alf of the population. It involves identifying the sets of interventions or services to which the population is entitled; choosing the providers from whom services will be purchased; deciding how these services should be purchased, including contractual arrangements and provider payment mechanism; and determining how the population will access them. Purchasing can be passive -- determining resource allocations, benefit packages, and provider arrangements by defaulting to historical patterns and arrangements; or strategic -- actively engaging citizens, governments and providers in choosing arrangements which will optimize coverage, equity and efficiency. In this talk, I will review the conceptual foundations of strategic purchasing, explore country experience with transitioning to more active purchasing arrangements, and outline current research on strategic purchasing being undertaken by the RESYST consortium.


INTRODUCTION
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Brazil has made advancements with its Unified Health System (SUS) by establishing universal and full care as its principles and by increasing the coverage of its Primary Health Care (PHC), through Family Health Care Strategy (FHCS). However, the biomedical health care model prevails, and it guides all professional practices, including dentistry.[@B4] ^,^ [@B13] ^,^ [@B35] ^,^ [@B48] ^,^ [@B50] ^,^ [@B54] ^,^ [@B55]

According to its last epidemiological survey, Brazil shifted its prevalence of caries from medium to low.[@B59] Although results are nationally satisfactory, some factors call our attention: (a) regional differences in the prevalence and seriousness of caries are distinctive, which indicates a need for policies focused on equal care; (b) small reduction of caries in deciduous dentition (18.0%) and 80.0% of affected teeth remaining untreated; (c) significant deficit for older adults, despite adolescents' and adults' need for prosthetics having been decreased; and (d) prevalence of malocclusion requiring treatment in 10.0% of adolescents, which suggests a need for resi