Problems facing Tonga's health care system intensified in the 1990s leading eventually to a decision by the government to address the "core problem", the Ministry of Health's planning, management, and coordination capacity. This case explores how attempts to enhance Ministry's organizational capacity, and improve its organizational culture, were aided by: consistent and strategic leadership and political support, participatory approaches, a clear sense of the capacity challenges, and the facilitative role played by the Australian Agency for International Development (AusAID). The paper describes it as a process of "developing Tongan solutions to Tongan problems".