A patient awaits treatment in the general hospital in Gaborone, Botswana. Photograph: Jerome Delay/AP
Will the parlous health of America's poor scupper the chances of improving healthcare provision in developing nations? They are seemingly unrelated - how on earth could the state of health of poor black Americans affect access to doctors for Zambians or Ugandans? But put it another way. What would poor residents in Washington DC, for example, say if they found out that the US administration was funding the removal of health charges in other countries while forcing them to pay or go without? Given that poor black Americans in that city have a higher infant mortality rate than people in Kerala, India, they might be justified in asking why charity doesn't begin at home.
This could be the major obstacle to the challenge that the international development secretary, Hilary Benn, is making in a speech tonight. Mr Benn is not only asking the US, among others, to fund the removal of health charges but also to back 10-year plans for education and to help developing nations build social security systems that support people from the cradle to the grave.
This new direction for UK development policy comes after strong lobbying from aid agencies like Save the Children, which has highlighted evidence that 230,000 children could be saved in Africa if health fees were abolished. The challenge for the west is not only to meet the aid targets they agreed to at Gleneagles G8 summit last year but to provide what is known in the jargon as "predictable funding" - there is little point building a new hospital in the developing world if funding for the doctors, nurses and drugs is not there too.
If health charges are removed, as the NGOs and the UK government want, who will replace this hole in developing countries finances? As well as these questions, Mr Benn is soliciting comments on the following questions:
* In addition to governments, what are the roles that NGOs, faith groups and the private sector etc. can play in stepping up support to basic services?
* How can the gap in the number of teachers and health workers in developing countries be filled most effectively?
* How can the needs of the poorest and of women be better met?
Guardian Unlimited readers can post their thoughts below or direct to Hilary Benn at the DFID website. GU has agreed to be DFID's media partner to garner public comments ahead of the development white paper in the summer.
