Aligning climate and health goals

Aligning climate and health goals

Observer Research Foundation proposes for the nations present at the COP26 to prioritise Aligning climate and health goals. It is by Oommen C. Kurian and Bhavya Pandey.

The sustainable development, climate action and COVID-19 recovery strands of the common agenda need to be better aligned to target the most vulnerable

This piece is part of the essay series, Towards a Low-Carbon and Climate-Resilient World: Expectations from COP26


The COVID-19 pandemic has severely impacted ongoing collective efforts on climate action. These efforts underscore the need for equal access to resources, judicious use and planning, strengthening critical infrastructure, and enabling vulnerable communities in the face of adversity. The multidimensional crises facing the international community, compounded by the COVID-19 pandemic, make it more urgent for countries to adopt forward-looking policies to act faster on sustainable transitions, adaptation and resilience, and provide impetus to recalibrating health systems for greater efficiency and quality. To this end, the 2021 United Nations Climate Change Conference of Parties (COP 26) in Glasgow, provides an opportunity for nations to address post-pandemic recovery through the lens of sustainable development.

The Grave Impacts of Climate Change

Research has shown that Asia is the continent most affected by weather-related disasters—some 2,843 of such events were recorded between 1990 and 2016, affecting 4.8 billion people and taking 505,013 lives. Deaths from natural hazard-related disasters are largely concentrated in poor countries.[1] Higher temperatures brought about by climate change, pose profound threats to occupational health and labour productivity, particularly for people engaged in manual, outdoor labour in hot areas. Also, labour capacity decrease due to climate change is among the highest in the Southeast Asia region. Climate information services for health—i.e., targeted or tailored climate information, products, and services that will aid the health sector—were found to be the lowest in Southeast Asia.[2]

By 2030, irreversible negative impacts on health because of climate change could undo much of global poverty reduction strategies and push over 100 million people into extreme poverty. Climate change will worsen emerging health challenges like cardiovascular diseases and respiratory illnesses, which are linked to air pollution. A higher frequency of extreme weather events, rising sea levels, rising temperatures, and changing patterns of precipitation will also result in negative health outcomes.

Higher temperatures brought about by climate change, pose profound threats to occupational health and labour productivity, particularly for people engaged in manual, outdoor labour in hot areas.

It is expected that climate change will increase health risks associated with extreme weather events, which are becoming more frequent, intense, of longer duration, and have greater spatial extent. Increased UV radiation; increased air pollution; increased food-borne and water-borne contamination; the introduction, expansion or re-emergence of rodent and vector-borne infectious diseases; and the exacerbation of health challenges faced by vulnerable populations are some of the additional risks from climate changeAdditionally, extreme weather associated with climate change can damage hospital buildings, cause power and water outages, and disrupt the delivery of healthcare at the frontlines as roadblocks may limit access to supplies and essential services (such as energy and water supply), and obstruct patients’ access to health facilities.

According to WHO, between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths per year from malnutrition, malaria, diarrhoea, and heat stress. The direct damage cost to health is estimated to be between US$2 billion and US$4 billion per year by 2030. Communities across the globe are confronting health risks from excessive heat, altering disease patterns, disaster events, and the potentially catastrophic impact of global warming on food and water security. The impact of climate change on human health, however, will not be uniformly spread due to the various degrees of exposure, sensitivity, and adaptation ability of different regions.

Extreme weather associated with climate change can damage hospital buildings, cause power and water outages, and disrupt the delivery of healthcare at the frontlines as roadblocks may limit access to supplies and essential services (such as energy and water supply), and obstruct patients’ access to health facilities.

Determinants of health are impacted by multiple social and environmental effects of climate change that are manifested as degradation in air quality, extreme fluctuations in temperatures, lack of adequate and safe drinking water, food insecurity and insufficiency, and the impedance of diseases. Natural disasters and variable rainfall patterns also affect essential services and medical facilities, and destroy property and food sources.

Extreme temperatures have been directly linked to cardiovascular and respiratory diseases, particularly among the elderly, which are further exacerbated by the rising levels of ozone and other pollutants in the atmosphere. For instance, over 70,000 excess deaths were recorded in Europe during the 2003 summer heatwave; and the long-term exposure to fine particulate matter has been linked with an increased rate of chronic bronchitis, reduced lung function, and increased mortality from lung cancer and heart disease. Furthermore, the number of reported climate-linked natural disasters has more than tripled since the 1960s. With over half of the global population residing within 60 kilometers of the sea, natural disasters and warmer temperatures threaten the loss of lives and livelihoods and could lead to more frequent occurrences of communicable diseases (such as water-borne diseases like cholera and diarrhoeal diseases like giardiasis, salmonellosis, and cryptosporidiosis) and mental health disorders (such as post-traumatic stress disorder).

Enduring Inequities 

According to WHO, 87 percent of all COVID-19 vaccines have been administered in the world’s wealthiest countries, while low-income countries have received only 0.2 percent of vaccine supplies. Specifically, less than 1 percent of sub-Saharan Africa’s population have been vaccinatedAccording to the People’s Vaccine Alliance, the wealthy nations are vaccinating one person every second, while the majority of the poorest nations are yet to administer a single dose.

Equity in COP26 deliberations is even more crucial now given that many components of the landmark Paris Agreement had a 2020 deadline. COP26 is an opportunity to discuss progress on curbing climate change, focus on ‘building back better’ amidst the pandemic, and ensure that the interconnected inequities that mar the two-pronged agenda of resilience and recovery, are also taken into account. However, marginalised communities and civil society organisations will likely have a greater burden of adhering to visa and travel requirements imposed during the pandemic since many countries from the Global South are on the UK’s travel red-list, and many may not be vaccinated in time to attend the in-person climate deliberations. Furthermore, the pandemic’s worldwide economic crisis has threatened access to climate financing that developing, vulnerable nations require.

Extreme weather events and health crises will be compounded by the cascading health, economic and social impacts of the COVID-19 pandemic. Beyond commitments to curb GHG emissions, advanced economies should also mobilise financial resources to assist vulnerable countries in meeting their climate objectives, especially during the pandemic. COP26 provides an opportunity to rebuild trust and coordination amongst nations and usher in the political attention and economic commitment required to pursue greater climate action.

Towards a Sustainable Future

The COP26 summit will take stock of nations’ promises to decrease emissions under the Paris Agreement. The pandemic has illustrated the importance of quick, targeted and concerted efforts in battling life-threatening crises. The lessons from this experience can be leveraged to fuel climate action, more so since both climate change and the aftermath of the global pandemic bear a common strand of interconnectedness owing to widening global inequalities and greater disparities. The imperative is for the adoption and implementation of a worldwide Green New Deal, along with other systemic alternatives in tandem with a new economic paradigm to rectify unsustainable development policies that threaten ecology, erode environmental protection laws, and undermine labour rights and social security systems. Solving the climate issue requires an overhaul of production, consumption and commerce systems, and human-nature ties.

Beyond commitments to curb GHG emissions, advanced economies should also mobilise financial resources to assist vulnerable countries in meeting their climate objectives, especially during the pandemic.

In parallel, the pandemic has also impacted the renewable energy market for vehicles using solar, battery or electric sources to fuel them. Large-scale investment to boost the development, deployment and integration of clean energy technologies, such as solar, wind, hydrogen, batteries and carbon capture, should be a central part of policy plans to address the pandemic since it will bring the twin benefits of stimulating economies and accelerating clean energy transitions. The deliberations at COP26 offer a great deal of scope to plan and commit to encouraging sustainable development transitions for participating nations.

The COVID-19 experience has perhaps permanently impacted the ‘global solidarity’ narrative. A cursory look at the global vaccine distribution will illustrate the inherent inequities in the system and how little is being done about it. The fallout of the COVID-19 crisis has also laid blows on the building blocks of human development, including income, health, and access to resources. The magnitude of the crisis response should inspire all to address existing and new inequities to mitigate the worst effects of climate change. The sustainable development, climate action and COVID-19 recovery strands of the common agenda need to be better aligned to target the most vulnerable and enable the transition towards a healthier, safer, and sustainable world.

Download the PDF of the report here.


Bhavya Pandey is a Research Intern at ORF’s Centre for New Economic Diplomacy and Oommen C Kurian is a Senior Fellow with the Health Initiative at ORF.


[1] Nick Watts et al., “The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health”, The Lancet (2017)

[2] Watts, “The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health”

.

Democracy vital for prosperity and sustainable development

Democracy vital for prosperity and sustainable development

In so far as the MENA region countries are concerned, Democracy being vital for prosperity and sustainable development or the lack of it, has been demonstrated over and over the millennia. Let us see what it means in today’s world for the rest of the world with Androulla Kaminara.

The above image is for illustration and is of the FDSD.

Democracy vital for prosperity and sustainable development

Transparency and reliability of how elections are carried out are key to ensuring that the winners enjoy legitimacy.

On 15 September, we are marking International Day of Democracy. Since the pillars of democracy around the world are threatened as new challenges emerge, this day is perhaps more pertinent than ever. Democracy is a dynamic concept that has evolved over time, as have the challenges facing it. To those challenges, new challenges have been added of late, including by the impact of the Covid-19 pandemic deepening existing inequalities, spreading disinformation and distrust, and undermining women’s rights. In addition, the fast evolution of new technologies and their impact on all walks of life has also had a profound impact on democratic processes around the world.

As the world took emergency measures to address the Covid-19 crisis, concerns began to emerge that these actions could infringe on civil and human rights of citizens. Covid-19 also highlighted and aggravated inequalities within societies, including in social protection, increased discrimination and violence against women as well as disinformation. The pandemic was accompanied by a global infodemic that poses a direct threat to one of the pillars of democracy: the right to access to information.

The answer is — ‘to build back better’ — to build a society that works for all and that represents the will of the people is the objective. Democracy is built on inclusion, equal treatment and participation — is a fundamental building block of a progressive, stable and peaceful society that enables sustainable development, human rights and economic justice for all.

Democracy is one of the core values of the European Union, together with human rights and the rule of law. The EU is taking steps to safeguard and strengthen democracy inside our Union since no democratic system is perfect and continuous efforts are need for improvement. In the EU, we practise our rights, also through regular elections both at individual Member State level — local, regional and national elections — as well as at the European Union level. The elections to the European Parliament are one of the largest democratic exercises in the world, with over 400 million citizens being represented.

The European Union also takes a leading role in promoting democracy around the world through the implementation of relevant projects and through Electoral Observation Missions (EOM).

In 2019, cooperation projects in support of democracy amounted to €147 million in 37 countries. Over the last 7 years, the EU has implemented projects of €618 million in Pakistan and currently, the EU supports the National Assembly, Senate and four provincial assemblies by strengthening their functioning in terms of capacity, transparency and accessibility as well as accountability towards Pakistani citizens with a project of €9 million.

Since 2019, the EU deployed over 20 observation missions globally as part of its commitment to democracy, human rights and the rule of law across the world and these offer a comprehensive and impartial assessment of electoral processes. In addition, EOMs publish recommendations aiming to improve future elections and strengthen democratic institutions.

In Pakistan, the EU so far has deployed four observation missions since 2002 upon the invitation of the respective governments. The EOM of 2018 put forward a set of thirty recommendations for electoral processes and framework reforms. It is encouraging to note that several of these recommendations are reflected in the 3rd Strategic Plan of the Election Commission of Pakistan.

However, other recommendations are still pending. Among those is the need to ensure a full level playing field for women: registration of women voters and women representatives in parliaments as well as in the media. In Pakistan, there are 63 million registered male voters and 50 million female voters, clearly indicating that about 13 million women voters are missing. The report argues that stronger involvement of women in political decision-making leads to more accountability, better use of public resources, as well as stability and peace. The fact that a large number of women are not eligible to vote leads to alienation of a significant part of the population. Ensuring their inclusion in the electoral process as well as adequate representation for marginalised groups is key to a more inclusive and fair democratic system.

We recognise the difficulties in implementation of some of the EOM’s 2018 recommendations which are public. Nonetheless, as Pakistan is approaching its next general elections, it is paramount to keep the reform momentum and maintain efforts to further strengthen the electoral system and practice. In this context, the role of a fully functioning Election Commission of Pakistan supported by all is crucial.

The experience within the European Union and elsewhere shows that for democracy to work, trust in the democratic process, including the electoral mechanism, is vital. Transparency and reliability of how elections are carried out are key to ensuring that the winners enjoy legitimacy and support from the electorate. Without democracy, peace and stability, sustainable development and prosperity cannot exist.

The EU continues to be committed to safeguarding and strengthening democracy within its borders and across the world, and we work with all our partner countries including Pakistan in this endeavour.

Published in The Express Tribune, September 15th, 2021.

Calls on World Citizens to Help Shape a Prosperous Post-Covid Era

Calls on World Citizens to Help Shape a Prosperous Post-Covid Era

Calls on World Citizens to Help Shape a Prosperous Post-Covid Era
Image for ‘Let’s Lessen The Gap’ Calls On World Citizens To Help Shape A Prosperous Post-Covid Era For Vulnerable Communities

‘Let’s Lessen The Gap’ Calls On World Citizens To Help Shape A Prosperous Post-Covid Era For Vulnerable Communities

The Big Heart Foundation (TBHF), a UAE-based global humanitarian charity dedicated to helping refugees and people in need worldwide, has made an impassioned call to citizens around the world to generously support its 2021 Zakat and general donations drive during Ramadan.

These fundraising activities under the“Let’s Lessen the Gap” campaign are part of a comprehensive long-term programme that TBHF has launched. In partnership with four leading UN agencies, namely, UNHCR, UNDP, WHO and UNICEF, the foundation is addressing humanitarian development challenges exacerbated by the COVID-19 pandemic amongst vulnerable populations in the MENA region.  

Furthering TBHF’s ongoing response efforts to mitigate the impact of COVID-19 worldwide, the programme will set the blueprint for TBHF’s COVID-response strategies in the long term. Evidence and research-based findings from the programme will enable TBHF and partnering UN agencies to identify the most pressing needs of the region, and subsequently aid the designing of sustainable and long-term interventions. The programme will also encompass advocacy campaigns aimed at bridging the gaps in vital sectors of Protection, Livelihoods, Healthcare and Education, which have been heavily impacted by the ongoing coronavirus pandemic.

Announcing the launch of “Let’s Lessen the Gap”, TBHF revealed the programme would address both the critical health and non-healthcare needs of marginalized populations to allow for a return to normalcy in the MENA region. As COVID-19 continues to shape the lives of individuals and societies around the world, TBHF is appealing to people worldwide to act on their humanitarian instincts and support in lessening, and eventually closing the gap between vulnerable communities and their access to the tools and resources they need to become enablers for building a prosperous MENA region of tomorrow.

To know more about how you can get involved and make your contribution, visit www.lessenthegap.org. Contributions can also be made via SMS by sending the word ‘sadaqa’ to the Etisalat numbers: 7857 to donate AED 10; 7859 to donate AED 50, 7788 to donate AED 100, or 7708 to donate AED 500. For Du: 9965 to donate AED 10; 9967 to donate AED 50, 9968 to donate AED 100.

Zakat contributions can also be deposited directly into Zakat Fund account no: 0011-430430-020 at the Sharjah Islamic Bank (International Bank Account Number ‘IBAN’: AE040410000011430430020).

COVID-19 hastens diverse humanitarian challenges in MENA

The COVID-19 pandemic has magnified many decades-long developments and humanitarian challenges in the MENA region such as high youth unemployment, inequitable development pathways, resource scarcity, gender discrimination, restricted access to services, and the devastating effects of ongoing conflict in some countries.

According to reports by UNESCWA, unemployment surged in the region with rates reaching up to 26.6% for youth compared to 13.6% globally. An estimated 25 million Arab youth are not in formal education, employment or training.

Further, the COVID-19 pandemic has deepened the learning crisis, disrupting education at an unparalleled rate across the region. A 2020 UNICEF report states that approximately 40% of students, accounting for 37 million children and young people across the region, were not reached by digital and broadcast remote learning.

The pandemic has also posed severe challenges in fragile and conflict-affected nations in MENA, overwhelming weak and overcrowded existing healthcare systems. A UNICEF study titled ‘The Potential Impact of Health Care Disruption on Child Mortality in MENA Due to COVID-19’ draws up a scenario highlighting a particularly bleak reality for children aged 0 – 5. It predicts that a protracted reduction in the supply and demand of primary health care services for children could potentially increase their mortality by nearly 40 percent, compared with a baseline scenario without the COVID-19 virus.

Additionally, refugees and displaced populations in the MENA region and across the world have been disproportionately impacted by the pandemic. Exclusion, discrimination, and inadequate access to health services have heightened protection risks and tested international standards of refugee protection.

UN partners in four sector-specific areas

The “Let’s Lessen the Gap” campaign and post-COVID programme will see TBHF collaborating with multiple UN agencies working on the ground in MENA to implement long-term strategies and initiatives in the fields of Protection, Livelihoods, Healthcare, and Education to assist those who are least likely to have access to these essential services.

UNHCR, the UN Refugee Agency, is a global organization dedicated to saving lives, protecting rights and building a better future for refugees, forcibly displaced communities and stateless people. UNHCR will partner with TBHF to empower, protect, and improve the lives of refugees and internally displaced people affected by COVID-19 in the MENA region.

The United Nations Development Programme (UNDP), which works in 170 countries and territories to bridge gaps in inequalities and exclusion, will join hands with TBHF to support youth livelihoods, develop capacity and skills, and accelerate structural transformations to advance the sustainable development agenda in the targeted nations. 

To build a better, healthier future in a post-COVID world, TBHF will partner with the World Health Organization (WHO) along with other global organizations coordinating vaccine efforts to roll out vaccination programmes that give highest priority to vulnerable populations.

The United Nations International Children’s Emergency Fund (UNICEF), which works in some of the world’s toughest places to build a better world for the most disadvantaged children, is TBHF’s partner in improving access to learning and education opportunities for children of marginalized communities across the region.

Fundraising for “Let’s Lessen the Gap” commences in April 2021

Appealing to the public, high net worth donors, and the private sector to honour the spirit of giving embodied in the obligation of Zakat, Mariam Al Hammadi, Director of The Big Heart Foundation, said: “At TBHF, we believe in our collective ability to support the most vulnerable communities in the region through these difficult times and beyond by steering efforts towards inclusive programmes that address the economic and social consequences of the crisis.”

Al Hammadi added that although 2020 was an extremely challenging year, it also demonstrated collective resilience as schools, offices, and essential services continued to operate without fail. “Unfortunately, this only represents the reality of the world some of us live in. In many communities and countries that The Big Heart Foundation supports, solutions are still being sought to aid the response and recovery process. It is this gap that we aim to address and bridge through your support this Ramadan, and in the coming months.”

Fundraising activities of the programme have commenced with TBHF’s Zakat 2021 campaign. To know more and make your contributions, visit lessenthegap.org.    

Ensuring a Stronger and Fairer Global Recovery

Ensuring a Stronger and Fairer Global Recovery

Mohamed A. El-Erian writes that ensuring a Stronger and Fairer Global Recovery is required for a better and more satisfactory tomorrow. The two ginormous economies of the World would lead it that way. Here is what he says about that.

Ensuring a Stronger and Fairer Global Recovery

2 April 2021

Although tough trade-offs are sometimes unavoidable, there is a way for policymakers to maintain a robust global economic recovery in 2021 and beyond while simultaneously pulling up disadvantaged countries, groups, and regions. But it will require both national and international policy adaptations.

CAMBRIDGE – An old joke about tricky trade-offs asks you to imagine your worst enemy driving over a cliff in your brand-new car. Would you be happy about the demise of your enemy or sad about the destruction of your car?

For many, the shape of this year’s hoped-for and much-needed global economic recovery poses a similar dilemma. Absent a revamp of both national policies and international coordination, the significant pickup in growth expected in 2021 will be very uneven, both across and within countries. With that comes a host of risks that could make growth in subsequent years less robust than it can and should be.

Based on current information, I expect rapid growth in China and the United States to drive a global expansion of 6% or more this year, compared to a 3.5% contraction in 2020. But while Europe should exit its double-dip recession, the recovery there will likely be more subdued. Parts of the emerging world are in an even tougher position.

Much of this divergence, both actual and anticipated, stems from variations in one or more of five factors. Controlling COVID-19 infections, including the spread of new coronavirus variants, is clearly crucial. So is distributing and administering vaccines (which includes securing supplies, overcoming institutional obstacles, and ensuring public uptake). A third factor is financial resilience, which in some developing countries involves preemptively managing difficulties from the recent debt surge. Then come the quality and flexibility of policymaking, and finally whatever is left in the reservoirs of social capital and human resilience.

The bigger the differences between and within countries, the greater the challenges to the sustainability of this year’s recovery. This reflects a broad range of health, economic, financial, and socio-political factors.

In a recent commentary, I explained why more uniform global progress on COVID-19 vaccination is important even for countries whose national immunization programs are far ahead of the pack. Without universal progress, leading vaccinators face a difficult choice between risking the importation of new variants from abroad and running a fortress economy with governments, households, and firms adopting a bunker-like mindset.

Uneven economic recoveries deprive individual countries of the tailwind of synchronized expansion, in which simultaneous output and income growth fuels a virtuous cycle of generalized economic well-being. They also increase the risks of trade and investment protectionism, as well as disruptions to supply chains.

Then there is the financial angle. Buoyant US growth, together with higher inflation expectations, has pushed market interest rates higher, with spillovers for the rest of the world. And there is more to come.

European Central Bank officials have already complained about “undue tightening” of financial conditions in the eurozone. Rising interest rates could also undermine the dominant paradigm in financial markets – namely, investors’ high confidence in ample, predictable, and effective liquidity injections by systemically important central banks, which has encouraged many to venture well beyond their natural habitat, taking considerable if not excessive and irresponsible risks. In the short term, high liquidity has pushed cheap funding to many countries and companies. But sudden reversals in fund flows, as well as the growing risk of cumulative market accidents and policy mistakes, could cause severe disruptions.

Finally, uneven economic recovery risks aggravating the income, wealth, and opportunity gaps that the COVID-19 crisis has already widened enormously. The greater the inequality, particularly with respect to opportunity, the sharper the sense of alienation and marginalization, and the more likely political polarization will impede good and timely policymaking.

But, whereas the old joke hinges on the unavoidability of tough trade-offs, there is a middle way for the global economy in 2021 and beyond – one that maintains a robust recovery and simultaneously lifts disadvantaged countries, groups, and regions. This requires both national and international policy adaptations.

National policies need to accelerate reforms that combine economic relief with measures to foster much more inclusive growth. This is not just about improving human productivity (through labor reskilling, education reforms, and better childcare) and the productivity of capital and technology (through major upgrades to infrastructure and coverage). To build back better and fairer, policymakers must now also consider climate resilience as a critical input for more comprehensive decision-making.Sign up for our weekly newsletter, PS on Sunday

Global policy alignment also is vital. The world is fortunate to have benefited initially from correlated (as opposed to coordinated) national policies in response to the COVID-19 crisis, with the vast majority of countries opting upfront for an all-in, whatever-it-takes, whole-of-government approach. But without coordination, policy stances will increasingly diverge, as less robust economies confront additional external headwinds at a time of declining aid flows, incomplete debt relief, and hesitant foreign direct investment.

With the US and China leading a significant pickup in growth, the global economy has an opportunity to spring out of a pandemic shock that has harmed many people and, in some cases, erased a decade of progress on poverty reduction and other important socio-economic objectives. But without policy adaptations at home and internationally, this rebound could be so uneven that it prematurely exhausts the prolonged period of faster and much more inclusive and sustainable growth that the global economy so desperately needs.

MOHAMED A. EL-ERIAN, President of Queens’ College, University of Cambridge, is a former chairman of US President Barack Obama’s Global Development Council. He was named one of Foreign Policy’s Top 100 Global Thinkers four years running. He is the author of two New York Times bestsellers, including most recently The Only Game in Town: Central Banks, Instability, and Avoiding the Next Collapse.

MENA countries weighed down by pandemic debts

MENA countries weighed down by pandemic debts

ARAB NEWS‘ article on the MENA countries weighed down by pandemic debts as these have already registered the advent of this pandemic inadvertently hit some declines in real GDP growth from their oil exports reduction. Since the beginning, these had difficulty coping with COVID 19 pandemic prevention for many reasons that are of a logistics nature but structural.

MENA countries weighed down by pandemic debts will struggle to grow – World Bank

  • Average MENA debt to GDP rose 9 points since 2019 to 55% in 2021
  • Countries with low external debt can still borrow cheaply
MENA countries weighed down by pandemic debts will struggle to grow – World Bank
In early March UAE had the highest percentage of its population vaccinated, at 63.5%. (File/Reuters)Short Url

WASHINGTON, D.C.: The outlook for the Middle East and North Africa has worsened considerably over the past year as countries accumulated debt to pay for pandemic relief measures, leaving them with less to invest in post-pandemic economic recovery, according to the World Bank.

Average debt to GDP in the MENA region rose by 9 percentage points since the end of 2019 to 55 percent in 2021, the World Bank said in a report Living with Debt: How Institutions Can Chart a Path to Recovery in the Middle East and North Africa released on Friday. Debt among the region’s oil importers is expected to average about 93 percent of GDP this year, it said.

MENA economic growth will rebound by 2.2 percent in 2021 after contracting 3.8 percent in 2020, but will be 7.2 percentage points, or $227 billion, lower by the end of this year than it would have been had the pandemic not happened, the World Bank estimates. Real GDP per capita will be 4.7 percent lower in 2021 than in 2019.

“The MENA region remains in crisis, but we can see hopeful signs of light through the tunnel, especially with the deployment of vaccines,” said Ferid BelHajj, World Bank vice president for the Middle East and North Africa. “We have seen the extent to which MENA governments borrowed to finance critical health care and social protection measures, which saved lives and livelihoods, but also boosted debt.”

As of the first week of March, the UAE had the highest percentage of its population vaccinated, at 63.5%, followed by Bahrain at 30% and Morocco at 12.2%, then Qatar at 11.4%, World Bank data shows. Saudi Arabia had a 2.2% vaccination rate.

MENA countries will need to keep on borrowing this year to prop up their citizens’ finances but will face high borrowing costs, particularly those with high debt and low growth, the bank said. However, those with low levels of public external debt, such as Saudi Arabia, Qatar and Morocco, could issue debt at lower rates, it said.

The remedy for the increasingly precarious situation of many of the region’s economies is faster growth that makes it easier to roll over existing debt, the World Bank said. Those that cannot roll over debt face potentially painful restructurings and should enter into negotiations before they hit crisis point, the report advised.

Of benefit to the whole region would be enhanced debt reporting transparency and financial market vulnerability monitoring, it said. MENA countries should reveal all their borrowing, including those from China, as should debt become exposed during periods of distress it will be added to the public tally just as they are negotiating with lenders, the report said.

“Economic growth remains the most sustainable way to reduce debt,” the report said. “Boosting economic growth requires deep structural reforms to raise the productivity of the existing workforce and to put idle working-age people in jobs. Many MENA countries that have characteristics associated with ineffective fiscal stimulus, such as high public debt and poor governance, could consider fiscal reforms early in the recovery from the pandemic.”