Director- General's Message ie ahead, and identify major avenues for health While universally applicable, these reforms systems to narrow the intolerable gaps between do not constitute a blueprint or a manifesto for aspiration and implementation action. The details required to give them life in These avenues are defined in the Report as each country must be driven by specific condi- four sets of reforms that reflect a convergence tions and contexts, drawing on the best available between the values of primary health care, the evidence. Nevertheless, there are no reasons why expectations of citizens and the common health any country-rich or poor- should wait to begin performance challenges that cut across all con- moving forward with these reforms. As the last texts. They include: three decades have demonstrated. substantial a universal coverage reforms that ensure that progress is possible health systems contribute to health equity Doing better in the next 30 years means that social justice and the end of exclusion, pri- we need to invest now in our ability to bring marily by moving towards universal access actual performance in line with our aspirations. and social health protection expectations and the rapidly changing realities of a service delivery reforms that re-organize our interdependent health world United by the health services around people's needs and common challenge of primary health care, the expectations, so as to make them more socially time is ripe, now more than ever, to foster joint relevant and more responsive to the changing learning and sharing across nations to chart the world, while producing better outcomes most direct course towards health for all a public policy reforms that secure healthier communities, by integrating public health actions with primary care, by pursuing healthy public policies across sectors and by strength ening national and transnational public health Dr Margaret Chan interventions: and eral a leadership reforms that replace disproportion- World Health Organization ate reliance on command and control on one hand, and laissez-faire disengagement of the state on the other, by the inclusive, participa tory, negotiation-based leadership indicated by the complexity of contemporary health systemsix Director-General’s Message lie ahead, and identify major avenues for health systems to narrow the intolerable gaps between aspiration and implementation. These avenues are defi ned in the Report as four sets of reforms that refl ect a convergence between the values of primary health care, the expectations of citizens and the common health performance challenges that cut across all con￾texts. They include: Q universal coverage reforms that ensure that health systems contribute to health equity, social justice and the end of exclusion, pri￾marily by moving towards universal access and social health protection; Q service delivery reforms that re-organize health services around people’s needs and expectations, so as to make them more socially relevant and more responsive to the changing world, while producing better outcomes; Q public policy reforms that secure healthier communities, by integrating public health actions with primary care, by pursuing healthy public policies across sectors and by strength￾ening national and transnational public health interventions; and Q leadership reforms that replace disproportion￾ate reliance on command and control on one hand, and laissez-faire disengagement of the state on the other, by the inclusive, participa￾tory, negotiation-based leadership indicated by the complexity of contemporary health systems. While universally applicable, these reforms do not constitute a blueprint or a manifesto for action. The details required to give them life in each country must be driven by specifi c condi￾tions and contexts, drawing on the best available evidence. Nevertheless, there are no reasons why any country − rich or poor − should wait to begin moving forward with these reforms. As the last three decades have demonstrated, substantial progress is possible. Doing better in the next 30 years means that we need to invest now in our ability to bring actual performance in line with our aspirations, expectations and the rapidly changing realities of our interdependent health world. United by the common challenge of primary health care, the time is ripe, now more than ever, to foster joint learning and sharing across nations to chart the most direct course towards health for all. Dr Margaret Chan Director-General World Health Organization