As we enter into our 30^th year of operation, we at IntraHealth are reflecting on the evolution of our organization and the role of the wider community of international non-governmental organizations. Now, as funding levels from government and private sector are at all time highs, there is more discourse around the role of international organizations and increasing cynicism about their value—why not just fund local institutions directly? Aren’t such organizations just inefficient bureaucracies with bloated headquarters and high-priced staff? These are critical questions that we all need to be asking ourselves and finding answers that lead to improved ways of doing business. IntraHealth, like many global health organizations that have been in existence for decades, has always held true to the international development foundational principles of local ownership, capacity building of southern institutions and individuals, equal partnership, and mutual respect. We celebrate the increased attention and resources being invested in strong and vibrant southern institutions. We continually strive to invest more and more resources into the countries where we work. At the same time, we strongly believe there is a continued critical role for international organizations – we know how to rapidly mobilize resources toward achieving results, we effectively share best expertise across countries and institutions, we nurture local champions creating environments for them to excel, we form long-standing relationships of trust that facilitate greater and greater levels of engagement and lasting results. In this blog space, I encourage conversation about the role of international organizations, what we could be doing better, what are our biggest challenges.