The document discusses different approaches to course design for English for Specific Purposes (ESP) programs. It describes three main approaches: language-centered, skills-centered, and learning-centered. The learning-centered approach is presented as the most comprehensive because it considers the learner at every stage of the design process, including needs analysis, syllabus and materials development, methodology, and evaluation. It emphasizes that course design should be a negotiated and dynamic process that adapts to learners' needs and changing resources over time.