Chapter 3.7 reviews priority-setting. Priority-setting is about taking explicit decisions on where limited public resources should be allocated. Vertical priority-setting focuses on choices for particular sets of health conditions or population groups whereas horizontal priority-setting looks more broadly across types of care, such as primary or secondary care, and broader investments. Key learning includes that

• Defining a health benefits package that is affordable and accessible by all implies a horizontal approach to priority-setting.

• Countries cannot progress towards UHC without horizontal priority-setting and without some form of collective funding and procurement mechanisms.

• Horizontal priority-setting is highly context-specific. Countries may need to reorganize financing and procurement mechanisms to overcome barriers to progress.

• Increasing the total resources for health benefits packages (HBP) can help with the introduction of more horizontal approaches.

• Improving procurement can also support the move towards horizontal priority-setting whether through national efforts (such as better data gathering and use) or international initiatives (i.e. harmonizing regulation across countries or global investment in health security).

• Local capacity is key in supporting the pooling mechanisms, HBP design and regulation which enable horizontal priority-setting. Donors can usefully support health systems strengthening by investing in capacity-building and information sharing.

• Strong political will and cooperation between stakeholders is critical in progressing towards appropriate priority-setting for UHC and in designing, financing and implementing a comprehensive health benefits package.