Central America experienced almost a decade of economic progress between 2003 and 2008, when GDP per capita growth averaged 3 percent per year. Yet the region’s five countries–Costa Rica, El Salvador, Guatemala, Honduras and Nicaragua–still lag other middle income economies. Their high dependence on their primary commodities and the U.S. economy makes the growth slow and volatile. Even more worrying are high levels of poverty and inequality. Significant structural changes are urgently needed to secure sustained and inclusive growth.