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The International Monetary Fund is the centre of a global financial system that encourages budgetary discipline and full integration into world trade to facilitate development and alleviate poverty. Yet this policy 'conditionality' of the IMF is highly controversial. Critics state that fifty years of IMF existence has been 'fifty years too long', and that its doctrinaire policy must change or Fund programmes will have only limited ability to achieve their objectives. This book examines the arguments, tracing the extent of Fund adaptation, presenting major new evidence on the consequences of Fund programmes, and considering its future role.