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The Busan partnership adopted at the 4th High Level Forum on Aid Effectiveness at the end of last year is a significant step forward towards the improvement of aid quality and the promotion of development.In particular, the inclusiveness achieved in Busan and the shift in discourse from 'aid effectiveness' to 'development effectiveness' are emblematic. However, key challenges still remain. Firstly, decisionmaking should be more bottom-up, finding ways to take into account the populations' needs and experiences and to enhance self-learning dynamics during the policy process. Today, it is particularly necessary to define what 'development' means at country level, according to the aspirations of particular categories of people and meeting operational and local expectations. Secondly, changes in language should be followed by a real change in mindset. Development stakeholders should further adapt their procedures to the reality of complex systems in which development interventions are being dealt with.keywords development, health policies, bottom-up approaches, behaviour change, aid effectiveness

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