This report attempts to intervene in the discussion on the social effects of structural adjustment through an empirically-based assessment of the impact of the Economic Structural Adjustment Programme (ESAP) of the Zimbabwean state on the country's health sector. The author's conclude that ESAP has resulted in a serious degradation of the poor in Zimbabwe, and an overall decline in the health status of the working poor, which the Social Dimensions Fund has failed to mitigate.