Friday and delivered a "failing health report" and an order to close down the institutions. 

They set up a massive three-dimensional three metre by two metre job advertisement, complete with life-size cut-outs of teachers, doctors and nurses, outside the World Bank and IMF. 

Their aim was to illustrate the shortage of two million teachers and four million health workers in developing countries, which don't have the money needed to educate and hire for these essential posts because of budget disciplinary conditions imposed by the IMF. 

The protesters say that the IMF has set such strict economic targets for developing countries that the governments cannot afford to pay salaries for teachers, doctors and nurses. 

They say the IMF's sister institution, the World Bank, is no less guilty when it comes to health issues because it constantly fails to pressure donors to commit to long-term aid that could cover health expenses. 

Longtime IMF and World Bank critics from groups like Oxfam, Jubilee USA Network, Mobilization for Global Justice and Stop HIV/AIDS in India took part in the protest. 

Africa Action, a Washington-based group that monitors policies towards Africa, says that the continent's governments have had to limit their spending on health care and privatise health care services in order to meet macroeconomic targets set in Washington. 

"The policies of these institutions have added fuel to the fire of HIV/AIDS in Africa, and the World Bank and IMF have proven themselves to be extremely hazardous to the health of the continent's people," said executive director Salih Booker. 

About 600,000 health professionals are currently working in Sub-Saharan Africa. In order to achieve major strides in health goals mandated by the United Nations Millennium Development Goals (MDGs), at least one million more will have to be trained and hired. 

Another group that took part in the protests, 50 Years Is Enough, reports that under the IMF, spending on public health in Latin America and the Caribbean fell from 131 dollars per person a year in 1997 to 122 dollars in 2001. 

Between 1997 and 2001, healthcare spending in Sub-Saharan African countries fell from an already low 17 dollars per person annually to only 12 dollars. 

The main demand from anti-poverty campaigners is that the IMF should allow countries that resort to its loans because of balance of payments shortages or in emergencies to spend money, including aid money, on key services such as education and health. 

A report by the international advocacy group ActionAid, released on the eve of the IMF and World BAnk meetings, also found out that IMF is peddling contradictory policies especially ones related to health problems. 

It says that the current policies in the loan programmes continue to be based on targets that have characterised the last two decades of a low-spending and low-economic growth mode. 

The report says that in the IMF reform debate, developing nations and policy advocates should not merely focus on demands for greater representation and better governance, but also call for revamping economic policy advice at the IMF to ensure that its "future lending programmes include macroeconomic policies that will truly enable borrowing countries to invest in the levels of scaling-up needed to fight HIV/AIDS and achieve the MDGs by 2015." 

"Current levels of health spending must be increased if these countries are to build and maintain the viable public health systems upon which successful HIV/AIDS programs will depend," says ActionAid. 

The IMF says its policy advice is designed to help economic growth and better equip governments to integrate internationally.