Poor countries account for 56 percent of the global disease burden but less than 2 percent of global health spending. With the global commitment to the Millennium Development Goals in 2000, poverty and the deplorable health conditions of the world's poor have finally reached center stage in the international policy arena, and aid for health has greatly increased. This paper evaluates health financing in developing countries from global- and country-level perspectives and briefly describes the types of reforms needed in the global aid architecture to make effective use of this historic opportunity to improve the plight of the world's poor.