A decade of adherence to a program of economic reforms prescribed by the IMF and the World Bank has made Ghana a test case for structural adjustment in Africa, revealing both the potential for African economic renewal and the highly problematic nature of the reform process, particularly in its political dimensions. This study argues that neither the multilateral lenders (who have wrongly assumed that economic progress would automatically generate political support for reforms) nor the governments undertaking reforms, including Ghana's, have given enough attention to the political strategies, vocabulary or institution-building necessary to ensure the durability of the economic changes underway. Unpopular measures such as devaluation may call for a measure of authoritarian control if they are to be successfully applied, but over the longer run market-based economies can only flourish in a democratic institutional context where the rule of law, press freedom and freedom of association prevail. For the sake of Africa's future, the author argues, a focus on the political essentials underlying effective growth strategies should take precedence over the emphasis on distributive issues and neo-imperialism stressed by critics of structural adjustment. Not the last word on this vital subject, but a stimulating dose of hard-nosed realism.