Adding to official development assistance (ODA), private foundations have emerged as important donors to the global health agenda. Amid this increasing funder diversity and growing global health budgets, responsiveness to recipients’ needs is a central concern. Merging datasets on ODA flows in 2005–07, over 2,800 foundation grants, disease burden, and perceived priorities in 27 low- and middle-income countries, this study offers the first comprehensive national-level analysis of global health aid responsiveness. The analysis shows that national patterns of disease burden explain neither public nor private aid flows during this period. While ODA committed during these years was weakly yet significantly correlated with health priorities, private grants’ responsiveness was even weaker and did not achieve ODA significance levels either.