southern european neighborhood: realities in the middle east and north africa region european health...

Southern European Neighborhood: Realities in the Middle East and North Africa

Region

European Health Forum 2003, Gastein, AustriaOctober 4, 2003

Akiko Maeda, Ph.D.Lead Health SpecialistThe World Bank(E-mail: amaeda@worldbank.org)

Middle East and North Africa Region

The Region in Brief…..

Some 20 countries, 307 millions population (2001): Relatively wealthy, highly dependant on

oil Diverse income levels, wide disparities

30 % of the population (87 millions) live under $2 per day

Geopolitically volatile region (5 % of world population, 25 % of conflicts)

Proportion of oil reserves and production of crude oil

Sources: Crude Oil Production: IEA Oil Market Report Annual Statistical Supplement for 2001, August 2002, Table 11 (Bahrain information provided by DECPG); Petroleum Reserves: US Department of EnergyNotes: Les pays de la région MENA inclus dans le graphique :’Arabie saoudite, Iran, Irak, Emirats Arabes Unis, Koweit, Bahrein, Qatar, Libye, Algérie, Oman, Syrie, Yémen, Egypte, et la zone neutre.

Crude oil production (million barrels per day, 2001)

Oil reserves(billion barrels, 2001)

52.87

24.03(MENA)

69 % 31 %

303.0

725.2(MENA)

29 % 71 %

Reste du Monde

Irak

MENA

Irak

Exports as percentage of GDP, 2000MENA and Rest of the World

0%

10%

20%

30%

40%

50%

60%

Non-pétrolières Pétrolières

MENA East Asia Europe/ High Latin South SubSaharan Pacific Central Income/ America Asia Africa Asia OECD Carib.

The Region in Brief…..

Young population, high unemployment rate, growing demand for social services "Arab Development Report" (ADR 2002) a "mismatch between aspirations and their fulfillment has in some cases led to [Arab] alienation, apathy and discontent."

EU and MENA DemographicsPopulation share by age groups,

2000

Population share by age groups,

2050

0-14 15-59

60+ 0-14 15-59

60+

EU-15

17.4

61.8 20.8 14.3 50.1 35.6

MENA 37.4

56.9 5.7 22.3 59.0 18.7

Source: United Nations Population Division

Since 1989, net migration is a main component of annual population change in EU.

In 2000, the annual net migration rate was 2.0 per 1 000 population, representing 65% of total population growth.

Around 5% of the EU population are non-nationals (3.4% non-EU nationals including MENA nationals).

EU and Labor Migration

MENA Region suffers from the three «deficits » Lack of participation Lagging in knowledge economy Delays in women’s rights

Source: UNDP Report on Human Development 2002 for Arab Region

The Region in Brief…..

Unemployment Rates, 1997*

0%

5%

10%

15%

20%

25%

30%

MENA MENA MENA East Asia Latin OECD South Sub-Saharan Total Non-GCC GCC & Pacific America High Asia Africa & Carib. income

Note: * or more recent estimates.

IranAlgérie

Libye

LibanIsraelMaroc / Yémen (officiel)Tunisie BahreinJordanieSyrieEgypte Oman

Koweit

Adult Illiteracy RatesAdult Illiteracy Rates(% aged 15 & above, 1998)(% aged 15 & above, 1998)

0%

10%

20%

30%

40%

50%

60%

70%

80%FemaleMale

Source: World Bank

Poverty

0

10

20

30

40

50

National (% of population)

1980s 1990s

MENA Asie de l’Est Amérique Latine Asie Afrique sub- et Pacifique & Caraïbes du Sud Saharienne

Source : Enquêtes sur la Pauvreté

Deaths per 1000 live birthsDeaths per 1000 live births

11593

7647

423333

262626

2524

221817

149

776

0 20 40 60 80 100 120 140

Djibouti

Iraq

Yemen, Republic

Morocco

Egypt, Arab Republic

Algeria

Iran, Islamic Republic

Lebanon

Libya

Tunisia

Jordan

Syrian Arab Republic

Palestinian Administration

Saudi Arabia

Oman

Qatar

Kuwait

Bahrain

United Arab Emirates

OECD

Infant Mortality Rates, 2000Infant Mortality Rates, 2000

Source: World Bank, WDI, 2002; UNICEF , The Situation of the Children in Iraq, 2002

Maternal Mortality RatiosMaternal Mortality Ratios

570

350

310

230170

117

100

75

71

7070

41

41

37

23

1918

5

3

0 100 200 300 400 500 600

Djibouti

Yemen

Iraq

Morocco

Egypt

Algeria

Lebanon

Libya

Syrian Arab Republic

Tunisia

Palestine

Qatar

Jordan

Iran

Bahrain

Oman

Saudi Arabia

Kuwait

UAE

Maternal Mortality Ratio (per 100,000 live births)

Source: World Bank, WDI, 2002

Per Capita Health Spending

Source: World Bank, WDI, 2002

842

752

690

499

430

352

344

222

134

122

118

96

62

56

56

51

42

38

20

0 100 200 300 400 500 600 700 800 900

Qatar

United Arab Emirates

Kuwait

Lebanon

Bahrain

Saudi Arabia

Libya

Oman

Jordan

Palestinian Administration

Tunisia

Iran, Islamic Republic

Algeria

Djibouti

Morocco

Iraq

Syria, Arab Republic

Egypt, Arab Republic

Yemen, Republic

Per Capita Health Expenditure in US$

Per Capita GDP vs. Per Capita GDP vs. Per Capita Health ExpenditurePer Capita Health Expenditure

per capita GDP

pe

r c

ap

ita

he

alt

h e

xp

en

dit

ure

100

1,000

10,000

10 100 1,000 10,000 100,000

10

Algeria

Djibouti

Egypt

Iran

JordanLebanon

Morocco

WB&GS*

TunisiaYemen

Iraq

Libya

Syria

Source: World Bank, WDI, 2002

S

hare

of

govern

men

t h

ealt

h

exp

en

dit

ure

(%

)

0

5

10

15

20

25

30

35

Poorest Quintile Richest Quintile

Africa ECA South Asia

Gwatkin, 2001

Inequities in Public SpendingInequities in Public Spending

Middle East and North Africa: Strategic Neighbor for EU

Major producer and exporter of oil Major source of labor migration Potential markets and trading partnersPolitically volatile region in need of Human Development and institutional reforms