The Alliance Lift is a series that spotlights the journeys of Alliance alumni shaping health systems around the globe. In this episode, Dr Kumanan Rasanathan, Executive Director of the Alliance for Health Policy and Systems Research, speaks with Dr Keith Cloete, Head of Health for the Western Cape Government in South Africa.Recorded following the recent Alliance Policy-maker Forum in Cape Town, the conversation reflects on lessons from the Western Cape health system, where policy-makers from around the world explored how leadership, research partnerships and systems thinking shape performance.A physician with more than three decades in public service, Dr Cloete shares how his experiences – from frontline clinical care to system leadership – have shaped his approach to building a learning health system.Together, they discuss relational leadership, system-wide and system-deep approaches and what it takes to lead health systems through crisis and change.