The World Health Report 2000 This shift has been partly due to the profound political and economic changes of the last 20 years or so. These include the transformation from centrally planned to market-oriented economies, reduced state intervention in national economies, fewer government controls, and more decentralization deologically, this has meant greater emphasis on individual choice and responsibility Politically, it has meant limiting promises and expectations about what govemments should do. But at the same time peoples expectations of health systems are greater than ever before. Almost every day another new drug or treatment, or a further advance in medicine and health technology, is announced. This pace of progress is matched only by the rate at which the population seeks its share of the benefits The result is increasing demands and pressures on health systems, including both their public and private sectors, in all countries, rich or poor. Clearly, limits exist on what govern- ments can finance and on what services they can deliver. This report means to stimulate public policies that acknowledge the constraints govemments face. If services are to be provided for all, then not all services can be provided THE POTENTIAL TO IMPROVE Within all systems there are many highly skilled, dedicated people working at all levels to improve the health of their communities. As the new century begins, health systems have the power and the potential to achieve further extraordinary improvements Unfortunately, health systems can also misuse their power and squander their poten- al. Poorly structured, badly led, inefficiently organized and inadequately funded health systems can do more harm than good This report finds that many countries are falling far short of their potential, and most are making inadequate efforts in terms of responsiveness and fairness of financial contribu- tion. There are serious shortcomings in the performance of one or more functions in virtu ally all countries These failings result in very large numbers of preventable deaths and disabilities in each country: in unnecessary suffering in injustice, inequality and denial of basic rights of indi viduals. The impact is most severe on the poor, who are driven deeper into poverty by lack of financial protection against ill-health. In trying to buy health from their own pockets, sometimes they only succeed in lining the pockets of others In this report, the poor also emerge as receiving the worst levels of responsiveness they are treated with less respect for their dignity, given less choice of service providers and offered lower-quality amenities The ultimate responsibility for the overall performance of a countrys health system lies with government, which in turn should involve all sectors of society in its stewardship. The ng of the population is the ve sence of good government. For every country it means establishing the best and fairest health system possible with available resources. The health of the people is always a na tional priority: government responsibility for it is continuous and permanent Ministries of large pa Health policy and strategies need to cover the private provision of services and private financing, as well as state funding and activities. Only in this way can health systems as ing goals that are in the compasses the tasks of defining the vision and direction of health policy, exerting influence lation and advocacy, and collecting and using information. At the intenaxiv The World Health Report 2000 This shift has been partly due to the profound political and economic changes of the last 20 years or so. These include the transformation from centrally planned to market-oriented economies, reduced state intervention in national economies, fewer government controls, and more decentralization. Ideologically, this has meant greater emphasis on individual choice and responsibility. Politically, it has meant limiting promises and expectations about what governments should do. But at the same time people’s expectations of health systems are greater than ever before. Almost every day another new drug or treatment, or a further advance in medicine and health technology, is announced. This pace of progress is matched only by the rate at which the population seeks its share of the benefits. The result is increasing demands and pressures on health systems, including both their public and private sectors, in all countries, rich or poor. Clearly, limits exist on what govern￾ments can finance and on what services they can deliver. This report means to stimulate public policies that acknowledge the constraints governments face. If services are to be provided for all, then not all services can be provided. THE POTENTIAL TO IMPROVE Within all systems there are many highly skilled, dedicated people working at all levels to improve the health of their communities. As the new century begins, health systems have the power and the potential to achieve further extraordinary improvements. Unfortunately, health systems can also misuse their power and squander their poten￾tial. Poorly structured, badly led, inefficiently organized and inadequately funded health systems can do more harm than good. This report finds that many countries are falling far short of their potential, and most are making inadequate efforts in terms of responsiveness and fairness of financial contribu￾tion. There are serious shortcomings in the performance of one or more functions in virtu￾ally all countries. These failings result in very large numbers of preventable deaths and disabilities in each country; in unnecessary suffering; in injustice, inequality and denial of basic rights of indi￾viduals. The impact is most severe on the poor, who are driven deeper into poverty by lack of financial protection against ill-health. In trying to buy health from their own pockets, sometimes they only succeed in lining the pockets of others. In this report, the poor also emerge as receiving the worst levels of responsiveness – they are treated with less respect for their dignity, given less choice of service providers and offered lower-quality amenities. The ultimate responsibility for the overall performance of a country’s health system lies with government, which in turn should involve all sectors of society in its stewardship. The careful and responsible management of the well-being of the population is the very es￾sence of good government. For every country it means establishing the best and fairest health system possible with available resources. The health of the people is always a na￾tional priority: government responsibility for it is continuous and permanent. Ministries of health must therefore take on a large part of the stewardship of health systems. Health policy and strategies need to cover the private provision of services and private financing, as well as state funding and activities. Only in this way can health systems as a whole be oriented towards achieving goals that are in the public interest. Stewardship en￾compasses the tasks of defining the vision and direction of health policy, exerting influence through regulation and advocacy, and collecting and using information. At the interna-