This article focuses on the main issues vital for the survival of the International Monetary Fund in the context of rapid and almost revolutionary changes in the world's money and capital markets, the rise of fast growing, emerging economies, and the decline in the use of the institution's resources and consequently in its income. It also discusses the structure of the IMF, the inadequacy of the instruments it currently employs and the new ones being contemplated as part of the Medium-Term Strategy it designed recently. April 5-11, 2008