Guyana is the only English-speaking country in South America and shares cultural and historical bonds with the Anglophone Caribbean. Guyana's two largest ethnic groups are the Afro-Guyanese (descendants of African slaves) and the Indo-Guyanese (descendants of Indian indentured laborers), which together comprise about three quarters of Guyana's population. Tensions periodically have boiled over between the two groups, which back ethnically based political parties and vote along ethnic lines. Poverty reduction has stagnated since the late 1990s. About one-third of the Guyanese population lives below the poverty line; indigenous people are disproportionately affected. Although Guyana's literacy rate is reported to be among the highest in the Western Hemisphere, the level of functional literacy is considerably lower, which has been attributed to poor education quality, teacher training, and infrastructure.
Guyana's emigration rate is among the highest in the world - more than 55% of its citizens reside abroad - and it is one of the largest recipients of remittances relative to GDP among Latin American and Caribbean counties. Although remittances are a vital source of income for most citizens, the pervasive emigration of skilled workers deprives Guyana of professionals in healthcare and other key sectors. More than 80% of Guyanese nationals with tertiary level educations have emigrated. Brain drain and the concentration of limited medical resources in Georgetown hamper Guyana's ability to meet the health needs of its predominantly rural population. Guyana has one of the highest HIV prevalence rates in the region and continues to rely on international support for its HIV treatment and prevention programs.