This chapter concludes the analysis in this book with an agenda for moving the region forward, drawing on the discussions of preceding chapters and the accompanying empirical analyses. While a survey of current policies through the Caribbean suggests that there is plenty of work yet to do on the fiscal sustainability agenda, the lack of an economic recovery in the presence of high debt for many countries calls for action. While each country will need to tailor its specific strategy, we outline below some key elements that should be part of any medium-term framework that countries in the region may consider adopting. Already, some countries are responding to the need for action by independently selecting some elements of the menu proposed in this book and putting them in place to meet their debt reduction targets. These include some difficult and complex new institutional arrangements, such as Jamaica’s proposals for implementing a new fiscal rule.