Odier challenges arise from the specific way the country's health system and its institutions were reorganised in 1993 and the subsequent adjustments made since then. To name but a few, improvements in health care access and outcomes have not been equally distributed across geographic regions and socio-economic groups, and the envisaged model of managed competition between payers has not much materialised in practice, creating weak incentives for care qualify enhancing activities at the provider level. Specifically, a set of policy strategies is presented, based on the experience of other countries that have faced similar challenges to Colombia.