Despite high levels of per capitaincomes and good social service provision, poverty remains apersistent problem in St. Kitts and Nevis. To improvecompetitiveness, restore rapid economic growth, and ensureits medium-term sustainability in the context of thecurrency union, the main challenges to the St. Kitts andNevis government are to (a) tighten fiscal policy, notablythrough expenditure cuts; (b) increase the efficiency ofpublic investments and public service delivery; (c)strengthen regulation and efficiency of public utilities andsea/air transport; and (d) promote education and skillsdevelopment to prepare the population, notably the poor, totake advantage of new opportunities in the globalenvironment. The report is organized as follows: Chapter 1discusses fiscal sustainability in St. Kitts and Nevis andpresents options for fiscal consolidation; Chapter 2discusses the role of the business cycle in the design offiscal policy by reviewing the cyclical components of thefiscal accounts; Chapter 3 discusses the budget managementsystem in place and its effect on budgetary outcomes;Chapter 4 examines the Public Sector Investment Program;Chapter 5 discusses public sector employment andcompensation; Chapters 6 and 7 examine public expendituresand outcomes in the education and health sectors; andChapter 8, the final chapter, discusses social protection programs.