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The Gaza Strip now has limited self-rule. Its people inherit a health-care system provided by four sectors--the Israeli government, the UN Relief and Works Agency, non-governmental organisations, and private facilities. They also inherit a legacy of health indices comparing unfavourably with those of Israel, huge numbers of refugees, a looming water crisis, civil unrest, and a health care expenditure bill (as a proportion of gross domestic product) that will be unsustainable. Four plans have been drawn up for health services in autonomous Gaza but none is exactly right.