We are at an unprecedented moment in history in terms of the health of populations around the world. New and old problems all require both short- and long-term solutions, at the individual, community, national and global levels. Unique solutions for each challenge may not be feasible or adequately effective or cost-effective. We are confronted by health systems that are not well matched to current and future needs, both for sustained prevention and chronic care. Moving forward effectively as a field will benefit from a focus on the changing needs of global health, and on how changing conditions, globally, should define the next generation of public health leadership so as to best accomplish global health goals.