This report describes how the Iraq war and its aftermath continue to have a disastrous impact on the physical and mental health of the Iraqi people, and the urgent measures needed to improve health and health services. It focuses on the many failures of the occupying forces and their governments to protect health, or to facilitate the rebuilding of a health system based on primary health care principles. It assesses the current state of the health system, including the impact of insecurity, and the workforce, supplies, medicines and equipment it lacks. It also looks at health information and health policy. There is a special focus on mental health care, a particularly neglected area. The report ends with conclusions and recommendations, exploring what needs to happen now in Iraq and what lessons can be learned.