This keynote address opens the Joint 9th WARFS Global Conference and 12th AMNET Conference 2015. Initially a brief history of the WARFS conference, which began in 1999 in Atlanta, is given. Much ground has been covered since that initial conference. There have been many developments and expansion, but at the same time many challenges were unmet and remain as challenges to risk factor surveillance globally. Historically we have focused on the many technical challenges facing surveillance. This presentation will address the structural and theoretical challenges facing risk factor surveillance. The major challenges are: incorporating the social determinants of health perspective into risk factor surveillance; moving away from continuing to collect data on what we already know; and creating the evidence base to evaluate health policies and interventions designed to improve population health. Above all, the underlying assumption of what we do remains important: continuous data collection, analysis and use of surveillance data provides an evidence base for public health interventions.