Policy Forum The Global Health System: Strengthening National Health Systems as the Next Step for Global Progress

This is the second in a series of four articles that highlight the changing nature of global health institutions. Three circumstances make the present moment unique for global health. First, health has been increasingly recognized as a key element of sustainable economic development [1], global security, effective governance, and human rights promotion [2]. Second, due to the growing perceived importance of health, unprecedented— albeit still insufficient—sums of funds are flowing into this sector [3]. Third, there is a burst of new initiatives coming forth to strengthen national health systems as the core of the global health system and a fundamental strategy to achieve the health-related Millennium Development Goals. In order to realize the opportunities offered by the conjunction of these unique circumstances, it is essential to have a clear conception of national health systems that may guide further progress in global health. To that effect, the first part of this Policy Forum examines some common miscon-ceptions about health systems. Part two explains a framework to better understand this complex field. Finally, I offer a list of suggestions on how to improve national health system performance and what role global actors can play