Source: Asia Development Bank
Kenichi Yokoyama, Director General, South Asia Department, ADB
What are the major human development challenges in South Asia?
Despite remarkable progress in human development outcomes over time, the South Asia region faces several challenges ranging from remaining poverty, diverging inequality, insufficient quality of education, a workforce with poor market-relevant skills, fueled further by the learning crisis, high youth unemployment, and inadequate health systems leading to poor health outcomes.
Even before the COVID-19 pandemic, South Asia was home to almost half of the global poor.1 The pandemic has pushed millions more into poverty and decimated livelihoods. The pandemic also exacerbated the preexisting learning crisis in the region with some of the longest school closures. For example, Bangladesh, implemented the longest school closure in the world. This is likely to lead not only to learning losses but result in earning losses in the future, particularly for those from low-income households, and children in grades 1-3 whose foundation skills education has been severely affected. In developing Asia, the present value of learning losses is estimated to be $1.25 trillion, and the effect in South Asia is the most serious considering the prolonged school closure. Rising youth unemployment combined with lack of market-relevant skills is also a serious concern. This is even more so for women given their lower access to post-secondary education and training, not to mention gender biases.
In terms of health, poor health infrastructure, lack of human resources, and low health spending are some of the key challenges. Average health expenditure as a share of gross domestic product is 3.5% for South Asia—which is much lower than the average of 5.34% for low-income countries. Furthermore, countries in the region face an increasing burden of noncommunicable diseases and increasing healthcare challenges especially in urban areas.
Addressing these gaps will be critical for improving overall human development in the region.
How is ADB supporting DMCs in the health sector?
Even before the pandemic, ADB was already supporting DMCs in areas of urban and primary health care and enhancing health systems. Therefore, ADB was in a position to respond strongly and rapidly to help DMCs address the impact of the COVID-19 pandemic. In the early stage of the pandemic, ADB provided grants to finance urgent needs such as protecting health workers and strengthening hospital facilities. Subsequently, ADB established a new financing modality—the COVID-19 Pandemic Response Option (CPRO) that provides quick-disbursing countercyclical economic stimulus packages focused on support to the poor and vulnerable and essential health sector responses. Following the development and approval of COVID-19 vaccines, ADB launched the $9 billion Asia Pacific Vaccine Access Facility (APVAX) to help countries procure and deliver safe and effective vaccines swiftly and equitably.
All South Asian countries have received pandemic-related grants, technical assistance, and loans from ADB, namely Bangladesh, Bhutan, India, Maldives, Nepal, and Sri Lanka.
In addition to these immediate support for pandemic response, ADB is supporting countries in strengthening their health system resilience and future pandemic preparedness. This includes support for vaccine manufacturing capacity and comprehensive health sector assessment for system strengthening in Bangladesh. Technical assistance projects and investment projects support countries in strengthening capacity for vaccination planning, logistics, monitoring, capacity building, and waste management in several countries. ADB will also enhance our support Bangladesh, Bhutan, India, and Sri Lanka in strengthening health systems, especially comprehensive and accessible quality primary care as the foundation for resilient health systems and selected tertiary care and health human resource development in 2023–2024. A new intervention in early childhood development, combining child health, nutrition, and care/education aspects, is also being prepared in Meghalaya state in India. Investing early in health, nutrition, and education, especially for disadvantaged children, helps address early gaps in cognitive skills which have serious short-term (e.g., school readiness and achievement) and long-term cognitive consequences (e.g., lifelong learning, employability, and productivity).
What about in the education and skills sectors?
Given the disproportionate impacts of the pandemic on the poor and vulnerable, ADB education projects will support countries to address the learning loss and reverse dropouts caused by COVID-19 in the short-term, but will continue to aim for long-term goals of making quality education accessible to the poor, particularly girls, to reduce social inequity. In order to respond to the rapid technological changes brought forth by the fourth industrial revolution, ADB’s projects will also focus on transforming education systems to close the skills gap, enhance youth employability, and create a human capital foundation for building a knowledge-based economy.
With over $15 billion in loans and grants to the education sector for over 50 years, ADB has a long track record in assisting its developing members achieve the goal of quality education for all. In Sri Lanka, ADB is supporting the government’s Education Sector Development Framework and Program (ESDFP), which aims to enhance youth employability by diversifying pathways from secondary education. Another example is Nepal’s School Sector Development Plan (SSDP), which aims to improve access, equity, and quality of school education by building model schools. Lessons from Nepal’s online learning system during the COVID-19 pandemic will also prepare us for future disruptions in education and learning.
ADB also supports inclusive education. For example, in Bhutan, ADB is supporting a disability inclusive development project as a part of the Skills Training and Education Pathways Upgradation Project (STEPUP). The objective is to help persons with disability to build their skills and improve their opportunities for gainful employment.
Model schools in Nepal are improving the quality and access to basic and secondary education, critical to the country’s human capital development. Photo: ADB
Given the debilitating effects of the pandemic on the poor, how is ADB supporting countries in building social resilience?
With the onset of the pandemic, ADB has expanded support for social protection. ADB’s CPRO assistance supported India to provide income support to over 85 million farmer families, 200 million women, and 28 million old age people, differently abled people and widows. At least 10,000 micro, small, and medium-sized enterprises in Nepal were provided concessional lending to help them cope with the immediate effects of the pandemic and support their economic recovery. In Bangladesh, 350,000 vulnerable women in 112 most poverty stricken Upazilas, 3.5 million poor families, and 12.93 million vulnerable families were supported with cash or rice, along with 3.8 million workers with salary subsidy under ADB’s CPRO. ADB, along with other development partners assisted the governments in providing short-term, emergency relief to the most vulnerable in all six South Asia countries.
Beyond the short-term measures, ADB also began to support a longer-term social protection system strengthening, accelerated by the dire needs of the vulnerable population revealed by the pandemic. ADB has been supporting the implementation of Bangladesh’s National Social Security Strategy, which articulates a long-term vision of building an inclusive social protection system to mitigate poverty and inequality. ADB’s Strengthening Social Resilience Program in Bangladesh will streamline and strengthen the existing social protection programs with a view to achieve better results. Among the targets are: (i) improving the coverage of social protection, (ii) developing a national social insurance scheme, and (iii) harmonizing the social protection programs. Given the global challenges, such as climate change and economic disruptions, which will create exogenous shocks to the most vulnerable—the poor, old people, informal workers, small hold farmers, etc.—the need for more and better social protection will increase, and ADB will work with the governments to provide necessary support for them.
What are ADB’s future plans in the field of human development?
ADB will ramp up efforts for improving human development, keeping in mind of the needs for addressing pandemic impacts and post-pandemic recovery, let alone for transformational change to meet long-term human development goals, focusing on programs that can demonstrate exemplary service delivery systems and impacts. In the short to medium term, ADB’s projects in education will focus on recouping learning losses and accelerating reforms to enhance the quality of education that remain a long-lasting challenge. ADB will also support DMCs for bringing about transformational changes in skills development and training systems and leveraging digital disruptions for workforce development. On the health side, our projects will continue to focus on building and demonstrating responsive and resilient health care systems. ADB will also expand the universal health coverage agenda and support health financing to ensure access to quality health care for all. Strengthening secondary and tertiary systems drawing private capital matching with public funds will also be supported. Given the disproportionate effects of the COVID-19 pandemic on the poor in vulnerable environment, ADB will expand support for social protection as well as for addressing risks from climate change. Across all sectors, our projects will aim to institutionalize innovative practices, support multisectoral interventions, and promote regional cooperation in South Asia.
1 Christopher Fannigan. 2019. Poverty in Asia: The Long View. The London School of Economics and Political Science Blog. 16 April. https://blogs.lse.ac.uk/southasia/2019/04/09/poverty-in-south-asia-the-l….