The World Bank is supposed to work with poor countries in distress. When it all goes well, the Bank supports reformers with advice and money. Sometimes, however, the Bank prolongs a country’s pain by throwing a lifeline to recalcitrant regimes. The difference between a helping hand and a counterproductive crutch requires the Bank to understand the trends inside a country and how its own actions might affect those dynamics. Often, it’s difficult to discern these subtleties.