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As the Bush Administration prepares to announce its long-awaited plans to reorganize U.S. foreign assistance, CGD president Nancy Birdsall and colleagues Stewart Patrick and Milan Vaishnav highlight four fatal flaws in the current U.S. development policy. These include the relatively low volume and poor quality of U.S. assistance; the incoherence of the non-foreign aid aspects of U.S. development policy; the failure to implement a coherent strategy for institution building in weak and failing states; and the U.S. penchant for unilateral over multilateral action. To make a dent on global poverty, any plan to reform U.S. foreign aid must address these problems, rather than shift bureaucratic boxes.