The health financing landscape has transformed over the past 30 years as private aid flows increasingly overtake official development assistance.42 43 With this shift, the supremacy of IBRD’s non-concessional financing model has ended, and IDA, IFC, and trust fund commitments now dwarf its own.6 At the same time, the bank has transformed from a country based lender to a development organisation with representation on the most global partnership programmes in the world.16