Chapter 1: Main developments in the national and regional context
In 2021, the COVID-19 pandemic has presented new challenges in development efforts and has to some extent set back the promising progress made in recent years. Following a rapid border closure in early 2020 and the introduction of prevention and control measures, Lao PDR has largely succeeded in containing the spread of COVID-19 in the country until the second quarter of 2021. After Lao New Year in mid-April, imported cases spread rapidly among populations such as migrant workers, factory workers, prisoners and eventually to several provinces in the center and south of the country, resulting in a second wave of the pandemic in Lao PDR.
Strategically located along the Mekong River in central Southeast Asia, Lao PDR is classified as a Least Developed Country (LDC) and Landlocked Developing Country (LLDC), with an ethnically diverse, largely rural population and agrarian of approx. 7.2 million. The country is experiencing the fastest rate of urbanization in the region and the population is expected to reach 8.1 million in 2030 and 9.4 million by 2045, entering a 20-year window of opportunity during which the ratio of working-age population to older and younger dependents is high, providing a one-time opportunity to profoundly transform the country economically and in terms of overall development.
Three in 50 people will be over 65 by 2030, and the largest age group will be of working age (15-64, 68%) with women of childbearing age in a small majority3 . Limiting the adverse health effects of aging and ensuring good health for those entering working age are necessary prerequisites for seizing the opportunity of a demographic dividend.
Progress during the UNPF cycle
Prior to the pandemic, Lao PDR was among the fastest growing economies in the region over the past decade, leading to significant poverty reduction and improved living conditions. Lao PDR graduated from low-income to lower-middle-income country status in 2011 and the country has continued to make key progress, meeting the three criteria set for LDC graduation – gross national income , Human Capital Index and Economic Vulnerability Index – paving the way for the Committee for Development Policy to recommend graduation from LDC status by 2026.
Recognizing the exceptional circumstances of COVID-19, the Committee further recommended an extended preparatory period of 5 years, instead of the default 3 years. In June 2021, this recommendation was endorsed by the Economic and Social Committee and in December 2021, the United Nations General Assembly presented its formal endorsement.
Despite the substantial progress that led to the recommendation to graduate LDCs, many challenges remain. After a steady decline, poverty levels are now estimated to have increased due to the pandemic. Even before the pandemic, strong regional, gender and urban-rural differences persisted, as well as differences in progress between different ethnic groups. To ensure a more holistic and inclusive development model, the UN has identified eleven groups that deserve special attention4 in programming to ensure that no one is left behind. Those with compounded cross-deprivation across multiple dimensions are most at risk. These groups have been identified in the Common Country Assessment (CCA) using a five-factor framework taking into account vulnerability to shocks, governance, socio-economic status, geography and discrimination as required by the United Nations.
The share of the population affected by hunger has fallen from a third to less than a quarter over the past decade. However, even with this progress, Lao PDR is still ranked as “severe” on the Global Hunger Index, as one third of children under five are undernourished and the proportion of stunting remains very low. high, at 33%. Life expectancy at birth has increased from 59 years in 2000 to 68 years in 2018. Similarly, key health indicators such as maternal and child mortality rates have improved, although they remain high compared to to regional peers. Limited access to quality and coordinated health services, including urban-rural disparities, discrimination and availability of reproductive health services, remains a challenge. Moreover, the majority of the population does not yet drink safe water and there remains a strong disparity in the use of basic sanitation facilities and safe hygiene practices associated with income levels.
Enrollment in basic education has improved, now reaching over 90%, with negligible gender differences. Key outstanding challenges are to address the root causes of high secondary school dropout rates, including child labour, early marriage and early pregnancy, to improve learning outcomes and completion of the full cycle of basic education, combined with the expansion of early learning opportunities, with only one third of children currently participating in pre-school education programmes. Not only are problems such as child labour, early marriage and teenage pregnancies obstacles to access to education, but also to young people, and in particular girls, to decide freely about their education and of their reproductive health without discrimination.
In response to COVID-19, the Government of Lao PDR (GoL) has introduced stricter prevention and control measures, including the lockdown of major cities, the closure of schools and the suspension of inter-provincial movements. Despite a decrease in positive cases reported in the middle of the year, transmission increased from September due to the more infectious Delta variant. Since the last quarter of the year, while continuing to immunize the population, the number of positive cases registered has risen to 111,060 with 372 victims registered by the end of the year, and the GoL has started taking measures to ease restrictions in order to revitalize the economy.
WHO, UNICEF and other partners provided critical support to the Ministry of Health (MoH) in the implementation of a National Deployment and Vaccination Plan (NDVP) for COVID-19 vaccines, including shipment of vaccines supported by COVAX and partners, vaccination campaigns and building chain capacity.
The socio-economic implications of the pandemic have been significant, with COVID-19 exacerbating longstanding structural vulnerabilities in Lao PDR. For example, revenue collection has continued to decline during the pandemic and public debt has increased, leading to further difficulties in servicing the debt, worsening budgetary constraints for social sector services, essential elements of COVID-19 recovery and more inclusive development. .
The year 2020 marked the conclusion of the implementation of the 8th National Socio-Economic Development Plan (8th NSEDP) and the start of the next five-year plan (9th NSEDP 2021-2025). The 9th NSEDP is dominated by challenges related to development sustainability and climate change, quality and inclusive growth, human capital, infrastructure development and transition from LDC status. The NSEDP will be accompanied by a 2022 COVID-19 recovery strategy to ensure reprioritization in light of the continued fallout from the pandemic.
The United Nations Sustainable Development Cooperation Framework (UNSDCF) 2022-2026 was developed in 2021 as the 2017-2021 cycle of the United Nations Partnership Framework (UNPF) drew to a close. The UNSDCF was developed through an extensive consultative process drawing on a Common Country Analysis (CCA) and the 16 key recommendations of the independent evaluation of the UNPF.
The NDVP has been particularly successful in Lao PDR due to strong GoL commitment to the programme, active donor support and engagement with GoL, joint efforts by WHO and UNICEF to coordinate with partners through COVAX and beyond, as well as the active engagement of the United Nations country team. with communities to leave no one behind. Including shipments that arrived in January 2022, COVID-19 vaccines through the COVAX facility provided full vaccination to more than 3.8 million people, or approximately 52% of Laos’ population. Unlike many other developing countries, Lao PDR has had minimal vaccine wastage.
The 50% vaccination target was reached by the end of 2021 with over 3.7 million people fully vaccinated and over 4.6 million people vaccinated with at least one dose.
The table above shows that all provinces except Xaisomboun met the 2021 target of 50% vaccination rate in February 2022, while Bokeo and Vientiane Capital have already met the target of 2022 in terms of all recommended doses. The UN will continue to provide support to the GoL to improve access to vaccination for hard-to-reach populations and accelerate the booster program in 2022. For more information on UN technical and logistical support to the NDVP in 2021, please refer to outcome 5 in this report