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Indeed Martin. New medical and public health education paradigms and curricula rooted on evidence are needed along with the careful crafting of strategies adapted to local realities to ensure buy-in, acceptability and engagement on the part of policy makers, faculty and service providers. The good news is that there is a tangible yearning for new knowledge and skills among current medical staff, public health practitioners, and students that offers a good entry point for the international community to support well-planned, systematic changes over time. But as you say we have to be realistic and not to expect that change will occur overnight.