Mary Robinson, the first woman President of Ireland (1990-1997) and more recently United Nations High Commissioner for Human Rights (1997-2002) shared with the conference team some of the main challenges at hand when it comes to access to health for all: accountability, financing, the brain drain and the responsibility of those who have the means to make a difference, such as the private sector. She pointed out that the high turnout at the Forum was an indicator of the need for it and the urgency of discussing access to health. Access for all is the concern of all.

The speakers stressed the importance of concentrating on system failures rather than individual mistakes and errors. This involves the setting of standards and the development of systematic improvement programs that are complemented with constant performance monitoring. The experience of other high-risk industries such as the aviation industry highlights the importance of sustained action over the long term. The symposium also dwelt on the importance of involving consumers in the reduction of patient hazards.

One of the major talking points of this conference is that funds and programmes aimed at those most in need are not reaching their intended target. There is widespread agreement that urgent action is needed to improve access to health for billions of poor people in developing countries. Despite vast investment, largely on the part of governments and international bodies but also by donors and companies seeking to honour a commitment to corporate social responsibility, it is widely acknowledged that precious few inroads are being made.

Health reform is badly needed in many countries in the developing world in order to stop the burden of catastrophic healthcare costs remaining on the shoulders of individual families. We talked to Dr. Frenk, Minister of Health for Mexico, where an important healthcare system reform was launched in 2003. The reform implemented, among other things, a 7-year plan to finance "el seguro popular" or popular insurance.

Mr. Salih Meky, Minister of Health of Eritrea, spoke with us about achievements and challenges in the field of health in his country and Africa more generally. In Eritrea, health care is free of charge. The country has managed to keep under control a number of infectious diseases, but faces the increasing challenge of chronic illnesses, such as diabetes, hypertension and cancer. Hospital costs are a major issue. Minister Meky also questioned whether there was a simple solution to the brain drain, but urged that it needed to be addressed not just by the South, but also by the wealthy countries in the North.

The final plenary session of the "Geneva Forum: Towards Global Access to Health" was dedicated to summarizing the key issues which emerged during the three days of discussion and exchange and to formulate suggestions on how to develop these issues in the future. The final plenary was also a moment to thank all the contributors of the Forum for their effort and participation.

Malaria, being the number one disease and responsible for half of the children's mortality rate in Africa, has been lately gaining increased media and political attention. This symposium focused on the latest tools and methods of malaria prevention and treatment. The participants pointed to the encouraging results of some of these methods and discussed the challenges that still hamper their universal implementation.

In face of many recent humanitarian and natural crises in Lebanon, Ethiopia and other places, the topic of today's round table was centred on the issue of how to most effectively access the victims of these crises. Humanitarian relief agencies have to be able to react quickly to any kind of disaster and provide adequate assistance to the concerned governments, as well as evacuating the local population if need be. Unfortunately, as Mr. Angelo Gnaedinger from the International Committee of the Red Cross, Switzerland pointed out, there are limits to the operation of these aid agencies and they have failed in several cases, due to insecurity, and despite a constant optimisation process.

Research is the basis of developing sustainable health care to communities. However, research must be conducted ethically and persons participating in medical research, especially in clinical drug trials, must be protected. This means that the many actors who participate in international collaborative research must apply the highest ethical standards. Universities and health training institutions must provide leadership in ensuring that research is conducted in an ethical manner.

Hospitals have always played a pivotal role in the global healthcare system. They have power, authority and professional competences in both the rich and poor worlds. But what if we all begin to re-think the mission of hospital care and re-design the way we deliver it in order to increase access to health? The moment has arrived for reform in order to achieve optimal care, to learn from examples of real innovation and disseminate this knowledge, sharing ideas as well as best practices.