Challenges and Opportunities in Each Region

September 2005—The Millenium Development Goals provide challenges and opportunities for the following regions:

• Latin America and the Caribbean
• Sub-Saharan Africa
• Middle East and North Africa
• East Europe and Central Asia
• South Asia
• East Asia and Pacific

Latin America and the Caribbean
32 countries · Population: 541 million
The Latin America and the Caribbean region as a whole has the highest income per capita and life expectancy among developing regions. But these promising regional averages mask wide disparities in social conditions across countries and by income, ethnicity, gender and geographic location. Due to inconsistent economic growth and the frequency of crises, since 1990 the proportion of people living under $1 a day has dropped from 11.3% to 9.5%, and those under $2 a day has dropped from 28.4% to 24.5%, while the absolute number of poor has actually grown.

Growth prospects have improved recently, but governments need to strengthen their economic management to be able to sustain this reduction in poverty. Girls' primary and secondary school enrollment has caught up with that of boys in most Latin American countries, and primary school completion is almost universal.

96% of the urban population has access to safe water, but only 69% of the rural population does. This reflects a wide gap in well-being between rural and urban areas. This coincides with the gap between indigenous people, who make up about 10% of the region's population, and other groups. Indigenous people and many Latin Americans of African descent have fewer years of schooling on average, and lower earnings than the rest of the population.

Sub-Saharan Africa
48 countries · Population: 719 million
Slow growth in Sub-Saharan Africa has meant increases in both the poverty rate and number of poor in the 1990s. It is the region with the largest proportion of people living on less than $1 a day. The number of extremely poor people increased significantly, from 227 million in 1990 to 313 million in 2001. Although economic growth has picked up in the last 5 years, it still falls far short of what is needed to reduce poverty to the 1990 level. Amid this discouraging overall picture, 22 Sub-Saharan African countries have registered annual growth rates of 4% or higher over the past decade, and 12 have posted annual growth rates of 5% or more. Lessons from these experiences can help other countries in expanding exports, making farms more productive, and encouraging small and medium-sized enterprises. Also, efforts to achieve education for all in many African countries have posted primary school enrollment, putting pressure on government s to expand secondary education.

Health remains a huge challenge. Life expectancy across the region has declined from 50 years in 1990 to 46 years in 2003. Successful campaigns to reduce Vitamin A deficiency, river blindness, and fertility reduction have been offset by shortages of health workers, chronic poor nutrition and reproductive health, the burden of HIV/AIDS which is killing over 2 million people a year, and the resurgence of malaria and tuberculosis.

Middle East and North Africa
14 countries · Population: 294 million
The Middle East and North Africa's rapid population growth—the second fastest in the world after Sub-Saharan Africa—has coincided with an increase in poverty. Since 1990, the proportion of people living below $1 a day has remained the same, while the percentage living below $2 a day rose from 21% to 23%, increasing from 51 to 70 million people.

The region has well-developed public infrastructure services, but sustainable water management is a significant challenge. Reforming economic instruments and service delivery is critical—the region's annual per capita water availability two decades ahead is projected to be just over 500 cubic meters. The current world average for annual internal freshwater resources per capita is 7, 000 cubic meters.

Gender equity in education has been rising. In 2001 the ratio of girls' enrolled in primary and secondary school is at 94% that of boys, up from 82% in 1990. At the university level, 63% of students are women.

The region now faces an unprecedented labor challenge. Its labor forces, currently totaling 112 million, are expected to increase to 146 million in 2010, and 185 million in 2020. Millions of new jobs are required to absorb these new entrants, who are increasingly educated, young, and female.

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East Europe and Central Asia
27 countries · Population: 472 million
Since the beginning of their transition from command to mixed economies, when poverty rose in many countries of East Europe and Central Asia, there has been a strong turnaround, with all countries in the region experiencing economic growth. Even though the $1 a day poverty rate at about 5% is already considerably lower in most countries in the region than the rest of the world, the $2 a day poverty rate is still significant.

The health MDGS present the greatest challenge. The region is facing rapidly rising HIV/AIDS and tuberculosis cases. Denial, stigma, and the institutional challenges of providing services to marginalized and vulnerable groups remain serious obstacles to progress in stemming the numbers of people living with—and dying of—AIDS. Child mortality rates of 36 per thousand births across the region also, remain a stubborn challenge, especially as progress may be blocked because many people shun hospitals due to concerns about quality and costs. Major progress has been achieved on gender equity in schools because of this region's tradition of equal access to education. Despite the high enrolment rates in primary and secondary schooling, a decline in quality of education is of particular concern.

South Asia
8 countries · Population: 1.4 billion
South Asia, with income per capita of $590 a year, is home to 40% of the world's extremely poor people. But since 1990 the region's economic growth has averaged more than 5% a year, which has helped cut the proportion of people living in extreme poverty from 41% to 31%, or 31 million people. Child mortality rates in South Asia have fallen sharply too, from 130 per thousand births in 1990 to 92 per thousand births in 2003. In Bangladesh, child mortality has been halved, from 144 to 69 per thousand births during the same period.

Primary and secondary school enrollments have risen.

But challenges remain in child malnutrition, primary and secondary school completion rates, maternal mortality and gender balance in education and health.

Nearly half of all children under 5 are malnourished. Youth illiteracy is high—23% for males and 38% for females. Tuberculosis has resurfaced as a threat, as has HIV/AIDS. With a maternal mortality ratio of 567 per 100,000 live births, mothers' deaths in childbirths in South Asia remain tragically frequent.

East Asia and Pacific
24 countries · Population: 1.9 billion
Rapid economic growth in East Asia and the Pacific—the faster among the world's developing regions in recent years—has quickened progress toward the Millennium Development Goals. Over 200 million people have climbed out of extreme poverty in the region since 1990, and the proportion of those living under $1 a day has dropped by half, from 30% to 15%.

Education has been a key to East Asia's growth. 10 countries—China, Fiji, Indonesia, Mongolia, Palau, the Philippines, Samoa, Tonga, Vanuatu and Viet Nam—have already achieved universal primary school completion, but 14 others will need to increase efforts to enroll and keep children in school.

Progress has been slower in health. Child mortality remains too high. In Papua New Guinea, the under-5 mortality rater fell only slightly, from 101 per thousand live births in 1990 to 93 in 2003, and in Cambodia, it actually rose from 115 per thousand live births in 1990 to 140 in 2003. And disparities remain, even where the goals have been achieved overall: In Viet Nam, almost half of those aged 15–19 in the country's poorest group have not completed primary school.

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