The point made on on the "link between allocation of funds to results (Bank and own country funding) and the need to help poor countries strengthen their health systems to make sure they maximize the impact of their own resources and aid" is a critical one. As the lessons learned from different sectoral initiatives around the world indicate, focusing only on interventions alone will not suffice. Implementing effective result-based approaches that are sustainable indeed require institutions and institutional strengthening initiatives that are properly sequenced and adjusted to the absorptive and learning capacity of the countries. And the third point, is right on the mark. Perhaps we need to adopt a more balance approach to health challenges: while supporting reforms in the "health services for the sick" we also need to pay attention (I would say added attention) to addressing the determinants of poor health outcomes--this would require a multisectoral response. Quoting the classics: "Healthy people don't need a doctor--sick people do." Luke 5:31, New Testament Gospels.