University College London 2 December 2013

1. How must the global health and AIDS architecture be modernized to achieve sustainable global health? Preliminary Findings University College London 2 December 2013

2. Underlying political economy of incentives • Drivers of funding engagement at global level • Post-ODA focus & nature of public-private engagement • Concrete focus on options • Acquisitions, mergers and abolition (equivalent internal logics) • Integration & fragmentation/plurality (at top and bottom) • Need for clear-eyed reflection on UNAIDS by WGs • Dig down on examples of success and failure & counter-factual • Activist fatigue and accountability deficits • Pathways of change & alliance structures • Can architecture capture the ‘spirit’ of the movement Taking Stock: Opportunities and Lessons Learnt from the AIDS Response for Global Health Governance

3. Assumption of equivalence: AIDS & global health • Disease targets and/or • Social determinants of health • Principles: justice, human rights, equity and rule of law • Framework Convention on Global Health • Building scenarios – MDG versus SDG lens • Market mechanism (‘survival of the fittest’) • UN as legitimate focal point (global public goods) • Consolidation around country-level (e.g. IHP) • Form follows function (SDG: goal-oriented) • How scenarios affect current decision-making (finance) • Modernising the global heath and AIDS architecture: Law, Institutions, and Public-Private Authority

4. Caution in seeking out ‘low-hanging fruit’ • Responsive architecture • Incentives & distributional consequences (winners & losers) • Recipient-led and/or donor-led reform • LIC (financing) and MIC (data-demand/what works?) • The BRICS • Exercising different forms of power (hard versus soft) • Reporting and soft law approach • Arbitration body • Enhance accountability system (beyond reporting) • Independent accountability arrangement • Pathways to enhancing coherence of the global health architecture