The geography of poverty and social deprivation has changed dramatically over the last two decades. More than 70 percent of the world's poor now live in middle-income countries.

This pattern, likely to continue into the next decade, raises important questions. Have poverty reduction and human development kept up with income growth? Is growth incomplete without social progress and gender-inclusiveness?

Consider South Asia, where the poverty rate fell from 60 percent in 1981 to 40 percent in 2005. But the number of poor people (defined as those living on less than US$1.25 per capita per day at 2005 purchasing power parity) in South Asia increased from 549 million in 1981 to 595 million in 2005, and from 420 million to 455 million in India, where almost three-quarters of the region's poor reside.

In other words, while South Asia's economies have not underperformed on poverty reduction, merely matching global trends may not be enough for the region with the world's largest concentration of poor people.

Income growth has contributed to improved education. Adult literacy rates in South Asia match the global norm. But education outcomes lag behind when it comes to secondary and tertiary education.

Nor have health indicators kept up with income growth. South Asia has the world's highest rates of malnutrition and the largest number of undernourished children, who have higher mortality rates, lower cognitive performance, and a greater likelihood of dropping out of school. And, while much of the existing international health care assistance is focused on sub-Saharan Africa, India, along with Bangladesh, Bhutan, Nepal, Pakistan, and Sri Lanka, are just as devastated by neglected tropical diseases.

Over the last 50 years, the most striking forms of inequality, including discrimination against women in access to education, health, employment, political participation, and household resources, have been largely reversed. But dramatic gender inequities persist in South Asia, more so than in other low-income countries.

Although gender parity in primary education has improved, dropout rates for girls are higher than for boys. The dowry tradition puts pressure on girls' families to marry them early, leading to a preference for sons. The expectation that girls will grow up to do little other than serve their husbands reduces parents' incentives to invest in their daughters' education.

Uneducated women then have few alternatives, and the expectation becomes self-fulfilling, leaving women in a continuous cycle of powerlessness that has had significant adverse long-term effects.

The paradox of South Asia is that growth has been instrumental in reducing poverty and improving social outcomes, but poverty rates have not improved fast enough to reduce the total number of people living in misery.

Policy makers should begin to consider direct policy interventions to accelerate social progress, with a particular focus on human development and gender inclusiveness. A development strategy that promotes growth first, and only then deals with human misery, is not sustainable.

The author is Economic Adviser on South Asia Poverty Reduction and Economic Management at the World Bank. Copyright: Project Syndicate, 2011.www.project-syndicate.org. Shanghai Daily condensed the article.