In July 2005 the BMJ will devote a theme issue to the medical problems of hundreds of millions of people in post-communist countries geographically located in central, eastern, and southeastern Europe. Communism came to the Soviet Union after the first world war and to the rest of now transitional Europe after the second world war. The fall of the Berlin Wall in 1989 marked the beginning of the end of communism, and the former communist countries entered a phase of transition to democracies and market economies.

The arguably common path that these countries started out on branched in many different directions, partly because they all started from different bases. Today the countries in transition are politically and economically as heterogeneous as is the health status of their populations.1 Although for some the first stage of transition ended with their accession to the European Union in May this year, others are still battling the scars left over from recent or possibly newly emerging wars. Healthwise, however, they have certain common features.

Life expectancy at birth is now lower in the …