World Bank Document

tion than on individual diseaseTradeoffs in Sri Lanka control programs. While theBut pricing policies discouraged new region's ratio of physicians toSri Lanka's record on life expectancy, investment in tea and other export crops. population is high by the standardsliteracy and fertility (in relation to its low And there was too much emphasis on of low-income countries, they tendincome level) is one of the best in the industrial import substitution and tooworld. But to achieve this the govern- little on export promotion-in part because to be clustered i urban areas.ment has spent on average over the past of an increasingly overvalued exchange The relative abundance of highlytwo decades nearly 10 percent of GNP on rate. After 1970 the economy was hit by educated people in South Asiaeducation, health and nutrition pro- bad weather, which affected agricultural (especially India), and the improvedgrams. To what extent, then, were these production, and by a steeper fall in theachievements in human development at world price of its exports relative to itsooutlook for economic growth,the expense of economic growth? imports. These problems were aggravated should allow the larger countriesGrowth of GDP in the 1960s was 0.7 until 1977 by poor economic management in the region to tackle the challengpercentagepoints above the low-income -including an unresolved conflict with ing tasks of (a) increasing the shareaverage, inpartreflecting one of the highest the private sector (which depressed its of spending on primary educationgrowth rates of rice production in the investment and expansion), excessive useworld. In the 1970s, though, slower growth of public investment for highly inefficientin agriculture and especially manufac- industrial projects, and expansion of theand expanding enrollment, espe-cially among girls and the poor;turing caused Sri Lanka's GDP growth public payroll in an expensive and unsuc- (b) improving the efficiency of therate to be somevvhat below the low-income cessful attempt to curb unemployment. educational system-better quality,average. But because Sri Lanka's pop- The tradeoff between expenditures on fewer dropouts and repeaters; andulation growth rate was well below the human development and growth in Sri ) expanding the network oflow-income average (it fell to 1.7 percent Lanka has thus not been so sharp as isa year in the 1970s), the growth of GNP sometimes suggested. In the 1960s fairly primary health centers (India isper person over the period 1960-77, at rapid growth permitted expansion of social already devoting renewed attention2.0 percent, was above the low-income expenditures. In the 1970s growth deteri- to this).average of 1.4 percent.orated for reasons generally independentSri Lanka has thus done no worse in of the human development spendingtermsof growth than other countries at and indeed caused a decline in real Primarily middle-income regionsits income level, while greatly out-perform- expenditures per person on health anding them in human development. But it education, as well as in food distribution With some injustice to theircould have done even better-realizing per person. The election of 1977 led to considerable diversity, the threemore of the economic potential of its a change of government and to sub- primarily middle-income regionshuman resources-had better economic stantial alterations in policies. From 1977policies been pursued. to 1980 annual GDP growth is estimated can be characterized as follows.In the 1960s Sri Lanka's economic to have spurted to 6.5 percent, or aboutmanagement was better than in the 1970s. 5 percent per person.* Middle East and North Africa:income growth has been extremelyrapid in recent years, reflectingthe direct and indirect effects ofoil revenues; but human develop-Calorie consumption per person in ultimately on raising the incomes ment still lags behind.Sri Lanka has not been higher than of the poor. * Latin America and the Caribinthe rest of South Asia, but there bean: the most urbanized andhas been much less malnutrition EDUCATIONANDHEALTH. Spend- industrialized region, with highsimply because food has been ing on education has been relatively average levels of human developrelativelyevenly distributed. low-about 1.5 percent of GNP in ment; economic and social progressIndia, Pakistan and Bangladesh Bangladesh, 2.5 to 3 percent in has been rapid, despite fast popularespectivelyspent 0.6 percent, 1.9 Burma, India and Sri Lanka-mainly tion growth; yet one in seven peoplepercent and 0.1 percent of their because educational costs are the still live in absolute poverty.GNPs on limited food subsidies in lowest in the world, which in turn 0 East Asia and Pacific: best pertheearly 1970s-but with relatively reflects the large supply of educated formance on growth of incomeslittle nutritional effect (outside people. Except in Burma and Sri and human development in relationKerala), since rural areas and urban Lanka, however, policies have to income; rapid growth has beensquatters were largely bypassed. tended to favor higher education: based on efficient use of labor,Greater attention to nutritional most poor children still fail to capital and technology rather thanconsiderations in food production complete primary school. on natural resources.and subsidy programs could have In health, future gains will deamajor impact; but sustained nu- pend more on improvements intritional improvement will depend nutrition, health care and educa- The countries of the Middle East90