nanda. >> i don't want to repeat what he said. and i completely agree with what he said and the need is to focus on effort in the absence of effort, that's why we use the word shared responsibility but shared responsibility has to come with effort on both sides. i think and that point is extremely well taken. and more so probably in the h.i.v.-aids than elsewhere. my sense is that just as we are talking about moving the h.i.v. resources to geography's most in need, you also have to understand that the h.i.v. phenomenon is not uniformly distributed across all and it's interesting to understand that what we might have done is killed the private markets that can put finance and provide the services for people who are willing to pay. right if so, one of the questions i think we have to take on clearly is there segments of the population which i believe there are that were willing to self-finance and self-pay spurns or out-of-pocket payment as look long as they get good quality care provided to them in the private or the public sector.

nanda, let's just brainstorm. [laughter] >> the fact remains that donor financing is not going to be sufficient. to meet the needs of financing of health and h.i.v. and so that is no option but to work with countries on a shared responsibility agenda. and the bulk of the financing has to come from domestic resources. the other question is how do you make that happen? so it's what modality one uses has to be -- what we have to do is manage for results, and the results have to focus in two areas. one is more money and better use of money and measurable impact of what the money invested brings. so i think what we would have to focus on going forward whether it's pepfar, global fund, u.s.g. or anyone ills on this three dimensions. and having the data and the evidence really to demonstrate this increasingly. unless we can demonstrate the value proposition, arguing for more money by itself is not going to get us very far. and i agree that there are significant deficiency gains that can be achieved. and i'll give you one

nanda. >> i don't want to repeat what he said. and i completely agree with what he said and the need is to focus on effort in the absence of effort, that's why we use the word shared responsibility but shared responsibility has to come with effort on both sides. i think and that point is extremely well taken. and more so probably in the h.i.v.aids than elsewhere. it is interesting to understand that what we might have gotten. questions i think we have it is segments of the willing tothat were -- as long as they get good quality care. publicprivate or the sector. i think going forward we also have the segmenting population. be -- by that bestr that gives you the value. i think it goes back to your question that we have to focus on getting results and by that i mean diagnostic but also looking at population. mark? point. one competing with a the countries percentage, sometimes when you the in a way you'd take out at the start of it you cannot overestimate the funding. i think those countries that are persistently not responding to e