<div class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><span style="FONT-SIZE: 16pt; FONT-FAMILY: TimesNewRomanPS-BoldMT; mso-bidi-font-family: TimesNewRomanPS-BoldMT"><font face="Times New Roman"></font></span></b> </div>
<div class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><span style="FONT-SIZE: 16pt; FONT-FAMILY: TimesNewRomanPS-BoldMT; mso-bidi-font-family: TimesNewRomanPS-BoldMT"><font face="Times New Roman">Setting a Developing Country Agenda for Global Health.</font></span></b></div>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><span style="FONT-SIZE: 8pt; FONT-FAMILY: TimesNewRomanPS-BoldMT; mso-bidi-font-family: TimesNewRomanPS-BoldMT"><font face="Times New Roman">(excerpts)</font></span></b></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman"> </font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman">[In May 2008, the Global Economic Governance Program of Oxford University brought together a group of current and former health ministers and senior health officials from developing countries to discuss gaps and challenges they face in dealing with current global health financing and governance arrangements. This short report summarizes key points emerging from the meeting.</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman">Over the course of the meeting, participants voiced their frustrations with the current state of health assistance. Already, within countries health policy-makers face strong incentives to prioritize clinical care and infectious diseases and to under-fund prevention and wider inter-sectoral health issues such as access for the poor to health services and maternal mortality. Crucially, national health strategies need to aim at stronger health systems.<span style="mso-spacerun: yes"> </span>However, far from helping to correct this imbalance, at present, donors are exacerbating and magnifying it].</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><i><span style="FONT-FAMILY: TimesNewRomanPS-BoldItalicMT; mso-bidi-font-family: TimesNewRomanPS-BoldItalicMT"><font face="Times New Roman" size="3"> </font></span></i></b></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><i><span style="FONT-FAMILY: TimesNewRomanPS-BoldItalicMT; mso-bidi-font-family: TimesNewRomanPS-BoldItalicMT"><font size="3"><font face="Times New Roman">1. Too many new initiatives: donors need to learn to `stay the course':</font></font></span></i></b></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">At the international level, a constant deluge of new initiatives, focusing on specific diseases or issues makes it extremely difficult for governments to develop and implement sound national health plans for their countries. "C</font></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">ountries are being jostled from one initiative to another. We need to reverse the situation. It is the moral duty of international community to accept developing country leadership". </span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Donors shift attention from one issue to the next without working to build capacity or 'stay the course.' Too often donors want to 'plant their flag' and take credit for</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">moving health forward. Often the same countries are involved in several such initiatives at any one time.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><i><span style="FONT-FAMILY: TimesNewRomanPS-ItalicMT; mso-bidi-font-family: TimesNewRomanPS-ItalicMT"><font size="3"><font face="Times New Roman">Solutions?</font></font></span></i></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">Containing donors' enthusiasm for launching new initiatives is difficult, but a few donors – the Gates Foundation and the Global Fund were mentioned – are beginning to recognize the need to support underlying health systems. In the face of powerful incentives for donors to pursue vertical strategies, one suggestion made was: "</font></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">A step forward would be for a percentage of all donor funds going into initiatives, especially vertical program, to be earmarked for health systems development".</span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Another solution which improves the possibilities for a national health strategy is pooled or 'basket' funds in Ministries of Health which are seen as creating policy space for the ministry.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">Debt relief has also been identified as assisting countries in moving towards self-sufficiency in financing health. "</font></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">Nigeria</span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"> finally got debt relief … that will not give you money, but what you are setting aside to service your debt is now available for local spending. In 2006, that money was set aside, but not just set aside, the Ministry of Health was given 21% of that money on top of the regular policy".</span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">In addition, South-South cooperation with the emerging powers, such as between Mozambique and Brazil on HIV/AIDS, was seen as a positive way forward as well as providing an alternative to the traditional donors.</font></font></span></p>
<div class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><i><span style="FONT-FAMILY: TimesNewRomanPS-BoldItalicMT; mso-bidi-font-family: TimesNewRomanPS-BoldItalicMT"><font size="3"><font face="Times New Roman"></font></font></span></i></b> </div>
<div class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><i><span style="FONT-FAMILY: TimesNewRomanPS-BoldItalicMT; mso-bidi-font-family: TimesNewRomanPS-BoldItalicMT"><font size="3"><font face="Times New Roman">2. National strategies are being weakened by parallel priorities and implementation directed by donors</font></font></span></i></b></div>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">Too often donors find or direct their own ways of implementing initiatives in-country, thereby distracting from, weakening, and neglecting national health strategies and systems. The World Bank was cited by several Ministers as a very poor donor, dictating how money is used, how programs should be implemented, and how evaluation and monitoring should be undertaken. This has led some governments to choose not to take World Bank assistance. "D</font></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">onors should not be</span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman">Intrusive". "We want to work with them [the donors] not to be told what to do by them".</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Even assistance which has been explicitly aimed at strengthening local capacity falls prey to the problems of donor over-direction. In some countries, capacity-building assistance directed by donors results in a plethora of workshops which draw key staff members away from the ministries where they are most needed.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman"> </font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Hiring of international consultants often provides undesired technical</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">assistance. </font></span><span style="FONT-SIZE: 11pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">"H</span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">iring highly paid consultants from outside, a lot of money goes back</span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman">to those consultants. So why not use our own consultants, who are national, who are equally competent, who know the country well".</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">Much funding is used for technical assistance which is sometimes unwelcome. "</font></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">From our assessment, it was only 40% of World Bank aid that has tangible benefit. The other 60% is in the form of technical assistance"</span><span style="FONT-SIZE: 11pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">.</span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><i><span style="FONT-FAMILY: TimesNewRomanPS-ItalicMT; mso-bidi-font-family: TimesNewRomanPS-ItalicMT"><font size="3"><font face="Times New Roman">Solutions?</font></font></span></i></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">Negotiating with donors identifying leadership at the country level and a clear national strategy. "</font></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">We understand the problem better than our partners and also we understand the priorities – where we need to put the resources". "We have a program. Whoever wants to help must swim with us in the program".</span><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"></span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">Sticking to the strategy and strong leadership can be undermined by the fear of donors walking away and moving resources to another country. For heavily donor-dependent countries this is a stark alternative. Reflecting on the refusal of PEPFAR to participate in the national approach agreed to by all other donors, one minister noted </font></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">"We have never put our foot down. We fear. We are cowards."</span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Ministers of Health and senior advisors need to convince other ministries and sectors of the importance of investing in activities which impact health. Policies that have the most impact in terms of ensuring good health and preventing illness often lie outside the health sector. The domain of Ministries of Health is predominantly treatment, resulting in an under-emphasis on preventive activities at the country level.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Once governments have the space to set their own policies, participatory multi-stakeholder mechanisms can then be used to ensure that policies reflect the needs of the people. A particularly successful example of a participatory process for setting health priorities is the creation of a National Health Assembly:</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman">"The Thai National Health Assembly brings together citizens from all parts of the country, civil society and parliamentarians to collectively decide on policies".</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Similarly, the National Human Rights Commission of India which holds public hearings on the access to health and has been used to hold state officials responsible for ensuring the health of their constituents. </font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman">"Unless the planning process becomes more broad-based, the priorities may not appropriately reflect the societal needs. This is problematic if governments progressively abdicate their responsibility for stewardship of the health system, with increasing economic liberalization".</font></span></p>
<div class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><i><span style="FONT-FAMILY: TimesNewRomanPS-BoldItalicMT; mso-bidi-font-family: TimesNewRomanPS-BoldItalicMT"><font size="3"><font face="Times New Roman"></font></font></span></i></b> </div>
<div class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><i><span style="FONT-FAMILY: TimesNewRomanPS-BoldItalicMT; mso-bidi-font-family: TimesNewRomanPS-BoldItalicMT"><font size="3"><font face="Times New Roman">3. Too little transparency and information about aid activities: donors must learn to report fully to developing countries.</font></font></span></i></b></div>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Severe lack in donor accountability has resulted in little progress on improving health assistance. Donors seldom report fully on what they are doing.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman">"Donors talk a lot about transparency and accountability, but they themselves do not practice this".</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Serious problems arise for planning when there is no accurate information provided to the government about the scope of donor activities.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">There is a lack of transparency from donors about the quantity of aid flowing into the country and how it has been used. Part of the difficulty is that recent initiatives, such as PEPFAR and the Gates Foundation, disburse funds directly to NGOs. This makes it difficult for Ministries to plan their efforts as they do not know which NGOs are already receiving funds, and also the purpose of and region where the funds are being used. </font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">An accounting for that part of aid which remains in donor countries is equally necessary. At the joint review with donors each year, recipient governments have no way to know if, or how much money, has actually reached their country. Donors often accuse developing countries of corruption and mismanagement of funds, yet developing country officials note that funds `leak' at the donor</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">end of the equation.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Country experience highlights that information sharing also needs to extend into health research. </font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Moreover, the same donors adopt strategies which vary across countries: in some instances supporting health system development and in others undermining it. While in Tanzania the activities of PEPFAR and the PMI are</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">governed by USAID which sits within the caucus of development partners, in Uganda PEPFAR and the PMI insist on remaining absolutely separate from other donors.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><i><span style="FONT-FAMILY: TimesNewRomanPS-ItalicMT; mso-bidi-font-family: TimesNewRomanPS-ItalicMT"><font size="3"><font face="Times New Roman">Solutions?</font></font></span></i></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">It would be very useful for recipient countries collectively to evaluate and compare donor activities and practices across different countries. While the Paris Declaration, and the principles of ownership and support for national development strategies take the right steps towards accountability, the problem lies in implementation. For example, no institutions monitor donor programs and</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">practices at both the global and national level. "</font></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">They [donors] like to monitor activities, but they do not like to be monitored and evaluated".</span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Donor coordination has been happening for years, but continues to lack a genuine respect for country ownership.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3">The World Health Organization has become dependent on donor funds and thus cannot serve to independently monitor donors. "</font></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">The major international organizations are being distracted. They are looking for money because they are judged by the way they are mobilizing money. They are not guided by what has to be done".</span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">WHO's <span style="mso-spacerun: yes"> </span>limited budget, lack of mandate for primary research, sparse technical capacity and its need to derive its mandate from countries, does not allow it to take on such a political task. It is a bureaucratic institution controlled by certain donor countries. Several participants pointed to the key role of academia in serving as independent evaluators of donors providing information on current practices. However, even the most reputable universities are heavily dependent on donor funds, and thus cannot be seen to be objective and impartial. The challenge of maintaining the independence of researchers and academic institutions in the face of vast concentration of funding from the same donor(s) is a tough one.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">Countries could come together to 'name and shame' the major violators of the</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><font size="3"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">Paris</span><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"> Declaration. </span></font><span style="FONT-SIZE: 11pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">"</span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">What happens is there is an exploitation of weaknesses in countries. If the donors see that in country A there has strong leadership, and direction on what they should do, they are not going to mess around. They go to another country where they can do things differently and that country will accept. We need to get a grouping of countries with one voice, that say 'if you want to deal with us let us be together, and what we have to achieve is the country's benefit, not the donor's A, B or C". "</span><span style="FONT-SIZE: 11pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">We need to </span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">provide a 'collective defense' for developing countries"</span><span style="FONT-SIZE: 11pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">.</span><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"> </font></span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">A possibility is grouping the 68 countries failing to meet MDGs four and five to consult one other and coordinate before major meetings. Also, civil society needs to help bolster the capacity of countries to form such coalitions.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font size="3"><font face="Times New Roman"><i><span style="FONT-FAMILY: TimesNewRomanPS-ItalicMT; mso-bidi-font-family: TimesNewRomanPS-ItalicMT">To monitor progress on global health goals, d</span></i><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">onors and recipients could each nominate two representatives to sit on a taskforce, chaired by an academic. </span></font></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font size="3"><font face="Times New Roman"><i><span style="FONT-FAMILY: TimesNewRomanPS-ItalicMT; mso-bidi-font-family: TimesNewRomanPS-ItalicMT">To set ethical standards for health assistance, </span></i><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">a universal code of conduct on health assistance that is based not just on efficiency, but on ethics could also help; such a code would progress best if it can be taken to the highest levels of the UN. </span></font></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font size="3"><font face="Times New Roman">To proceed with either of these initiatives, further analysis is needed to provide an evidence-base for what kinds of donor assistance are most effective, to provide tracking of grants from commitment to actual impact on-the-ground, to provide information on the quantity of donor financing in-country, and provide further documentation on the case for health.</font></font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><span style="FONT-FAMILY: TimesNewRomanPS-BoldMT; mso-bidi-font-family: TimesNewRomanPS-BoldMT"><font face="Times New Roman" size="3"> </font></span></b></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><b><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPS-BoldMT; mso-bidi-font-family: TimesNewRomanPS-BoldMT"><font face="Times New Roman">Participants</font></span></b></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">Brazil</span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">, Nigeria</span><b><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPS-BoldMT; mso-bidi-font-family: TimesNewRomanPS-BoldMT">, </span></b><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">Indonesia</span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">, Uganda, Nepal, Tanzania, Kenya, Ecuador, India, Egypt, Mozambique, Thailand, Indonesia. (Minister of Health)</span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT">For the Oxford Working Group</span><i><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPS-ItalicMT; mso-bidi-font-family: TimesNewRomanPS-ItalicMT">:</span></i></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><font face="Times New Roman"><b><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPS-BoldMT; mso-bidi-font-family: TimesNewRomanPS-BoldMT">Rajaie Batniji, Harold Jaffe, Devi Sridhar </span></b><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPS-BoldMT; mso-bidi-font-family: TimesNewRomanPS-BoldMT; mso-bidi-font-weight: bold">and<b> Ngaire Woods. </b></span><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"></span></font></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman" size="3"> </font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt; mso-layout-grid-align: none"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman">Further updates will be available at </font><a href="http://www.globaleconomicgovernance.org/"><font face="Times New Roman" color="#0000ff">www.globaleconomicgovernance.org</font></a><font face="Times New Roman"> <span style="mso-spacerun: yes"> </span>along with video of a public panel featuring the Working Group. Please direct queries to the Global Economic Governance Programme.</font></span></p>
<p class="MsoNormal" style="MARGIN: 0in 0in 0pt"><span style="FONT-SIZE: 10pt; FONT-FAMILY: TimesNewRomanPSMT; mso-bidi-font-family: TimesNewRomanPSMT"><font face="Times New Roman">Email: <a href="mailto:geg@univ.ox.ac.uk">geg@univ.ox.ac.uk</a></font></span><span style="FONT-SIZE: 10pt"></span></p>