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Despite the success of the Heavily Indebted Poor Countries (HIPC) in reducing the debt burdens of low-income countries, at least eleven Sub-Saharan African countries are currently in, or face a high risk of, debt distress. A few of those currently at risk include countries that have been excluded from traditional debt relief frameworks, notably Eritrea, Sudan, and Zimbabwe. For countries outside the HIPC process, this paper lays out the (formidable) steps for retroactive HIPC inclusion. It then explains two successful debt relief efforts outside of HIPC (Myanmar’s ‘HIPC-lite’ process in 2013 and Nigeria’s discounted buyback in 2005) and one effort that has so far stalled (Zimbabwe). The paper concludes with lessons for countries seeking exceptional debt relief treatment.