After a decade of rapid economic growth, many developing countries have attained middle-income status, but poverty reduction in these countries has not kept pace with economic growth. Most of the world’s poor—up to a billion people—now live in these new middle-income countries. These countries also carry the majority of the global disease burden.
Most of the world’s poor no longer live in low-income countries. An estimated 960 million poor people—a new bottom billion—live in middle-income countries, a result of the graduation of several populous countries from low-income status. That is good news, but it has repercussions. Donors will have to change the way they think about poverty alleviation. They should design development aid to benefit poor people, not just poor countries, keep supporting middle-income countries, think beyond traditional aid to craft coherent development policies, and work to help create space for more inclusive policy processes in new and old MICs.