The current performance of organic farms in relation to animal health often does not surpass the level of conventional production and does not always meet the self-proclaimed aims and the expectations of the consumers. Taking into consideration the specific characteristics of multi-factorial diseases and the need for appropriate living conditions, the question arises which obstacles are decisive for the current situation and need to be changed in order to improve animal health status. \ud Taking the system approach of organic farming into account, several theses in relation to the most relevant obstacles are discussed. Obstacles seem to be evident in relation to deficits concerning the perception of health problems, lack of a clear goal in relation to the acceptable animal health status, lack of resources and limitations to think through the complexity of the processes within the farm system. It is concluded that there seems to be no realistic chance to improve animal health status in organic farms without a change in paradigm from a standard to an output oriented approach. Simul-taneously, efforts and success in health management have to be honoured by pre-mium prices. \u
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