This report draws a range of new analyses and case studies carried out in preparation for the Accra High-Level Forum held in September 2008. It it is organized into four parts. Part 1 examines trends in aid for health from a global perspective, focusing both on how increases in aid finance have been used, and on financing modalities and patterns that impact on the implementation of the Paris declaration. Part 2 then draws on a series of country cases studies-including Rwanda, Uganda, Cambodia, Vietnam, Ethiopia, the Kyrgyz Republic, Mali and Tanzania-looking at practical experience from the perspective of the main pillars of the Paris Declaration. Part 3 examines current issues and future directions, highlighting new work on predictable financing, showcasing developments in mutual accountability through country compacts, and innovations in cross-cutting issues such as gender and human rights. Part 4 summarizes the key messages and recommendations following the structure and format of the Accra Agenda for Action.