Since the debt crisis erupted in 1982, the poor in the heavily indebted countries have paid a heavy price. As Cardinal Arns of Sao Paulo in Brazil said “every time the United States raises its interest rates, thousands die in the Third World, because money that would be used for health care and food is sent outside these countries to pay the debt”. Higher interest rates, falling commodity prices, inflation, devaluation, cheap labour policies, slashed public expenditure all have hit the poor hardest. Yet, as well as causing suffering, the I.M.F. austerity programmes have failed in their primary goal, which was to guarantee the continuation of debtor country repayments. The growing recognition of this failure has strengthened the position of those who have long argued for alternative policies. What are some of the alternatives available?