Health is a major development challenge facing Europe and Central Asia (ECA) today. Living long and healthy lives matters as much as achieving ever-higher incomes. This report is about how to improve health system outcomes in countries in the ECA region. This report, which explores the development challenge facing health sectors in ECA, identifies three key agendas for achieving more rapid convergence with the world's best-performing health systems: the first is the health agenda, in which the main imperative is to strengthen public health and primary-care interventions to help achieve the cardiovascular revolution that has taken place in the West in recent decades. The second is the financing agenda, in which growing demand for medical care must be satisfied without imposing an undue burden on households, by achieving better financial protection, or on government budgets, by ensuring a more efficient use of resources. The third agenda relates to broader institutional arrangements. Here, a few key reform ingredients are identified, each of which is common to most advanced health systems but lacking in many ECA countries.