Health Systems Strengthening (HSS) has been at the core of the U.S. Agency for International Development’s (USAID’s) mission in health for the last 20 years. Governments and donors acknowledge USAID as a valued partner in HSS because of our contributions of critical resources, technical expertise, leadership, and in-country presence. Many actors – development partners, non-governmental organizations, other civil society organizations, and public-private partnerships – increasingly are targeting their substantial resources to HSS. USAID must continue to adapt to today’s rapidly changing environment to meet HSS needs. Traditionally, USAID’s HSS efforts have been incorporated into our specifi c disease programs for such health challenges as HIV and AIDs, tuberculosis, and malaria. To elevate this work, USAID now issues this, our first-ever HSS vision statement – USAID’s Vision for Health Systems Strengthening (hereafter referred to as the Vision) – for focusing all USAID’s HSS work to achieve four strategic outcomes: financial protection, essential services, population coverage, and responsiveness. With this new Vision, USAID focuses its approach to spearhead concrete, integrated programs and projects for HSS that will help the Agency meet its goals for ending preventable child and maternal deaths (EPCMD), achieving an AIDS-free generation, and protecting communities from infectious diseases (PCID), including the Global Health Security Agenda (GHSA). The GHSA is a multi-sector, international initiative, designed to accelerate action and help build health system capacity to prevent, detect, and respond to infectious diseases. USAID is part of the U.S. Government interagency team for GHSA, and USAID’s goal of PCID and HSS efforts contribute to achievement of GHSA objectives.