This study on Zambia is part of a broader three-country assessment of the impact of International Monetary Fund (IMF) fiscal and monetary policies on the government’s capacity to address the HIV/AIDS and tuberculosis (TB) crises. Recent studies have shown that IMF macroeconomic programmes that focus on strict fiscal and monetary policies restrict public spending, limiting public investment in health, HIV/AIDS and TB. This study discusses the impact of IMF programmes on Zambia’s ability to overcome the challenges posed by HIV/AIDS, TB, and human resource shortage. The purpose of this research is to raise awareness within the IMF and the Zambian government and civil society about the potential impacts of IMF programmes on Zambia’s ability to overcome these challenges. This study combined qualitative and quantitative data collection methods in order to analyze IMF policies from 1990 to 2009. Using data collected from documents through a comprehensive data search and key informant interviews, this study assessed the impact of IMF programmes on public spending. National strategic plans, planning guidelines, pieces of legislature, and national budget documents were obtained from relevant ministries and other institutions like the IMF, World Bank, and the World Health Organisation and examined in detail.