In what amounts to a searing, self-inclusive indictment of the international donor community—official lenders as well as private nonprofits—this remarkably frank and disturbing World Bank report paints a bleak picture of Haiti today. Between 1971 and 2013, despite massive foreign assistance, Haiti’s per capita income fell by 0.7 percent every year, on average, owing to low growth and to a population explosion. Nearly 60 percent of Haitians still cannot meet their basic needs. In pinpointing causes, the authors fault Haitian business elites for not paying taxes and for taking part in anticompetitive practices. Despite an abundance of technical assistance from international institutions, Haiti’s legal and regulatory frameworks are “dysfunctional,” the country suffers from a “near total absence” of urban planning, and the government still cannot perform many basic functions. Fundamentally, “a social contract is missing between the State and its citizens.” And the future looks grim: the study warns of the dangers of rising urban violence among disaffected, undereducated youth. Nevertheless, the report concludes with a number of promising policy proposals, which must be undertaken simultaneously to be effective: maintaining macroeconomic stability, improving the collection and analysis of statistics, creating better jobs, rebuilding the social contract, and reducing the vulnerabilities of households to financial shocks and natural disasters.