This report "...examines evidence from nine IMF country programmes, chosen based on their HIV prevalence rates, and finds that although the IMF has changed its tune and is talking about greater flexibility, these changes are not enough and are only temporary. "In 2006, the World Health Organisation (WHO) estimated that 57 countries were facing a severe health workforce crisis.... Addressing this shortage, and action alongside it to strengthen health systems around the world, requires substantial, concerted effort from both aid donors and recipient governments. The current global downturn threatens to undermine steps taken in this direction so far and jeopardise progress towards the health-related Millennium Development Goals. "...the IMF has adapted its rhetoric so that it now claims its programmes are more flexible on fiscal and monetary policies, which determine to what extent governments can maintain or increase spending - including of foreign aid - and stimulate economic activity"