LETTER TO THE EDITOR A reply to Rose n

Professor Rose n has raised some extremely important issues. We strongly agree with him that policies to improve the performance of health systems need to be more ® rmly based on evidence than has been the case in the past, and that work to measure the extent to which systems are achieving the desired outcomes should continue and progress. This will require continued debate about the goals to which health systems contribute, indicators to measure them, and data collection strategies and methods to evaluate how well resources invested in health systems are contributing to these critical social goals. It is our fervent hope that this debate will lead to better indicators and data sources, and encourage countries to routinely collect and report data relatin