This policy brief outlines Save the Children's objectives for The Fourth High Level Forum on Aid Effectiveness, to be held in Busan, South Korea, 29th November – 1st December 2011. Since 1990 exceptional progress has been made in reducing child mortality. The total number of child deaths has declined by 4 million per year. There are a number of explanations for these gains, but they could not have been achieved without aid. However, aid needs to be delivered more effectively if it is to realise its full potential as a tool for fighting poverty. To accelerate progress towards the Millennium Development Goals (MDGs), significant further reform of the international aid architecture is urgently needed. The Summit in Busan will review the progress of the Paris Declaration and Accra and further reforms to the aid effectiveness agenda will be decided. This is the last opportunity before the MDG target date of 2015 to reform aid in ways that will accelerate equitable progress towards the MDGs and help to realise fundamental rights.