"The Peruvian health sector has recovered rapidly after collapsing in the late 1980s and early 1990s as a result of hyperinflation and terrorism. Total public and private spending on health rose by over 50% in real terms in the three years after 1994. The supply of health services increased sharply,... Health outcomes have also improved rapidly in recent years..."Several reforms were attempted during the health sector's recuperative years. Some were successful, others failed. To increase the chances for success in the future, policymakers in Peru must face three key challenges: • continue to reduce the large gap between the health status of the poor and that of the nonpoor; • increase the resources assigned to provide care for the poor; • increase the efficiency in the use of these resources. This report is meant to help the Government continue to develop its agenda to improve health care for the poor. Its focus is on poverty, and particularly on ways to improve the Ministry of Health's primary health subprogram, rather than on sector-wide reforms, to increase efficiency. The report emphasizes that there is much to be gained by sustaining and deepening the reforms directed toward improving health care for the poor while using the shift in focus and responding to the key challenges. The executive summary and introduction are provided in both English and Spanish.

During discussion of psychoanalysis and virtual reality in the new millennium, it was predicted that in the next century the differences between the conscious, unconscious, and the pre-conscious will have to be reconsidered in view of the ever-expanding concepts created by virtual reality. There will be virtual sexual acts over the Internet, ovum parthenogenesis will be possible without the intervention of the male, and clonic reproduction of the human being will be carried out in the laboratory. The child born in these circumstances will relate to a widening array of potential parental figures: the classic heterosexual couple, the single-parent family, the homosexual couple, the transsexual figure, etc. All this will of course alter the classic Oedipal constellation and without doubt the gender identity of the child. There will be attempts to undergo psychoanalysis via the Internet in the same way that other kinds of psychotherapy are being virtualized. But this will force us to redefine transference. On the other hand, it seems likely that psychoanalysis as a psychotherapeutic tool will, in the 21st century, relate more to somatic, medical patients or to the `worried well' than to psychiatric patients. These brief considerations on the scope of our deliberations in some way explain the diversity of this book, but also justify its interest.