The Republic of Seychelles in the Indian Ocean has developed rapidly over the last 30 years, partly due to booming tourism. GDP per capita increased in real terms from $2927 in 1980 to $5731 in 1999. In that time, infectious diseases have been tamed and infant mortality has dropped from 50 to 10 per 1000 live births. As a result, the absolute number of people in their 30s and 40s has doubled over the last 20 years. What challenges does this present for health services?