Health systems in developing countries are underfunded. There is shortage of personnel, equipment, and drugs. Yet, wastage in different forms is very common in health systems. In this talk, Yehuda will describe some of the most important features of the health supply chains in low income countries and the way they operate, and he will discuss the performance of these systems. Finally, he will present some of his thoughts on ways to improve the performance of such systems without investing additional resources.