This review deals with recent changes in health services development and support among the Member States of the European Region in response to changes in health indicators in the framework of the Regional targets for Health for all. Developments in research, in health legislation and in training which take into account the targets of Health for all represent long-term actions; several countries mention efforts to increase community participation in the development and evaluation of health programmes, efforts which must be actively pursued. Changes are perforce slow, and economic pressure represents both a challenge and a constraint.