Dr. Jennifer Hatfield is the Associate Dean of Global Health and International Partnerships at the Cumming School of Medicine, University of Calgary. She's has been my mentor for about six years, someone whose approach to relationship-building is unparalleled. When I made the pitch, her face pinched a bit. She explained to me that there is no need to describe the aid that "isn't working", that I was simplifying the story too much. In fact, the Canadian government's investment in Tanzania, where we had visited together a few times, is primary in health systems! But she agreed there is a lack of balance in investments in vertical and in horizontal approaches. The argument is that we need "more", rather than "or". So back to the keyboard.