Between 1993 and 1997, the project helped 175 non-governmental organizations carry out more than 400 grassroots campaigns educating high-risk groups such as injecting drug users and sex workers about unsafe or harmful behaviors. The NGOs handed out more than 180 million condoms, raised AIDS awareness among more than 500,000 people, and trained 3,800 teachers and 32,500 students in promoting AIDS and drug abuse prevention.

Aided by another $165 million World Bank loan in 1998, the project, now in its second phase, is helping Brazil’s Ministry of Health reduce the spread of HIV/AIDS while making it possible for Brazilians with AIDS to live longer, healthier lives. The program has contributed to a 38-percent drop in the number of AIDS-related deaths since 1993. While supporting 145 specialized AIDS care units as well as 66 hospital-based care units and 50 home-care teams, the focus of the Second AIDS and STD Project remains prevention. It has helped setting up a nation-wide network of 141 AIDS testing and counseling centers. In partnership with the National Business AIDS Council, the Bank's support has enabled 3,000 companies to provide AIDS awareness training to 3.5 million workers.

El Salvador Brings Schools and Teachers to Rural Poor

After years of civil strife, one million of El Salvador’s children were not in school in the late 1980s. The enrollment rate for basic education stood at 76 percent. Poor families in the countryside in particular suffered from a lack of schools and teachers.

To strengthen pre-school and primary education, the World Bank has since 1989 through three loans totaling $148 million supported a visionary and innovative education reform launched by the government of El Salvador. The program, EDUCO, has shifted control of schools from the central to local governments and, in turn, directly to parents’ community associations. These organizations actually run the schools, including hiring teachers and developing curricula.

The improvements are dramatic: by 1999, more than 237,000 children were enrolled in the EDUCO system, up from 8,400 in 1991. In EDUCO schools, dropout rates have plunged. Fewer students fail; the portion of students repeating grades fell from 23 percent in 1994 to just 15 percent in 1998. EDUCO has shown that underprivileged students from rural areas perform as well or better than more privileged students at government-run urban schools.

EDUCO is part of a wide-ranging education reform in El Salvador, which is pushing student enrollment up to almost 90 percent in both primary and secondary schools, reducing illiteracy, and improving secondary school curricula to link it more closely to local labor market needs. It is an example of partnership, in which the government leads and sets the agenda, while the World Bank provides financing and expertise to help meet government goals.

Mexico Expands Basic Health Care Coverage

Two of the main obstacles to improving public health services for Mexico's poor have been the population dispersion in rural areas and difficult geographic conditions for reaching them. It is estimated that there are more than 151,000 communities with fewer than 100 inhabitants with a combined population of 2.6 million, compared with 62 million living in 1,370 communities with populations of over 5,000.

Mexico's Expansion of Basic Health Services Program (PAC in Spanish), supported by a $310 million World Bank-loan, sought to reach these remote villages. Based on an unprecedented collaboration between the federal and local governments, hundreds of mobile units were put in motion to deliver a basic health care package comprised of 13 cost-effective interventions such as basic sanitation, diarrhea control, family planning, prevention and treatment of parasitic diseases, health and nutrition information, immunizations, child delivery, and prevention and control of tuberculosis and cervical cancer.

Thanks to the four-year old program, the number of Mexicans with no health coverage has decreased from 10 million in 1995 to 1.5 million in 1999, according to the Pan-American Health Organization. Starting in 11 states in 1996, the project has since been extended to 19 states, 850 municipalities, and 36,995 rural localities. Experts expect the project to help reduce the population with no coverage to 500,000 by the end of 2000.

Guatemala Streamlines Financial Management System

In Guatemala, a creaking budgetary accounting and payments system meant delays and frustrations for contractors waiting to be paid. Officials and the public were kept in the dark about how their budgets were spent. Since 1995, two World Bank loans worth $25.1 million have helped Guatemala’s government replace this unreliable system.

Using a Guatemalan-developed computer and management system, the World Bank-supported reform slashed payment time to three days. The new technology, combined with better, decentralized management, helped the Guatemalan government present its annual budget to the country’s legislators on time, and deliver on promises to decentralize health and education services so that they reach the rural poor.

Caribbean Countries Halve Telephone Rates, Stimulate Small Businesses

In Dominica, Grenada, St Kitts-Nevis, St. Lucia and St. Vincent, five countries of the Organization of Eastern Caribbean States (OECS), an expensive and erratic telephone system held back development. So in 1998, a World Bank project responded to the OECS countries’ request for help in setting up a regional telecommunications authority. This body was to negotiate terms for liberalization of the eastern Caribbean’s telecom market with Cable & Wireless, a British multinational company that enjoyed what was effectively an unregulated monopoly over telecommunications services among the islands.

So far, the telecommunications project have reduced telephone and internet charges by up to 50 percent. Service has improved, resulting in more jobs and fairer competition. The lower rates will help stimulate new, more diverse businesses in these small economies, while also opening greater opportunities for economic integration.

The project will establish a common regulatory system across the five countries, expected to be in place by the end of 2000. Proposed new legislation on telecommunications has been drafted and sent to the Attorneys-General of the five countries for review before going to their cabinets.