The document discusses several key topics related to scaling up health systems and achieving universal access: 1. Evidence is important for implementing sustainable change, but the right questions must be asked and appropriate models/assumptions used. 2. Much of the variation in health outcomes between countries is due to differences in technological progress, not income levels. More research is needed to address developing country needs. 3. Scaling up health systems is an experiment in itself. Different types of evidence are needed from individual, institutional, and systems-level research on scaling up programs. 4. Research and innovation systems must work together across sectors and levels to develop and disseminate new health technologies, processes and knowledge globally.

1. Beyond Scaling Up: Pathways to Universal Access Institute of Development Studies, Brighton, 24-25 May 2010 Building evidence Stephen Matlin

3. New Yorker, 2006 and thanks to R Terry, WHO

5. Technological and social innovation

7. Research system Innovation system Health research system Health sector Other sectors National Global Research and innovation systems

8. Mapping of country scientific capability to adopt 16 technology applications RAND, 2006: The Global Technology Revolution 2020 www.rand.org

12. “ Developing countries” Developing world GDP (measured in PPP) to overtake advanced economies in 2013 Euromonitor: Countries and Consumers – October 2008 www.euromonitor.com/Special_Report_Developing_world_to_overtake_advanced_economies_in_2013 Advanced economies Developing and emerging economies

13. Researchers per million inhabitants, 2007 or latest available year UNESCO Institute for Statistics, September 2009 Based on FTEs where possible, or on headcounts http://www.uis.unesco.org/template/pdf/S&T/Factsheet_No2_ST_2009_EN.pdf

16. Dealing with multiple, contested goals and framings. Are we talking the same language?

17. You’re 30 metres above the ground in a balloon You must be a researcher Yes. How did you know? Because what you told me is absolutely correct but completely useless You must be a policy maker Yes, how did you know? Because you don’t know where you are, you don’t know where you’re going, and now you’re blaming me Martin McKee Where am I?

18. Nobody asked me, anyway