This Public Expenditure Review (PER) builds on the commitments of the 2003 Country Economic Memorandum (CEM), and 2002 Country Assistance Strategy (CAS) Progress Report, being its primary objective to assess strengths and weaknesses in key areas of public expenditure, and identify policy options for fiscal sustainability. Jamaica's high debt aggravates debt sustainability and efforts to improve growth. Revenue performance is also a weak element in the country's overall fiscal framework, while the current level of public sector investment is too low to support strong sustained growth. Amidst mounting fiscal problems, the Government has been unable to spend the necessary on social sectors, and this has in turn catalyzed some innovative thinking on how to raise resources, and private sector involvement. Moreover, the effectiveness of the budget as a tool for fiscal policy has been muted by its perceived low credibility. The report suggests focusing on reconciling expenditure commitments to improve budget credibility, including direct and contingent commitments. This implies increased fiscal discipline, and improved expenditure management across all levels of government. Furthermore, the government should avoid the use of the capital budget as a de-facto contingency fund; rather, it should be a strategic development tool in the context of a live Public Sector Investment Program. Recommendations towards fiscal consolidation and a debt-reducing economic strategy, include reducing vulnerability, and the bilateral debt; increasing revenues and rationalizing Government expenditures to generate further growth; rationalizing education and health expenditures; and, improving the institutional framework for public expenditure management.