When there is an outbreak of measles, who decides locally what should be done to tackle it? Who is responsible for infection control in hospitals? Who collects data on assessing the health of children starting school? Who advises local policy-makers on health issues? The work done by the roughly 400 local health authorities in Germany is diverse, essential – and not sufficiently appreciated. ‘Even though the health authorities are a mainstay in protecting the health of the population,’ emphasises Lothar H. Wieler, President of the Robert Koch Institute, on the occasion of “Local Health Authority Day” on 19 March 2019.