Renovation of the public health system has been on the international agenda for some years. In the US, the Institute of Medicine released reports during 2003 about the public health workforce required for 21 st century challenges [1], as well as re-visited and updated its landmark report, The Future of Public Health in the 21st Century [2] . In the UK, following the path-breaking review of the NHS by Derek Wanless [3] the Treasury commissioned him, in 2003, to undertake a review of whole-of-government effort in public health. Arising in part from the challenges that confronted Canada during the outbreak of sudden acute respiratory syndrome (SARS) in 2003, a new public health agency, at arms length from government, is being created.