The most radical evolution of the role of the state (and the government as its executive branch) in promoting and securing public health happened after the Second World War, and can be divided into three broad stages: the 1950s and 1960s; the 1970s and 1980s; and the 1990s to the present. Such evolution has occurred along the following three dimensions. First, views on the responsibility of the state for ensuring public health have evolved and have been, and continue to be, heavily contested. Second, the way governments have intervened in public health has also changed as has the mixture of tools at their disposal. Third, the process of making public health policies, the number and identity of actors and the arenas for policy making have evolved. In this more complex scenario, governments are developing new approaches to the governance of public health and adopting new strategies for improving public health policy making.