Fundamental characteristics of healthcare, including approaches to priority-setting, culture, traditions of professional practice, leadership styles, and accountability mechanisms mean that many deep-seated causes of unsafe care have proved intractable to transformation. The wisdom and experience of patients and families that have suffered harm is enormous and should be better harnessed. The World Health Organization has led a diverse range of global action on patient safety over two decades. This has been highly successful in promoting interest, understanding, and commitment as well as driving specific programmes of action throughout the world. The organisation has also played a powerful convening role in bringing experts, organisations, and countries together to discuss and plan initiatives. This focus must be maintained in the face of slow and inconsistent improvement.