The purpose of the Review of Program Design and Conditionality (ROC) is to ensure that IMF-supported programs can better assist members in a global environment marked by high uncertainty, structural shifts, and more frequent shocks. Building on the informal discussion of the Executive Board on October 6, 2025, this paper presents further analysis and proposes a set of pragmatic reforms aimed at strengthening the Fund’s ability to help its members resolve their balance of payments (BOP) imbalances and restore medium-term external viability.