Both Cabrera/Carballo and Cook emphasize the importance of international law in promoting progressive judicial responses. This proved an important theme explored by a number of contributors; namely, the role of international law and international agreements in stimulating progressive change whether through the courts or political processes. Arthur Wilson and Abdallah Daar in their contribution to this special issue ambitiously tackle the question of what role, if any, international legal instruments have played in solving global health challenges. They assess a range of international instruments and related global challenges and — with humility given the difficulties of establishing causation in such a complex arena – suggest a number of factors that seem to be conditions precedent to success. Carrying on this theme, Constance MacIntosh focuses on the use of inter- national instruments to promote health standards among aboriginal peoples. She shows in her paper how international legal instruments and international legal fora have promoted global dialogue about indigenous peoples’ health inequalities — dialogue that was previously limited to the domestic sphere. MacIn- tosh emphasizes how the very active participation of aboriginal people at the international level has facilitated their recognition as legitimate contributors to domestic governance, thus contributing to “enabling substantive engagement.” Hard instruments, such as the International Covenant on Economic, Social and Cultural Rights and the Indigenous and Tribal Peoples’ Convention (ILO Convention 169) and soft instruments, such as the United Nations Declaration on the Rights of Indigenous Peoples, have provided the impetus for reform at the domestic level through negotiation, legislation, and litigation. MacIntosh provides examples of how internationally articulated norms found their way into domestic legal and policy initiatives related to health in New Zealand/Aotearoa and Canada.