Trust funds reflect the World Bank’s eagerness to capitalise on these private aid flows for global health activities. This business decision largely explains the proliferation of ad hoc administrative and operational policies for IBRD/IDA trust funds and financial intermediary funds. Competitive interests of private investors to IFC also explain its restrictive access to information policy44 and customised policies about safeguards. In our view, however, trust funds have operated largely in the shadows and beyond the purview of members of the public, without having to conform to the measures taken to increase monitoring and accountability in the bank’s core work. We call on the bank to commit to its “Forward Look” strategy41 for a stronger World Bank Group by improving its trust fund transparency (fig 3 gives explicit recommendations) as a first step.