Uganda: Technical Assistance Report-The Cost of Meeting the Sustainable Development Goals in Human Capital and Infrastructure Development

The mission estimates that making substantial progress in critical SDG sectors in Uganda would require additional annual spending of about 18.4 percent of gross domestic product (GDP) by 2030. Relative to low-income developing countries (LIDCs), additional spending in Uganda is higher in the social sectors and lower in the infrastructure sectors (Figure). Overall, Uganda’s additional spending is above the median LIDC and similar to the median Sub-Saharan African (SSA) country. (This analysis is an assessment of the spending to achieve a high performance in selected SDGs in Uganda and does not include an examination of options to finance the spending needs.) • Health—expanding the supply of medical staff. Total health care spending is low (4.2 percent of GDP) relative to peers, and there is substantial room to increase the efficiency of spending: health outcomes are below those of several other countries with similar spending. Overall, we estimate that total health care spending would have to gradually increase by an additional 7.4 percent of GDP in 2030 relative to today’s spending, to deliver superior health care outcomes. A major contributor to the additional cost is the need to substantially increase the supply of doctors—more than 16-fold—and to nearly triple the number of other health personnel. • Education—strengthening both quality and quantity of services. Uganda’s young population—60 percent are school-aged, a higher share than in the East African Community (EAC) and LIDC peers—combined with a relatively low enrollment rate, means that the country needs to invest in getting its children into schools. However, just as important is improving the currently low level of educational quality. Toward this goal, class sizes need to fall by hiring more teachers, thus bringing the student-teacher ratio down from 28 to 19. Public spending, currently well below LIDC and EAC averages, would need to triple as a share of GDP to help deliver on these goals. We estimate that Uganda’s total expenditures on education would need to increase by an additional 6.7 percent of GDP from its current level of 7.1 percent of GDP. • Water and sanitation—aiming at safely managed water and sanitation for all. Uganda is below regional and income-group peers in water and sanitation standards. In particular, while there has been progress in water provision, sanitation services have hardly improved in the past two decades, and its provision is lower than most countries in the subregion. Closing the water and sanitation gaps will require an additional annual spending of 1.1 percent of GDP, including maintenance costs to counteract depreciation. The bulk of the cost burden comes from safely managed water in rural areas, given the relatively high unit cost of such facilities and the large rural population unserved by this type of facility. • Electricity—investing in transmission and distribution networks to increase access. The vast majority of Uganda’s electricity is generated by renewable energy (hydropower). Overall electricity consumption per capita, at 83kilowatt-hour (kWh), strongly lags LIDCs and is below what would be expected given its level of GDP per capita. Transmission and distribution networks need to catch up with installed capacity, which, at 1,347 megawatts (MW), is far ahead of peak demand at 793 MW. We estimate that expanding current access, serving the future population through 2030, and increasing consumption in line with economic growth, will require annual investments reaching 0.4 percent of GDP in 2030. • Roads—gradually increasing rural access. Raising access to roads from its current level of 53 percent of the rural population to 75 percent by 2030 will require about 20.4 thousand additional kilometers of all-weather roads. While rural road access is higher than LIDCs, road quality lags subregional peers, thus the expansion of access will also need to include upgrading of roads in that are in poor condition. We estimate that this will require annual investments of 2.8 percent of GDP in 2030.