The 192-country World Health Assembly that governs the World Health Organization wholeheartedly adopted the conclusions of the 58-country Ministerial Health Research Summit in Mexico in November 2004, even adding some clauses that amplify the Mexico conclusions. But this came only after several powerful countries chose to have a long, nerve-racking private debate in an informal working group to re-write the Mexico agenda, leaving outsiders - even including WHO staff - biting the nails and guessing what they intended to do.