Here’s a paradox. Ministers of health are the government ministers most concerned with health. Yet their prime responsibility is for health services, not with key determinants of health that lie outside the health care system. The paradox extends to the World Health Organization (WHO). WHO is governed by ministers of health yet its remit is to improve health in the populations it serves. Such improvement requires universal health coverage, of course, but much more besides improvement in the conditions in which people are born, grow, live, work and age – the social determinants of health (1).