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They raise the risk that future shocks to domestic confidence or adverse changes in the external environment could lead to new pressures on exchange rates, on interest rates, and on the capacity of countries to fund themselves on sustainable terms. Apart from the risk of crisis, these debt levels are large enough to depress domestic investment and long-term growth prospects. In part because of these balance sheet and debt burdens, many emerging market economies face a protracted transition before they can expect to be comfortably considered stable investment grade credits, with sufficient levels of self-insurance against external and domestic challenges to financial stability. One of the most pressing challenges for the Fund is to help assist in this process of reducing vulnerability, by promoting an unwinding of these large balance sheet risks and, at the same time, providing a credible form of contingent insurance for those hopefully rare circumstances when its members face extraordinary financing needs. The Fund would be better able to contribute to this process if it were to strengthen its policies in a number of specific areas. My suggestions cover four types of reforms: changes to the substantive focus of Fund policy advice; to the relationship between the Fund and its members in the surveillance framework; to the Fund’s approach to countries undertaking a debt restructuring; and to how the Fund uses its financial resources.