Since the World Health Organization (WHO) was founded in 1948, the development of many new institutions in the field challenges its original vision as the 'directing and coordinating body on international health work'.
WHO evolved from a body principally aimed at the control of infectious diseases to a more holistic approach to the improvement of health characterized in the 1970s by the slogan 'Health for All'.
The entry of the World Bank as a major health funder in the 1980s and a proponent of market-based health policies challenged WHO's pre-eminent position in the field.
Under Director-General Dr Gro Harlem Brundtland in the 1990s a serious attempt was made to refocus WHO and raise its status as a player in the development policy arena, but with mixed success and limited sustainability.
More recently WHO's chronic financial problems, characterized by excessive dependence on voluntary short-term funding by donors, have precipitated another round of reform.
The question is whether WHO member states and its secretariat are asking sufficiently searching questions about WHO's place in the international system and what might need to be done to put its future on a more secure footing.
This is the first paper in a series related to the Centre on Global Health Security Working Groups, which are aimed at improving global health security.