This overview of the public health situation in the Middle East and North Africa (MENA) region focuses on the health situation in the region; demographic and epidemiological trends; activities already undertaken including assistance to improve the health of the population, identification gaps in current efforts, and the implications for a future regional public health strategy. Significant improvements in health status, morbidity and mortality have been achieved, largely through health services delivery, public health programs and socioeconomic development. Infant mortality rate has declined and life expectancy at birth has increased. Despite significant accomplishments, immense challenges stand in the way of achieving optimal health for all. Infectious diseases remain high while non-communicable diseases, and injuries increase with rapid urbanization and changing lifestyles. In conclusion, it is necessary to develop a national and regional public health infrastructure, that will include: a) training of public health personnel; b) development of public health leadership and the capacity to perform core public health functions of assessment; c) policy development and assurance; d) provision of the necessary resources and infrastructure; e) establishing diseases surveillance and information systems; f) developing partnerships for addressing public health issues; and g) integration of strategies to address public health challenges of common concern.