IMF managing director Kristalina Georgieva said that while US Treasury Secretary Scott Bessent and other US leaders recognised that the federal deficit and national debt had grown too high, just trying to grow the US economy out of its more than $US40 trillion ($A57 trillion) in national debt would not suffice.
"At the fund, we believe that, growth, of course, helps, but it cannot deliver fast enough the necessary adjustments," Georgieva said at the autumn meeting of the IMF and World Bank in Bangkok on Wednesday.
"There is no magic," she said, noting some other measures would be needed.
"You have to go in a direction of tightening that, bringing it down, bringing deficit down."
Rising debt levels and global inflation, partly resulting from high energy costs due to the Iran war, have pushed interest rates to multi-decade highs, adding to the burdens of the world's poorest nations.
Efforts to bring debt under control with what Georgieva and other experts call "fiscal consolidation" have suffered setbacks from heavy spending during the COVID-19 pandemic and since.
"Fiscal risks are rising, and a proper reaction is largely absent in many countries," said Rodrigo Valdes, director of the IMF's Fiscal Affairs Department.
"And in major advanced economies, the effect of fiscal indiscipline does not stop at the border. It travels to the rest of the world."
"Among the world's poorest countries, interest payments have reached historic highs relative to revenue, and declining amounts of aid are creating gaps that some countries have been unable to finance," the IMF's latest Fiscal Monitor said.
That is forcing countries to make hard choices between supporting their most vulnerable people and meeting their debt repayment obligations.
"We know that today the median developing country is going to pay, is actually today paying three times more on their interest repayments than developed countries," Alexander De Croo, former Belgian prime minister and the administrator of the United Nations Development Programme, said in an interview with The Associated Press.
On average nearly 10 per cent of government spending is going to repay debt, and the combination of high prices for fuel, fertiliser and other needs, the impact of the El Nino weather phenomenon and higher borrowing costs has left many low income countries with little opportunity to recover.
"I mean, we don't see really a light at the end of the tunnel," De Croo said.
