At the beginning of the transition decade, social indicators
for many Europe and Central Asia countries appeared better
than countries in other regions with similar income levels. But
after a severe economic downturn, many of the transition countries
could no longer afford the huge social infrastructure they
inherited, resulting in the reversal of many social indicators. And
poverty levels rose significantly in many countries in the region
during the early phase of the transition.
However, there has been a robust turn around in ECA with all
countries having begun to experience positive economic growth. This
is likely to continue but be at a more moderate pace than in recent
years. While growth is starting to lead to poverty reduction
in countries such as the Kyrgyz Republic, Moldova and Russia either
growth will need to accelerate or the poverty elasticity of growth
will need to rise to boost prospects for meeting the MDG target
across the region. It remains to be seen if this will translate into
comparable progress toward meeting the education, health, and
environmental goals, which will require significant resource
reallocations and major public sector and institutional reforms.
Universal primary education appears achievable across most of
the region, although in several countries improvements in enrollment
and completion rates would need to accelerate a litttle over the
trend observed for the MDG target to be met. Similarly, gender equity
in education does not appear to be a significant issue with the MDG
targets being close to or already having been met.
The health MDGs present the greatest challenge in ECA. There
are many countries (predominantly those from the CIS) where the
child and maternal mortality MDGs are unlikely to be met. Progress
with U5MR may be limited because utilization rates at
secondary hospitals are often lower than international averages and
there are concerns about quality and out-of-pocket payments acting
as barriers to care. With MMR, poverty, distance and poorly
performing hospital networks inhibit progress towards this goal and
in some cases such as Georgia maternal deaths are increasing rather
HIV/AIDS represents a very significant issue for the region.
While absolute numbers may be lower than in other regions, ECA is
experiencing the world’s fastest growing HIV epidemic. There is a
pressing need to improve the effectiveness of disease control
through epidemiological and behavioral surveillance systems that can
identify the status and trends of HIV and its determinants. Denial,
stigma, and the institutional challenges of providing services to
marginalized and vulnerable sub-populations, such as injecting drug
users, jeopardize progress to combating HIV/AIDS in this region.
While on the basis of access to improved water sources,
the ECA region appears to be doing well, there has been little
investment in water infrastructure so that water quality is becoming
a serious issue with drinking water frequently not meeting basic
biological and chemical standards.