The major challenge for health care planners lies in integrating health promotion and disease prevention on the one hand and treatment of acute illness and chronic care on the other. This has to be done at all levels of the health system with the aim of delivering quality services equitably and efficiently to the whole population. This is a particular problem as many governments spend less than US $10 per person per year on health. Acute sector healthcare, including anaesthesia, is often deficient under these circumstances.