In essence then, the health sector in developing countries is weak and fragile; it is vulnerable to external financial pressures and the vagaries of national budget priorities. Throughout the world, leaders in health must seek more effective ways of impressing upon others who make national policy the long term consequences of crises which disrupt health services. Above all, the impact of disinvestment in health in creating underdevelopment and the value of investment in health in creating development must be demonstrably established. Health must be seen as an engine of national development.