A well functioning health system responds in a balanced way to a population’s needs and expectations by:
ƒ improving the health status of individuals, families and communities
ƒ defending the population against what threatens its health
ƒ protecting people against the financial consequences of ill-health
ƒ providing equitable access to people-centred care
ƒ making it possible for people to participate in decisions affecting their health and health system.
Without strong policies and leadership, health systems do not spontaneously provide balanced responses
to these challenges, nor do they make the most efficient use of their resources. As most health leaders
know, health systems are subject to powerful forces and influences that often override rational policy
making. These forces include disproportionate focus on specialist curative care, fragmentation in a
multiplicity of competing programs, projects and institutions, and the pervasive commercialization of health
care delivery in poorly regulated systems. Keeping health systems on track requires a strong sense of
direction, and coherent investment in the various building blocks of the health system, so as to provide the
kind of services that produce results.