(*) The draft written by rapporteurs, Profs. Lobato and Rovira was enriched with suggestions by speakers and moderator.

The crisis or exhaustion of the post-war growth model for the world's economy, based on the availability of cheap raw materials and energy resources, State intervention and national markets reserved to benefit industrialization, has caused a re-structuring of the economic situation upon new foundations:

a) the importance of the market as opposed to the State as a means of coordination and allocation of resources;

b) the search for greater efficiency, thus facilitating the exploitation of scale economies - either by enlarging markets through the elimination or lightening of international trade barriers, or by creating free trade areas or regional groups;

c) more favourable conditions for research and technological development.

In this new perspective one can therefore put to task the role of the State in the economy and in society, to the point of reducing it to insignificant levels (as suggested by some). At the same time there are regional globalization and integration processes which cause an even larger restriction of the governments' scope of action in the economic and social fields.

The study of these changes and their implications for health services, health care and medicines, was the topic of the first six papers presented by Prof. Segura and Drs. Correa, O'Brien, Mossialos, Infante and Arango in this meeting of experts.

Another important topic of the meeting - Changes in the Pharmaceutical Industry - was developed by papers presented by Profs. Scherer, Le Pen and Dr. Dukes. With assistance from the speakers, moderator and Dr. Germán Velásquez, the rapporteurs wrote the following paragraphs trying to cover all the important issues discussed during the meeting.