David Evans, director of health systems financing, World Health Organisation

Address forgotten causes: Many forms of innovative financing mechanisms seem to target single diseases or issues, but for healthcare to be truly universal the global health community will need to make a concerted effort to focus on less popular causes.

Think holistically: Health workers, medicines, treatments, prevention, promotion, rehab and palliation all need to be in place and of good quality before universal healthcare is achievable.

Biodun Awosusi, research fellow, African Health Dialogues

Primary care is key: While each country must create its own path to universal healthcare, all health systems need to be strengthened with particular focus on primary care as the entry point.

Don't underestimate the importance of national health accounts: A robust national health account can capture all stages of cash flow. They are very useful tools to evaluate the sources of funding, its track within the health sector and expenditure trend.

Resources:

Public health leaders from Lagos Nigeria share success factors for a viable community based health insurance scheme in this article.

This Health Policy Project article set out the reasons why each country has unique economic, political, social, and institutional opportunities to expand health insurance.

Annie Haakenstad, project officer, Institute for Health Metrics and Evaluation at the University of Washington

Research is vital: It would be difficult to launch the kind of low tax-base funded healthcare found in the UK internationally. However, international development partners can play a key role in supporting universal healthcare in developing countries by supporting research on the costs and benefits of different financing methods.

Design systems with long-term coverage in mind: Once a system is in place, long-term coverage can be an issue. In Ghana, for example, although the national health insurance scheme has been in place since 2003, coverage for the least well off has been poor according to a recent publication by the World Bank.

Elaine Ireland, head of policy, Sightsavers

Improve health-seeking behaviour: Improvements in quality of healthcare in development countries must be matched by improvements in health seeking behaviour of patients and citizens.

Governments must take ownership of their national health systems: It is high risk for governments to depend on donors, and they must decide for themselves what type of financing model they want to use over the long-term. Development aid can assist but it should not be a replacement for the national financing of health systems.

Josephine Borghi, senior lecturer, London School of Hygiene and Tropical Medicine

National income and expenditure surveys are a valuable source: Typically carried out every couple of years, national income and expenditure surveys can be used to compare different sources of financing in low income settings (for example, different types of taxes and out of pocket payments.) They can also be used to assess the progress of specific health financing sources in response to policy changes.

Resources: This paper from the US National Library of Medicine National Institutes of Health shows the methodological challenges in evaluating healthcare financing equity in data-poor contexts.

Eric Friedman, project leader of the Joint Action and Learning Initiative, Georgetown University Law Center

A legally binding treaty could be the answer: There is growing interest in the Framework Convention on Global Health – a proposed treaty that would create legally binding commitments on all states with regard to both domestic and international health financing.

Resources: You can learn about the proposed Framework Convention on Global Health and how to get involved at http://www.jalihealth.org

Simon Wright, head of child survival, Save the Children

Fair taxing is essential: While many developing countries are moving towards establishing tax-based national healthcare systems, it's important that they tax all individuals and companies fairly and concentrate on essential primary healthcare for the poorest.

Dr Sneh Khemka, medical director, Bupa

Financing methods should only be judged on their success: As long as financing methods are affordable, equitable and have accessible coverage, it should not matter whether they are privately or publicly run.

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