Maximizing Public Health Impact: The Strategic Advantages of National Public Health Institutes in Countries with Existing Ministries of Health

The COVID-19 pandemic highlighted the need for resilient public health systems capable of managing both emergencies and ongoing health challenges. While Ministries of Health (MoHs) serve as primary stewards of national health systems, their ability to deliver essential public health functions is often limited by broad mandates and resource constraints. National Public Health Institutes (NPHIs) have emerged in many countries to provide technical expertise, coordination, and operational support. However, the extent to which NPHIs complement or enhance the functions of MoHs remains under exploration. This comparative case study examines the roles of MoHs and NPHIs across six countries with varying income levels, governance structures, and fragility contexts. We drew data from academic and gray literature, including government documents, institutional reports, and internal case studies. Using an analytical framework encompassing organizational mandates, delivery of essential public health functions, and emergency preparedness and response capacities, we assessed the contributions and complementarities of MoHs and NPHIs. We found that NPHIs offer four key advantages in countries with established MoHs: (1) strengthening public health operations; (2) enhancing technical expertise and capacity building; (3) advancing research and innovation; and (4) aligning national efforts with global health agendas. NPHIs often serve as the operational arms of public health systems—leading surveillance, workforce training, and outbreak response—allowing MoHs to focus on policy development and governance. These findings emphasize the value of strengthening institutional arrangements between MoHs and NPHIs to build more adaptive, evidence-driven public health systems capable of meeting future health challenges.