For Public Health approaches to have strategic impact, a vigorous and systemic approach is critically needed. This paper addresses three component parts, essential to achieving health system change. First, it paints a picture of the current approach in many Ministries of Health, with their strife of interests. Second, it distinguishes the elements of a health system, all of which need to be targeted and synergy achieved for effecting health system development. Third, it proposes additional competencies that Public Health experts need if they are to leaf and contribute to needed health system change for achieving the promise of Public Health's potential. [To view this article, please download the PDF.]