“One recurring theme in forum and in the first panel [of the World Bank’s ‘Africa Health Forum: Finance & Capacity for Results’] was that results-based financing (RBF) — where financing is conditioned on achievement of results in health — is a key approach to driving value for money,” Victoria Fan, a research fellow at the Center for Global Development (CGD), and Amanda Glassman, director of global health policy at CGD write in the center’s “Global Health Policy” blog. “By linking payments to specific outcomes, RBF makes a donor more accountable to its constituencies and also increases the mutual accountability between the donor and the country by focusing the contract terms on shared goals and verified results,” they note, adding this is “a reason why RBF represents a paradigm shift in global health and development aid — from what might be called the ‘auditing and accounting paradigm’ to ‘performance and results paradigm.'” They discuss the RBF approach, highlight a number of obstacles to its implementation, and write, “The World Bank’s recent Africa Health Forum highlighted that the World Bank has somehow overcome these historical obstacles, and stands to be a trailblazer in RBF.” They add, “Other donor agencies such as PEPFAR and the Global Fund [to Fight AIDS, Tuberculosis and Malaria] need to take the courageous steps to a much needed paradigm shift” (5/2).