of primary health care that were effective and affordable in settings of poverty and remoteness in developing countries. Some were found and served as the basis for strengthening health systems in a variety of settings. Now, new models are needed that, first, go beyond primary health care, to more comprehensive approaches in which primary and secondary care are effectively and efficiently joined to address emerging epidemiologic diversity, and, second, can act as policy generators for system development and change.

In material that follows, we will call attention to the usefulness of models and their limitations as universal solutions on the basis of the fact that each country is unique. Modeling remains important, but in a context in which each country is helped to build capacity to assess its own needs, reform its own policies, and adapt models to its own situation.

Thus, the new capacities required to advance health would build on the methods and strategies presented in this volume and would include construction of health care prototypes at the district level to handle changing epidemiology, relevant health research, human resources development, and related policy making and implementation. The metric described here and in the World Development Report for determining burdens of disease and the cost-effectiveness of interventions provides a basis for priority setting and related policy formulation, assuming that capacities exist at the country level for their adaptation and application.



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