The past decade has witnessed unprecedented evels of investment and engagement in global health spurred by the global HIV/AIDS crisis, the development of he Millennium Development Goals, momentum in polio eradication, and global outbreaks of infectious diseases such as SARS with its US$40 billion cost to. society. Characterized by a sense of urgency, pragmatism, and opportunity, global health services and public health systems are being advanced to respond to rapidly expanding demands with dramatic results. However, much more remains to be done. After a decade in emergency mode, the next phase of global health work requires an even more precise approach and smarter investments. Many "donor" nations and organizations have tightened their belts in response to the recent economic downturn, while at the same time increasing the numbers of "recipient" countries, and are now better able to invest more of their own resources to benefit and protect their own citizens. In this climate, global health investments in programs and innovations must be better targeted and better informed by strategic in about disease burdens, at-risk populations, and program effectiveness.