accidents (Um 2020). Just as the region’s challenges are diverse and complex, so are investment needs in infrastructure, education, health, and green technology.

Responding to the pandemic. The COVID-19 pandemic has highlighted inadequacies in the health and education sectors in MNA, and the urgent need to invest in them. Most MNA economies were ill-prepared for the pandemic, with public o ffi cials overcon fi dent about health system capabilities (World Bank 2021e). Even prior to the pandemic, achieving universal healthcare coverage would have required countries globally to increase spending on primary healthcare by at least 1 percent of GDP (WHO 2019). Despite signi fi cant progress in MNA over the last two decades toward achieving universal healthcare—meaning access to health services, when and where needed, without fi nancial hardship—the region still ranks below other EMDE regions and the advanced economies in this regard. In some of the region’s economies, public spending on healthcare, per capita, is among the lowest in the world, resulting in limited access and large out-of-pocket expenses for citizens. Insu ffi cient investment in health services, particularly in non-Gulf Cooperation Council (GCC) economies means inadequate numbers of health workers, insu ffi cient hospital beds per capita, and limited ability to provide essential health services The World Bank’s Human Capital Index has risen over the past decade in almost 80 percent of MNA economies with much of this gain coming from educational improvements.<sup>10</sup> Nonetheless, a child born in MNA in 2020 was expected to achieve only 56 percent of its future productivity on average based on the Human Capital Index. The pandemic has reversed some of the gains to education with pandemic-related school closures averaging 48 weeks in 2020-21 in MNA, above the global average of 38 weeks. The resulting outsized damage to human capital accumulation could signi fi cantly impair the lifetime earnings of many (Azevedo et al. 2021). Returns to education are also the lowest of any EMDE region, re fl ecting in part the low quality of education (Montenegro and Patrinos 2014). Anemic economic growth and job creation in the region have also contributed to high rates of youth unemployment, and the lack of work experience for many is a further set back for human capital (Kheyfets et al. 2019).

Responding to climate change. MNA has already been feeling the e ff ects of climate change, with natural disasters, including heatwaves and fl oods, becoming more frequent (IMF 2022b; World Bank 2014). Rising risks to lives and livelihoods highlight the urgent need to invest in climate change mitigation and adaptation and to ensure that the recovery from the pandemic is green and inclusive (Acerbi et al. 2021; IMF 2022b). Risks are particularly acute among economies dependent on agriculture: rising temperatures are expected to reduce growing areas and crop yields and exacerbate water scarcity, which will undermine food security, force migration, lower labor productivity, and raise the likelihood of con fl ict. In Morocco, for example, where droughts already constitute a major source of macroeconomic vulnerability, a continuation of recent trends could result in a

> 10 The Human Capital Index measures the amount of human capital (that is, the level of productivity) a child born today could expect to attain by the age of 18, based on the risks to health and education that child is expected to face.