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

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 misconceptions 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.