On average, the external debt burden of low and middle-income countries remains moderate. The ratio of external debt to GNI averaged 26 percent at the end of 2018, unchanged from the prior year average, and the ratio of external debt-to-export earnings improved slightly. 

Outcomes for countries in Sub-Saharan Africa are illustrative. About half of the countries in the region have seen external debt stocks double, and in some instances, more than triple, since 2009. At the end of 2018, the average debt-to-GNI and debt-to-export ratios of countries in the region, excluding South Africa, was 32 percent and 127 percent, respectively; the comparable ratios for 2009 were 24 percent and 87 percent, respectively.