Have structural adjustment programmes in Africa largely failed? Ought the World Bank and the IMF to be paying more attention to the particular circumstances of individual countries and to the alternative policies being proposed by the Africans? The contributors to this volume assert both positions. Case studies of education, health, public services and import-export performance demonstrate the frequent lack of success of structural adjustment. These are followed by alternative approaches to overcoming Africa's economic and human crises, including the importance of democracy in securing responsiveness of state policy to public needs, the structural advantages of regional integration, sustainable development strategies that build on the continent's resource base, and a new partnership between state and market.