This chapter synthesizes social, economic and demographic trends over the past three decades in the countries studied in this book. It argues that health policy is affected by and affects these trends. The chapter synthesizes data on economic and demogrphic trends as well as key health system input and outcomes. The chapter records impressive economic growth rates, decline in poverty, and prudent public finances in the region. It shows that all countries except India enjoy some of the best health status in the world, and that these were achieved at relatively low costs. However, rapid population ageing and rising incomes and expectations present serious health policy challenges that governments must meet.