A multi-author paper published in academic journal Organisation and Environment in June 2011 analysed health outcomes in Sub-Saharan Africa. The analysis of 31 countries over 15 years found that “when a country is under a World Bank structural adjustment loan it tends to have higher levels of child mortality”. The authors argue that cuts in health provision, which lead to reduced access to health services and, over the long-term, reduces government capacity to react to public health problems are at the root of the problem. The paper called for greater debt relief and “eliminating certain macroeconomic policy reforms, especially privatisation of government assets, which often limit access to health, education, clean water, and basic sanitation via higher user fees”.