Africa’s development crisis is unique. Not only is Africa the poorest region in the world, but it was also the only major developing region with negative growth in income per capita during 1980–2000 (table 1). Some African countries grew during the 1990s, but for the most part this growth recovered ground lost during the 1980s. Moreover, Africa’s health conditions are by far the worst on the planet. The AIDS pandemic is wreaking havoc, as is the resurgence of malaria due to rising drug resistance and the lack of effective public health systems. Africa’s population continues to soar, adding ecological stresses to the economic strains. Policy-based development lending to Africa over the past twenty years, known as structural adjustment lending, did not solve the problem. A heavy debt burden is evidenced by the 155 Paris Club restructurings of African countries’ debt between 1980 and 2001, much more than for any other region. In general, Africa remains mired in poverty and debt.