Ritva Reinikka, World Bank Director for Human Development in Africa, speaks about what’s happening in the region on the human development front—that is, in education, health, and social protection—and about what is needed in the run-up to 2015, when the Millennium Development Goals come due.
Q1. We hear a lot about Africa’s huge infrastructure gaps. What about investments in people?
It’s certainly true that a lot of physical capital must be built quickly in Sub-Saharan Africa. By that I mean roads, electricity, water supply, internet connectivity, and so on. But the other side of the coin is that countries also need to build “human” capital. That is, a skilled and knowledgeable workforce that can contribute to the economy productively. So countries need to make sure that people are healthy, well-educated, and have the right skills for jobs, and that they are protected from poverty and hunger. In Africa, the systems that deliver healthcare and education are often failing the people they are meant serve, and overhauling them is a mammoth task. But however difficult it is, it has to be done, and quickly. I think that one of the best long-term investments a country can make would be to improve these systems and make them deliver what they should.
Q2. Can you be more specific about systems and how they must be upgraded?
Let’s look at education systems. In one African country, a recent study showed that a quarter of teachers are typically absent and pupils are taught for only two hours a day. Only three percent of schools in this country have electricity, water and toilets. In another country, only a quarter of primary teachers know how to divide one fraction by another. So the question is, just what are pupils learning in primary school? And if you look beyond primary education, there are not enough quality secondary schools, vocational centers, and universities. Also, universities are not always in touch with what the private sector needs, so degrees are not always useful in the job market. I think that if education systems are modernized on a large scale to deliver real learning at every level, there could be enormous gains both for economies and for individuals. It is the same story for health systems. On the social protection front, many countries are taking steps to set up or expand affordable systems, but much more needs to be done.
Q3. Why is investing in people such an urgent priority in Africa?
Access to good education and health care are basic rights that everybody should have, so the clock has been ticking for a long time. The added urgency today is because Africa is changing rapidly on a number of fronts. First, economic growth in Africa has been picking up well after the crisis. For economies to sustain and improve this growth, they need to depend less heavily on natural resources. But becoming competitive regionally and globally in other industries requires human capital at home—and the reality is that professionals, skilled workers, and entrepreneurs are in short supply in many African countries. So that’s one reason why investing in people is so important. Another reason is that Africa has a very large share of youth in its fast-growing population. This is a double-edged sword. The region has a golden opportunity to invest in a generation that could transform Africa. But inaction means a huge missed opportunity, and possible threats to overall stability and growth. Third, a series of crises has shown the importance of affordable social protection programs and systems to protect the poorest and most vulnerable people across Africa. Fourth, there’s an ICT wave that’s sweeping across Africa, and this can help improve systems quickly. Finally, we are close to 2015, the target year for the Millennium Development Goals. Faster progress is difficult without better systems.
Q4. Have there been human development success stories that Africa can build on?
Yes, absolutely. There are some impressive signs of progress in many countries. When you consider what it would take to expand these successes, the answer lies to a great extent in improving systems and implementing reforms quickly on a large scale. For example, Rwanda has been able to reduce deaths among children under age five by a third between 2005 and 2008—largely due to health sector reforms, particularly its results-based financing for health facilities and more decentralized decision-making. With World Bank support, this approach is now expanding to other countries. In Nigeria, a polio campaign, with the support of traditional leaders, has been a tremendous success, and a midwives service scheme has revived health facilities so that the country’s high maternal mortality rate can be reduced. In Lesotho, a private-public partnership is about to revolutionize publicly financed hospital care. In Ethiopia, there are large and successful social protection systems. There are many examples.
Q5.What is the World Bank doing to help invest in people in Africa?
In education, we’ve worked with African countries to get more children into primary school. We’re helping countries to expand secondary education, especially for girls, and to finance higher education. In health, we’ve been engaging with countries to strengthen health systems and get better healthcare out to more people. And we tripled our social protection lending during the crisis years. We also do a large amount of analytical and advisory work with governments on human development. But what concerns us is that health, education, and social protection systems are going to come under major stress as they confront population growth. So, now is the time for reform. We help governments deal with immediate needs, but are also committed to helping them improve systems that will deliver long-term benefits.