Xavier de Béthune has worked during 20 years for different organisations in Africa and at the Institute of Tropical Medicine in Antwerp. After obtaining his MPH degree at the Harvard School of Public Health, he participated in projects that promoted health districts as the main unit of health systems and collaborated with the teams launching the Bamako Initiative in West-Africa. He spent the next 15 years in a Belgian hospital network, focused on the quality of care and patient safety. During the last years, Xavier was medical director at Médecins du Monde in Brussels and interim coordinator of Be-cause health. He is now retired, but remains active in different fora concerned with development and health (care).