Let me congratulate Dr. Sharief on her excellent effort on reviewing the Sudanese health system. The endeavor to write in Sudan is heroic and few will do it. I find myself agreeing on most of the findings except two, one historical and the other conceptual. The historical is that introduction of user fees started since 1978 when Sudan stated to adopt the World Bank prescription, better known as Structural Adjustment. In 1994 the free service – as misleading as it is – was abandoned. The conceptual comes in the policies to decrease the allocated GDP, which is an ideological choice and a socio-economical bias and not as said by the author. Furthermore, the government was faced with several political and economic constraints that resulted in a decrease in the proportion of GDP allocated for health from 1.5% in 1982 to 0.07% in 1990. I had finished a book about the Sudan health and would like to discuss more on the issue, my mail is added.