Developing countries experiencing severe debt problems often participate in conditionality agreements brokered by the IMF and the World Bank. Some argue that these agreements emphasize economic growth over socioeconomic equality, limiting access to health care for the majority of the population. Dr. Ayers tests the assertion that conditionality agreements are detrimental to health standards. A new model, the Distributive Environment Model (DEM), is proposed. The DEM demonstrates that a developing country with low economic growth can achieve improvements in health standards if broad and diverse segments of its population have access to its core economy. Economic growth-oriented policies (like those typical of conditionality agreements) are not always necessary to improve health standards in developing countries. A flexible approach to development policy that considers the socioeconomic reality of developing countries is recommended in lieu of the "one size fits all" approach associated with conditionality agreements.