This Public Expenditure Review (PER) wasprepared at the request of Mexico’s Ministry of Finance andPublic Credit (Secretaría de Hacienda y Crédito Público,SHCP); its analysis of the efficiency, equity and impact ofpublic spending in selected sectors is designed to informMexico’s ongoing process of fiscal consolidation. TheMexican government’s hard-earned reputation for fiscalresponsibility and sound macroeconomic management hasprovided a solid foundation for stability and growth. AsMexico strives to meet the challenges of a dynamic globaleconomic environment, this PER is intended to support thegovernment’s efforts to adjust expenditure policies tobetter reflect the country’s evolving macro-fiscalcircumstances. The PER is organized into two sections; thefirst focuses on overarching public expenditure managementand cross-cutting policy issues. Chapters two through fiveexamine the national macro-fiscal profile, selected issuesin fiscal decentralization, the budget process, theperformance evaluation system and human resource managementin the public administration. These chapters explore how acombination of revenue shocks and structural expenditurepressures is affecting Mexico’s public finances and considerthe implications of these trends over the medium term. Theyevaluate the extent to which federal budgetary inertiareflects sector-level policy commitments and describe howbuilt-in expenditure rigidities can complicate themedium-term consolidation process. Chapters’ six throughtwelve each focus on a sector with especially significantfiscal implications: health; education; social assistanceand labor market programs; subsidies for rural development,housing and small-businesses support; water and sanitationinfrastructure; and public security. These sector-levelanalyses explore the combination of demographic trends andpolicy commitments that are driving a secular increase inboth expenditure pressures and budgetary rigidities. Thegovernment’s policy goal of achieving universal secondaryeducation will permanently increase the education budget,while universal access to basic health insurance will drivea similar structural expansion in public spending on health,which will be compounded by the rising healthcare costs ofan aging population. These same demographic trends will alsointensify pressure on the social protection budget. Therapid expansion of the police and security services willentail significant long-term spending commitments, and thefiscal impact of accelerated hiring will be magnified by theincorporation of nearly half a million municipal police intothe national police force. Taken together, these trends willgreatly increase aggregate public spending in Mexico overboth the medium and long term.