This collection is a response to the growing need to reexamine the operations of social security institutions in the Caribbean and covers a number of the issues related to these social security challenges. The issues have been categorized underthe three subject areas of pensions, poverty and health with contributions being drawn from noted practitioners and researchers in the various areas. Although the papers do not all share the same philosophical perspective on social security, they all accept that there is an urgent need for reform. Of note also is that although the papers were put together more than four years ago the issues remain relevanttoday. In fact, it may be argued that the three subject areas identified are even more relevant and in need of urgent attention by both policy makers and researchers now.