Education Agenda

Healthy Population

Protecting Most Vulnerable

Thematic Perspectives

Investing in People

Two million children die every year from vaccine- preventable diseases. About three million people lost their lives in the year 2000 from HIV/AIDS. Many people living in poverty lack basic health and education, are vulnerable to crises, and have little personal income or savings. The world’s human development needs are staggering.

The World Bank remains the largest external financier of human development programs. It recognizes that healthy and educated people are the backbone of sustainable economic growth and central to any strategy for achieving the international develop-ment goals. Through lending and nonlending services, it helps countries invest in and provide social safety nets for their people—efforts that help alleviate some of the worst consequences of poverty while increasing people’s chances to improve their own well-being. In fiscal 2001 new lending commitments for education, health, and social protection amounted to $4.4 billion (figure 3.1). Nonlending services ranged from analytical work and sharing of best practice to support for preparation of people-focused poverty reduction strategies and considerable work at the global level, with multiple partners, to intensify the fight against communicable diseases in particular.

The Bank also helped clients better integrate human development concerns into overall poverty reduction efforts in fiscal 2001. The first Poverty Reduction Support Credit provided Uganda interest-free, medium-term multisector support for delivery of basic education, health care, and water and sanitation services, combined with broad public sector reform (see page 43). In addition, education projects addressing health, nutrition, and child labor issues demonstrate efforts to take advantage of synergies across social sectors (box 3.3).

The Education Agenda: Focusing on Access, Quality, and Gender Concerns

Education empowers people, enhances opportunities for greater participation in the labor market, and promotes security. The Bank’s education strategy focuses on efforts proven to make a difference in increasing access to schooling and improving the quality of education. The Bank has also committed to building human capacity for the knowledge economy. A key thrust is to help countries eliminate gender disparities in primary and secondary education by 2005.

At $1.1 billion, Bank lending for education in fiscal 2001 was 1.5 times its fiscal 2000 level. The increase reflects the Bank’s commitment—together with the United Nations Educational, Scientific and Cultural Organization, United Nations Development Programme, United Nations Children’s Fund (UNICEF), and United Nations Population Fund—to scale up its support to countries’ education systems, following the April 2000 World Conference on Education for All (EFA). New projects supported improved access, quality, efficiency, and equity at the primary, secondary, and vocational levels; an area of focus was distance learning. As of June 30, 2001, the Bank had 64 active education projects that address girls’ education. For example, innovative and effective programs are being implemented in Bangladesh to benefit secondary school girls, and in India to benefit primary school children. Results are improving: under a project in Guinea, for example, girls’ enrollment increased moderately to 49 percent in 2000–01 from 44 percent a year earlier. The Bank is also helping improve adult—especially female— literacy in several countries.

The Bank also provides varied nonlending support for education. In fiscal 2001 such efforts included analytical work, synthesis of good practice, and capacity building, as well as technical support to help countries prepare Poverty Reduction Strategy Papers. Major policy issues identified to be in early need of attention were education finance, teacher training and pay, and coverage (to widen access). Strategic alliances constitute another important form of support. In fiscal 2001 the Bank worked with donor, nongovernmental organization (NGO), and private sector partners to support the Focusing Resources on Effective School Health (FRESH) program in Africa (box 3.3), and with the private sector in particular to help countries address digital divide and information communications technology issues. Collaboration with the private sector will further benefit from the IFC’s new education strategy, which sees these players as partners in helping alleviate financial constraints, enhance social mobility, improve equity, encourage innovation, and promote effectiveness.

Expanding Efforts Toward a Healthy Global Population

In fiscal 2001 Bank lending to help countries improve health outcomes and health systems performance, and to promote sustainable financing of health care, amounted to $1.3 billion. Significant support was directed toward combating the HIV/AIDS epidemic and other communicable diseases, the former evolving rapidly from a health issue into a formidable development challenge for many countries, especially in Africa (see also pages 27, 67, and 103). The Multi-Country HIV/AIDS Program for Africa and a similar multicountry program for the Caribbean earmarked $500 million and $155 million, respectively, for HIV/AIDS projects that support the scaling up of national prevention and care programs. Total Bank support for HIV/AIDS prevention, treatment, and care in stand-alone projects, as well as components in other projects, amounted to $393.6 million in fiscal 2001, and to $851.5 million over the last five years (see footnote e to table 1.1). The Bank has also accelerated its efforts to combat malaria and tuberculosis, diseases that are preventable but which are leading killers of poor people.

The Bank also continued to help countries improve nutrition and reproductive health outcomes. Efforts to support nutrition focused on its links to poverty, its impact on learning and productivity, and women’s nutrition. The Bank’s work in reproductive health emphasized the impoverishing effects of unplanned pregnancy, maternal mortality and morbidity, and sexually transmitted diseases. Operational tools, such as practice guides on condom procurement and contracting for delivery of reproductive health services, are helping to improve outcomes. And to arrest the growing health burden posed by noncommunicable diseases, the Bank’s work on the economics of tobacco control is helping to demonstrate that taxation, together with nonprice measures (for instance, advertising bans), can reduce smoking and save lives without negatively affecting the economy.

Protecting the Most Vulnerable

Natural or manmade shocks can devastate poor families, robbing them of security, income, and productivity. Social protection—risk reduction and mitigation, and coping—measures are essential to making the poor less vulnerable. Such measures seek to help individuals, households, and communities better manage risks, and to provide support to the critically poor. In fiscal 2001 these measures helped countries build viable pension systems, develop equitable and inclusive labor markets, eliminate child labor, and rely on social safety nets and social funds to reach vulnerable groups (box 3.4). Lending for social protection continued to grow in fiscal 2001, amounting to $1.9 billion, compared with $1.5 billion last year.

The Bank adopted a new Social Protection Strategy in September 2000, prepared following extensive consultations with governments, donors, United Nations agencies, NGOs, and civil society. The strategy benefits from an analysis of vulnerability and proposes reliance on pilot social risk and vulnerability assessments as well as a methodology for social expenditure reviews that would enhance the coverage and impact of social protection programs.