This is a dynamic and challenging time for those working in public health, in global health cooperation, and in tuberculosis control specifically. As a result of commitments to health at the highest political levels, there are unprecedented opportunities for expanding response to disease epidemics and simultaneously improving health systems. These commitments have resulted in innovations in financing streams, public-private partnerships, civil society engagement, frameworks for cooperation, and channels of rapid communication and knowledge-sharing. The rapid scaling-up of HIV, TB, malaria and immunization programmes has reinforced awareness of the well-known weaknesses in health systems and services that require new strategies and new funds in addition to those serving the urgent needs to address priority public health conditions. There is consensus that strengthening health systems is essential if the health Millennium Development Goals (MDGs) are to be achieved and that the Paris Aid Effectiveness Principles provide essential guidance for ensuring that actions are aligned with national priorities and harmonized in practice.