Development assistance shifted in the 1980s from financing investment to promoting policy reform, since it was believed that low-income countries were held back more by weak policies than by lack of finance for investment. However, the reforms of the 1980s and 1990s advocated by the IMF and World Bank did not bring the expected results. Poverty remained high and the economic reforms lacked sufficient political support.

At the end of 1999, the IMF and World Bank developed a new framework for their support to low-income countries in Africa and elsewhere: the Poverty Reduction Strategy approach. This new approach was meant to focus more clearly on economic growth and poverty reduction.

Helping the Poor? The IMF and Low-Income Countries discusses the successes, failures and shortcomings of IMF and World Bank support to poor countries. Analysing in detail the policies pursued by, especially, the IMF the book reveals that the assistance has remained insufficient, often mal-directed and still too much inspired by beliefs held in Washington.

The book provides a wealth of critical reflections and practical suggestions of how poverty and development can be dealt with more effectively.
Various authors conclude that the IMF should adapt its conditionality to the needs of the low-income countries, support capacity building geared at greater empowerment of the borrowing countries and focus on longer-term planning and pro-poor macroeconomic frameworks.