Since 2004 the Howard Coalition government has implemented a new policy framework and administrative arrangements as part of its program of reform in Indigenous affairs. In this paper I will describe both the parameters of this reform program and review the processes established to support the implementation of national Indigenous health strategy. In particular, I will consider both the shift from a policy framework based on self-determination to one based on mutual obligation, and the implementation of Shared Responsibility Agreements (SRAs) that are based on the latter principle. I will use the example of the Mulan SRA to illustrate the difficulties in articulating the new arrangements with current approaches to Indigenous health planning and strategy implementation. I conclude that new arrangements pose a number of problems for Indigenous health planning and strategy that need to be addressed.