World Bank economists expect GDP growth in the Middle East and North Africa (MENA) to continue at a modest pace of 1.5 percent in 2019, slightly down from 1.6 percent in 2018. The declme reflects a contraction in one large economy, which more than offsets growth in other countries. In the medium term, the World Bank expects real GDP in the MENA to grow at 3.4 percent and 2.7 percent in 2020 and 2021, respectively. The expected upswing is partially driven by ongoing policy reforms, as well as reconstruction efforts in some countries. However, MENA's modest recovery will be insufficient to change its historically low growth in per capita GDP. External factors are unlikely to pull the region out of its low-growth equilibrium. In addition, many countries in the region have persistent current account deficits. A recent deterioration in external balances across MENA constrained the region's ability to finance these deficits. Although the region has a low risk of experiencing sudden reversals in capital inflows in the short run, structural reforms capable of raising aggregate labor productivity are urgently needed to gradually reduce external imbalances. The report concludes by providing examples of reforms in fiscal policies, trade-related policies, social protection and labor markets, and state-owned enterprises (SOEs) in network industries.