Higher education has been positioned as an important contributor to development in low-income countries in the context of the knowledge economy. This paper assesses the potential for building sustainable higher education systems that can contribute to development in low-income countries. The premise of this paper is that developing countries cannot be researched in isolation. The intensification of higher education relationships across national borders means that developments in low-income countries must be analyzed in the context of a changing world order and the transformation of higher education systems worldwide. Crucially, the influence of China on world hegemonic relations, and the development of innovative dimensions to higher education in countries such as Cuba and the Caribbean region in general need to be explored. The paper concludes by highlighting opportunities and dangers for the sustainable development of higher education with particular reference to the Caribbean, and the importance of developing regional ownership of the higher education and development agenda.