Structural adjustment can be dated to the World Bank's 1981 Accelerated Development (Berg) Report, albeit precursor World Bank programmes in Sub-Saharan Africa (e.g. Togo, Malagasy Republic) date to the late 1970s. It is taken by most supporters and critics alike - to be intrinsically neo-liberal in content, but the 1989 World Bank Report Long Term Perspective Study in fact advocates a sharp increase (from about 20 per cent to about 30 per cent of Gross Domestic Product) in government operating expenditure plus human and physical infrastructure. Many observers - again both favourably and unfavourably disposed - see the World Bank and IMF as monolithic in approach and giving top priority to external debt repayment, yet in SSA the Fund's shorter term, more demand management focused approach is often in uneasy balance with the Bank's focus on output enhancement and institutional reconstruction.