JALI RESEARCH QUESTIONS

							                                         JALI RESEARCH QUESTIONS
                                               December 9, 2011

In addition to identified priority questions, this document represents an initial brainstorming on
questions that JALI will likely need to answer as it works towards a global health agreement, such as a
Framework Convention on Global Health (FCGH), that is rooted in the right to health, aimed at closing
health inequities, and establishes a post-Millennium Development Goals health agenda. While
extensive, we do not expect that this set of questions is comprehensive. Some additional questions
might be possible to determine now; others may emerge through the research and consultation process
aimed at receiving input to help answer the questions and achieve a level of consensus around proposed
answers.

JALI welcomes feedback on any additional questions or issues that we should be asking and
considering that are not reflected below.

Overarching substantive questions of high priority

1) Health for all: What are the expectations of individual communities vis-à-vis health services and
goods to which everyone is entitled, and how do these relate to JALI’s proposed 3-pronged set of health
goods and services (effective health systems; essential medicines, vaccines and other medical
technologies; fundamental human needs)? How do these expectations translate into a set of national
level priorities and expectations, taking into account the most disadvantaged and least healthy members
of the population? Do these expectations extend beyond what we have defined as fundamental human
needs (i.e., clean drinking water and adequate sanitation, sufficient food and adequate nutrition, vector
control, and tobacco and alcohol reduction) to broader social determinants of health? What is the
estimated cost of such a set of goods and services? How do these expectations compare to health goods
and services in WHO health service costing estimates?1 Are the expectations similar enough that they
can serve as a common basis to translate international health funding responsibilities in specific dollar
terms or their approximate equivalent (e.g., percent of GNI)?

2) National funding targets: What should be the basis of national funding targets? To what degree
should they be tied to or extend beyond the health services and goods to which everyone is entitled?
Should the FCGH have a collective funding target across all relevant sectors (health, water/sanitation,
etc.), and if so, which sectors? Or should the FCGH have specific targets for each sector, and if so,
which sectors take precedence? What are the advantages and disadvantages of each approach? How can
funding targets best be coordinated with processes determining national budgets? How can the targets
be designed to take into account variations among countries as well as within countries? Should the
FCGH include default budget targets, along with stipulations on inclusive national processes for
adapting these targets domestically, to align with national targets and budgets with varying community
and internal regional priorities?

3) International health funding: How should international commitments for financing global health be


1   Taskforce on Innovative Financing for Health Systems Working Group 1, Constraints to Scaling up and Costs: Working
     Group 1 Report (Geneva and Washington, DC: World Health Organization and World Bank, 2009), at 80-81,
     http://www.internationalhealthpartnership.net//CMS_files/documents/working_group_1_report:_constraints_to_scaling_
     up_and_costs_EN.pdf.
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determined? What should be the overall financing goal, and how should it relate to the cost of the
health services and goods to which everyone is entitled? Are community expectations on these health
goods and services similar enough that they can serve as a common basis for determining a set of
health goods and services to be considered in determining overall health funding obligations? If not,
how to account for variations across countries? How should target(s) in the FCGH relate to other
international funding targets (e.g., 0.7% GNI, or a sector-specific target)? How should international
health funding responsibilities be divided among members of the international community? Which
states should have global health financing obligations? How can the funding goal be designed to reflect
changing disease-burdens, priorities, and costs? Are there approaches to ensure adequate funding and
clear division of responsibility at the international level that do not rely on a specific overall financing
goal? Might a process be developed whereby after a certain period of time, an initial goal is replaced
by a bottom-up approach that is based on funding gaps in national health and development strategies
that are designed to universal coverage for health and its underlying determinants?

4) Accountability and compliance: What incentive, accountability, and enforcement mechanisms can
the FCGH include? What accountability mechanisms can be adapted from other areas of international
law (e.g., trade)? What should monitoring and reporting requirements be, and what are the best
models? How can these mechanisms (including sanctions?) encourage countries to comply with their
FCGH obligations without creating a situation where people in countries with the least responsible
governments also receive the least international support? Should the FCGH require countries to
develop national and community accountability mechanisms, and if so, should the FCGH define what
these mechanisms are, or offer several possibilities? How could the FCGH ensure that states keep their
global health financing obligations (both domestic and international), as well as other FCGH
obligations?

What are the health services and goods guaranteed to every human being under the core content
of the right to health?

Defining the health services and goods [see also overarching substantive questions]

      What are the health outcomes that the health services and goods should achieve? For example,
       a certain level of or increase in life expectancy or quality-adjusted life years (QALYs),
       reductions in disability-adjusted life years (DALYs), or levels of or improvements in health
       equity (across and within nations)?
      To what degree of specificity should the FCGH define the health goods and services guaranteed
       to everyone under the right to health? Should the FCGH include specific goods and services,
       common standards for determining these goods and services, or national process for arriving at
       these health goods and services (e.g., by translating broad international standards to the country
       level according to national priorities and the specific needs of each country), or some
       combination?
      Should there be any differences with respect to these health goods and services (or timelines for
       securing them for all people in the country) based on different wealth and development levels of
       countries, and the current health status of their populations? Or should other aspects of the right
       to health – in particular, progressive realization – be the basis for differences in state obligations
       towards their populations to ensure that wealthier countries that are largely already providing
       the health goods and services to be secured for all people expand beyond these goods and
       services?

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      Are there benchmarks for health systems and their components (i.e., human resources for
       health, health services; medicines, vaccines, and medical technologies; health financing; health
       information, and; governance and leadership) that could be used as standards for all health
       systems? If so, what should these be, and how can these be developed in ways that respond to
       local circumstances (e.g., 5 km is very different in a city with paved roads, sidewalks, and
       cheap transportation as compared to over mountainous territory; the number of health worker
       needed varies considerably depending on skills mix, disease burdens, and so forth, and is only
       one dimension of access to health workers, who also require proper skills, supervision, tools,
       and motivation)?
      Are there benchmarks that the FCGH might include for fundamental human needs, such as
       clean drinking water and adequate sanitation, sufficient food and adequate nutrition, vector
       control, and tobacco and alcohol reduction? Or other critical determinants of people’s health,
       such as a clean environment (e.g., indoor and outdoor air pollution levels)? If so, what are they?
      What are the contents and costs of existing essential health packages (or universal health benefit
       packages), and how do these vary according to states’ level of development and burden of
       disease?
      What processes do countries currently use to establish essential health packages (or services to
       be covered by national health insurance schemes)? What are the technical, participatory, and
       political bases for these decisions?
      What underlying determinants of health, and other social-economic determinants of health (e.g.,
       education, employment, violence against women and degree of women’s empowerment, social
       status), should the FCGH address? Should some be included in the health goods and services
       guaranteed for everyone, and others addressed in other ways? How?

Beyond the core content

      To what degree should the FCGH seek to further operationalize elements of the right to health
       that are particularly relevant to the level of health goods and services a country has an
       obligation to provide? Among issues to consider would be appropriate metrics for progressive
       realization, determining maximum available financial (including international sources of
       funding) and other resources, and implementing core obligations of the right to health. What
       have human rights scholars, UN special rapporteurs, the Committee on Economic, Social and
       Cultural Rights, and domestic courts said about measuring and operationalizing these elements?

What is the responsibility that all states have for the health of their own populations?

National funding responsibilities [see also overarching substantive questions]

      What factors go into defining the level and nature of health services and goods that states are
       responsible for funding for their entire populations (e.g., health needs-based, epidemiological
       trends and national/global burden of disease considerations, cost of providing essential health
       goods and services, availability of resources)? Which underlying determinants of health should
       these funding responsibilities include? Should there be any variation by country in terms of
       approaches to defining these responsibilities or to the underlying determinants of health that
       they cover? If so, how would the FCGH address this variation?

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      How should domestic health funding targets be defined (e.g., percentage health sector spending,
       funding levels need to achieve specific health outcomes or provide certain goods and services)?
       How should overall economic strength (e.g., GNI) and capacity for generating additional
       revenue (such as through domestic financing mechanisms; see below) be incorporated into
       determining these targets and resource availability?
      What are the rationales behind existing targets for health, agricultural development, etc. (e.g.,
       Abuja Declaration, Maputo declaration on agriculture and food security in Africa)? How sound
       are these rationales as possible rationales for FCGH targets?
      What are legitimate reasons for which countries might deviate from (not meet) funding
       benchmarks?
      How (and how much) do macroeconomic (or other economic, e.g., trade regime) policies
       constrain national health spending, or otherwise impeding health, in developing countries? In
       practice, what control do developing countries (and other countries seeking support from
       international financing institutions, such as a result of the present financial crisis) themselves
       (as opposed to international institutions) have over these policies?
      What factors account for developing countries reducing domestic spending in response to
       increasing international health assistance? To what sectors and purposes are these domestic
       resources diverted? Are these other sectors and purposes promoting health? Human
       development more broadly?
      Should the FCGH promote strengthened national tax systems and innovative domestic
       financing mechanisms and (e.g., taxes on tobacco and unhealthy foods, dedicated taxes for
       health financing, methods to capture capital flight, improved tax collection)? If so, what
       mechanisms and how should the FCGH support them?
      To what extent should the FCGH address how funding should be used (including to build
       capacity [professional education, research capacity, leadership, etc.]), as opposed to assuming
       this is covered in national health strategies, and not specifying funding uses? If the FCGH
       addresses responsibilities for building national capacity, how should it do so? Should it suggest
       or direct that funding should be used for capacity building (or other areas beyond universal
       health coverage)? If so, what specifically? Should it outline broad areas of capacity building
       (and other uses of health spending) that should be included in national health strategies, but not
       provide further directives?

Governance

      Are there specific targets, principles, or strategies related to health equity within countries that a
       global treaty can promote or require? If so, what?
      What is the role of an FCGH in encouraging collaboration within countries among different
       sectors (e.g., health, education, finance, agriculture, etc.) and stakeholders (e.g., government,
       civil society, communities, etc.)?
      What targets, principles, or strategies could the FCGH promote or require to ensure community
       and civil society participation in developing, implementing, and monitoring and evaluating
       national and sub-national health-related plans and policies?
      What are best practices in transparency that the FCGH could incorporate (e.g., requiring health
       [and other] ministries to make public officials’ private assets and use transparent, competitive
       bidding processes)?
      Should the FCGH include governance reforms beyond the health sector, as these might still
                                                     4
           affect health (e.g., independent anti-corruption commission, transparency in health-related
           sectors)?

What is the responsibility of all countries to ensure the health of the world's population?

Funding [see also overarching substantive questions]

          Should the FCGH have a specific international health assistance funding target? If so, what
           should it be? What sectors should it cover?
          How would it relate to the long-standing 0.7% GNI commitment of “economically advanced
           countries” and any other existing commitments (what are other commitments?)?
          Should the FCGH have uniform international funding targets or another approach to burden-
           sharing (e.g., specifically agreed figures that vary by country income-level and are included in
           an annex or protocol to the treaty)? Should the FCGH have different responsibilities for OECD
           member and emerging economic powers, and if so, how would the responsibilities differ? Or
           should all countries have international funding responsibilities, where the level of responsibility
           for poorer countries is miniscule compared to the funding that they would receive under the
           treaty?
          What incentive, enforcement, and accountability mechanisms could the FCGH include to
           ensure sustainable, predictable international funding? How might a possible Global Fund for
           Health enhance this sustainability and predictability?
          What are the most politically effective arguments why wealthier countries should accept their
           responsibilities with respect to global health, including through increased and longer term
           health assistance?

Non-Funding

          What responsibilities attach to global health funding (e.g., participation, equity, accountability),2
           and how could the FCGH help operationalize these responsibilities?
          What additional principles might come into play vis-à-vis funding (e.g., harmonization and
           alignment), and how prescriptive should the FCGH be in operationalizing them?
          What are global health responsibilities of even the least wealthy countries? What obligations
           currently exist in international law (e.g., the International Health Regulations), and how should
           the FCGH relate to these obligations? Are there existing non-binding obligations (e.g., in codes
           of practice) that the FCGH should incorporate? Should there be additional responsibilities?
          What is the responsibility of countries, particularly developed countries, to ensure that the
           policies of international financial institutions, global trade regimes, and other non-health
           focused international regimes accord with the right to health? How could the FCGH ensure that
           they do so?
          What responsibilities do countries have to prevent other transnational activities from harming
           health abroad, including international health worker recruitment and transnational pollution?
           What are existing responsibilities in these areas (e.g., the Global Code of Conduct on the
           International Recruitment of Health Personnel), what could the FCGH add to them, and should


2
    See Maastricht Principles on Extraterritorial Obligations of States in the area of Economic, Social and Cultural Rights,
      adopted in Maastricht, Netherlands, September 28, 2011, at para. 32, http://www.maastrichtuniversity.nl/humanrights.
                                                                5
       it make any non-binding responsibilities obligatory?
      What measures could the FCGH take to ensure that policy-making in non-health spheres duly
       considers and does not negatively impact on the right to health and state obligations under the
       right?
      Should there be particular regional responsibilities, whether funding or non-funding? What
       regional responsibilities and mechanisms can enhance regional health solidarity for reducing
       inequities within regions?

What kind of global governance for health mechanisms are required to ensure that and enable all
states to live up to their mutual responsibilities to provide health-related goods and services to all
human beings?

Targets and timelines [see also overarching substantive questions]

      What are appropriate targets (e.g., funding levels, gains in health equity, improvements in health
       indicators), benchmarks, and timeframes for achieving them? What are appropriate indicators?
      Should targets be defined in the FCGH itself or in protocols? What is the appropriate level of
       specificity for these targets and timelines at the international level? Should the FCGH outline
       broad standards, which are then further developed at regional or national level? Should the
       FCGH outline these processes (e.g., inclusive, participatory), and if so, and what level of detail?
       Might there be a mix of specific global, regional and national targets?
      How should target dates be structured? Should there be a common set of timeframes for
       different groups of countries, or should there be ambitious yet achievable timelines that differ
       for each country, developed nationally through participatory processes? Should there be
       different timelines, too, for different elements of universal health coverage, or for different parts
       of the country (as it might be feasible to achieve universal health coverage faster in some areas
       than rural – though would this have negatively equity implications, if this leads to longer
       timelines for rural areas?)? Should there be a process to revise timelines based on the level of
       progress, or would that undermine accountability? How prescriptive should the FCGH be with
       respect to these questions, or should it largely leave it to country processes?

Financing mechanisms

      What approaches to channeling global health resources to countries would be the most
       effective, equitable, and efficient for involving communities and civil society and achieving
       accountability? For example, a Global Fund for Health (that operates similarly to the Global
       Fund for AIDS, TB and Malaria), or direct support to countries through sector wide approaches
       (SWAps), or a combination of approaches? What criteria can be used to measure and compare
       these (and other?) approaches?
      If there is a Global Fund for Health, what governance structures should it have? What is and is
       not working for the Global Fund to Fight AIDS, Tuberculosis and Malaria that could inform a
       Global Fund for Health? How should the cancellation of Round 11 of the GFATM affect
       thinking about a Global Fund for Health?
      How can international health financing best complement national health financing schemes to
       maximize coverage and equity?
      Are there measures (besides those addressing transparency and accountability, discussed
       elsewhere) that the FCGH could include to increase the efficiency of health spending (to
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       achieve improved health services and outcomes for equivalent amounts of health funding)?
      What should be the role, if any, of disease-focused (vertical) funding streams in a revised global
       governance for health?
      What are the best ways to ensure the effective, efficient, and accountable use of international
       health funding (e.g., anti-corruption policies, reporting requirements)? How should these
       requirements be designed (e.g., to have effective reporting without overburdening countries
       with reporting requirements, and developing processes to ensure that where problems are
       identified, countries and other partners take necessary steps to address them)?
      What conditions (if any?) should be attached to international health funding (requirements
       related to countries receiving this funding)? Conversely, what measures can countries take to
       ensure that global health funding is aligned with their own strategies and priorities, and how can
       the FCGH support these measures?

Accountability [see also overarching substantive questions]

      What are the best strategies to monitor compliance with the FCGH? What besides state
       reporting on compliance? How can and should civil society be involved in monitoring
       compliance? What about other independent monitors? Is there any support the FCGH can or
       should provide to the media in monitoring FCGH compliance? How might information
       technology be used to ensure honest reporting? For more difficult to measure aspects of the
       treaty, are there more qualitative approaches that can be used to monitor compliance? What role
       should WHO or other international (or independent) institutions have in monitoring
       compliance?
      What incentives and sanctions might the FCGH include to encourage countries to keep their
       funding and other commitments to their own populations? For example, should certain global
       funds, or how they are delivered, be contingent on governments meeting their own
       commitments? If so, how can such approaches be designed to avoid harming the very people
       that global health funding is supposed to help?
      What are incentives or sanctions that could be aimed primarily at wealthy countries to ensure
       that they meet their funding commitments?
      To encourage compliance with the FCGH, could the treaty encourage or require states parties to
       grant national courts jurisdiction to hear cases brought by their populations involving FCGH
       violations? What are other incentives or sanctions? Is one possibility worth considering
       suspension of eligibility for WHO Executive Board membership or of other WHO rights? What
       about incentives or sanctions that go beyond the health sector
      What existing or proposed innovative financing mechanisms for health can the FCGH advance
       or institute? What level of funding would these mechanisms likely raise, and how might they
       impact traditional government assistance? How can these be designed to ensure that they do not
       compete with other international funding needs related to global social justice (e.g., climate
       change mitigation and adaptation measures)?
      What role should private financing (including from individual charitable giving, corporate
       charitable giving, foundations, and investors) have in meeting global health funding needs, and
       how might an FCGH address this? Are there any innovative financing approaches for health that
       would give a financial return on investments, thus encouraging health investments? Would these
       raise ethical and human rights, or other, concerns?
      What role, if any, would direct budget support have in revised global health structures?

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   What structures and safeguards can be developed or strengthened to ensure the long-term
    reliability of international health financing that gives states justified confidence in making and
    implementing long-term health plans? Should the FCGH establish a global health trust fund (or
    other such mechanism), to be used to compensate for unmet commitments? How would this be
    structured, and could it be designed and financed in a way that does not reduce the availability
    of funds for current health needs? Should the FCGH include a strategy to collectively
    compensate for funding shortfalls from other parties to the FCGH, and if so, how might such a
    compensatory mechanism be designed?
   What structures will ensure that an FCGH that enables countries to receive more international
    health financing nevertheless enhances, and does not risk undermining, the accountability of
    governments to their own people?

Global health actors

   Does the FCGH have a role in ensuring funding for health-related international actors (e.g.,
    UNICEF)?
   What is needed for WHO to achieve its constitutional role as the coordinating authority on
    international health work? What role should the FCGH have in supporting WHO, including
    with respect to its funding?
   How could the FCGH exert control over multi-national corporations (and other non-state
    actors)? What regulatory mechanisms should states employ? What are ways to increase the
    accountability and transparency of multi-national corporations (e.g., Access to Medicine
    Initiative) that the FCGH might incorporate?

Civil society and community-based accountability mechanisms

   How can the FCGH strengthen grassroots organizations, including by ensuring that they are
    able to access international health funds? What forms of accountability should exist for these
    funds?
   How can the FCGH support community-based accountability strategies (e.g., community
    scorecards, village health committees?)? What are the most effective strategies? Should the
    FCGH require countries to develop national strategies for supporting community-based
    accountability mechanisms?
   What are the national and international roles in building the capacity for and providing
    oversight to community-based health accountability mechanisms? Do such mechanisms need
    any (national?) strategies for their own accountability to their communities, and if so, what role
    (if any) should an FCGH have?
   How should the FCGH promote capacity building for civil society organizations and for
    government officials and institutions?

Global health coordination and prioritization

   How (including through what legal means) can an FCGH effectively prioritize health and the
    right to health in other international legal regimes that could come into conflict with health,
    such as trade and intellectual property?
   What are the main obstacles to global health coordination? What are the most effective ways to

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       improve global health coordination, cooperation, and collaboration, and how could these be
       incorporated into the FCGH?
      What are specific ways that an FCGH might directly affect other international legal regimes
       (e.g., informing adaptation measures that will reduce the health impact of climate change,
       ensuring that intellectual property agreements and laws do not interfere with public health [such
       as agreement on ensuring TRIPS/Doha Declaration flexibilities in bilateral and regional
       agreements?], and regulating “land grabs” [the large-scale foreign purchase of land in
       developing countries, which can threaten food security])?
      Should the FCGH regulate food production and processing, or other factors that affect non-
       communicable diseases (NCDs)? What elements of the Political Declaration on NCDs
       (http://www.un.org/ga/search/view_doc.asp?symbol=A/66/L.1) should an FCGH incorporate or
       build upon?

   Additional governance considerations

      What are shared global health priorities that the FCGH should promote, and how should it
       promote them? How would this relate to national priorities, and processes for determining
       them?
      What are new and emerging mechanisms and models through which the FCGH could address
       innovation, access to medical products, access to knowledge and information, etc.?
      Should the FCGH address equitable distribution of vaccines and medicines in the face of a
       public health emergencies, etc.? If so, how should it build upon the Pandemic Influenza
       Preparedness Framework for the Sharing of Influenza Viruses and Access to Vaccines and Other
       Benefits?

Cross-cutting issues

      Would an effective way to organize part of the FCGH be to explicitly address how different
       aspects of the right to health -- and actions to fulfill them -- are implicated at different levels
       (community, national, international), for example, through separate sections that address
       participation at these three levels, accountability at these three levels, equity at these three
       levels, and so forth?
      What requirements should the FCGH include to make it most effective in improving the health
       of women and girls? What strategies can the FCGH draw on from existing national efforts in
       this regard, as well as international strategies, including the Global Fund’s Gender Equality
       Strategy
       (http://www.theglobalfund.org/documents/core/strategies/Core_GenderEquality_Strategy_en/),
       the Global Health Initiative’s Guidance on Women, Girls, and Gender Equality Principle
       (http://www.ghi.gov/documents/organization/162100.pdf), and the WHO’s report on women's
       health (http://www.who.int/gender/documents/9789241563857/en/index.html)? Including to
       address the ways in which men’s health can positively (e.g., HIV prevention) and negatively
       (e.g., alcoholism) affect the health of women? Addressing violence against women?
      What special measures should governments take to ensure the right to health of marginalized
       and vulnerable populations, and how should the FCGH incorporate these measures? Given the
       fact of marginalization, are particular accountability and enforcement mechanisms needed for
       such measures? Or incentives for governments to give higher priority to these populations?
       Should the FCGH address discrimination against marginalized populations that affects health
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       but is rooted in laws and practices outside the health sector (e.g., criminalization of homosexual
       acts)?
      To what degree should the FCGH specify marginalized populations that require special
       measures (e.g., prioritized outreach, participation), and to what degree should this be left
       entirely for countries to determine? Should the FCGH include a minimum set of populations to
       be considered with respect to any treaty stipulations on marginalized populations, and if so,
       which groups? What are such groups presently included in international instruments (e.g.,
       international declarations on HIV/AIDS)? Should the FCGH establish or provide guidelines for
       a national process to identify these groups? Or should the FCGH simply refer to such groups in
       broad terms (e.g., disadvantaged, marginalized, and vulnerable populations), without further
       specification? Or does this approach pose the risk that certain marginalized or disfavored
       groups would be left out from national definitions and measures to support (and reduce
       discrimination against and other mistreatment of) these populations?
      Are special FCGH provisions required to address non-citizens including refugees, internally
       displaced people, stateless people, non-citizen permanent residents, non-citizen temporary
       residents (including migratory/foreign workers), and undocumented immigrants? If so, what
       provisions?
      Are special FCGH provisions required to address mental health and the rights and needs of
       people with physical and mental disabilities? Should the FCGH require that national health
       strategies address physical and mental disabilities, and measures to increase access of people
       with disabilities to health services? Are there areas in the Convention on the Rights of Persons
       with Disabilities that the FCGH could build upon?
      What special provisions will be needed to ensure essential health services for people who live in
       conflict areas over which the state lacks authority, as well as in post-conflict states? What about
       states experiencing other political, social, or economic change or upheaval that disrupts health
       and social systems?
      Should an FCGH address specific right to health responsibilities during natural disasters and
       other humanitarian crises?
      How should an FCGH address factors outside the health sector and other sectors directly related
       to fundamental human needs yet significantly impact health (such as infrastructure, e.g., rural
       roads)? If so, how?
      Should the FCGH address the important emerging role of health information and
       communications technology, such as for e-health (e.g., electronic medical records, distance
       learning, telemedicine, collecting and sharing health data and other information, making more
       health information directly to patients) and for accountability purposes? If so, how?
      Does the FCGH have any role in addressing health research? If so, how? Should it address
       specific categories of research required (e.g., tuberculosis, need for new antibiotics)?
      Are there additional issues not adequately covered above that the FCGH should address (e.g.,
       safe health care and patient safety, access to quality health information for individuals and
       health workers), and if so, how?

Lessons from previous experiences and approaches

      What lessons and knowledge can be gained from the AIDS movements and its success?
      Why have previous efforts to mobilize a global health movement not been more successful?
      What developing countries are most effectively providing universal health coverage and what

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    lessons can be learned from their experiences?
   What factors have led some countries to achieve the Abuja target of countries spending at least
    15% of their government budgets on the health sector?
   What factors have enabled countries with consistently high levels of global health investments
    to maintain such investments? How are financing trends being affected by the economic
    downturn?
   What approaches of the Commission on Information and Accountability for Women’s and
    Children’s Health and its accountability framework
    (http://www.everywomaneverychild.org/images/content/files/accountability_commission/final_
    report/Final_EN_Web.pdf) could be adapted to use in the FCGH?
   What has been the experience of IHP+ of trying to improve coordination and country-led
    approaches, and what can be learned of its successes and shortcomings?
   What role might the Joint Assessment of National Strategies (JANS) or comparable process
    have in future global health governance structures?




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