This document discusses different approaches to health systems strengthening. It notes that while health systems strengthening is a high priority, there is lack of consensus on its definition and how to implement it. The document explores health systems strengthening as having both conceptual dimensions related to principles and frameworks, as well as operational dimensions regarding coordination and implementation. It also examines the Global Fund's portfolio of health systems strengthening, noting common weaknesses in applications and proposing options to improve access and harmonization of health systems strengthening financing.