Africa is the world's most aided major region. Yet economic growth has been disappointingly low there. A number of factors explain the poor outcomes and limited sustainability of and in Africa. But the organisation and management of the aid relationship is a particularly important one, including the dependence of Africans on that aid. The currently popular nostrums for solving the problem of the effectiveness in Africa - selectivity, ownership, sector investment programme and more aid - are as yet inadequate and often contradictory. Much more work and honest debate needs to occur before the problem of aid effectiveness can be tackled in Africa.