The team of external evaluators has presented a rich analysis based on developments in ESAF-supported programs in several low-income countries. This analysis is rooted in the observation, which we share, that adjustment and reform do raise incomes and improve their distribution. The common objective of the Fund staff and the evaluators is how to strengthen the design and implementation of programs so as better to achieve lasting improvements in the economies of ESAF countries. The main issues on which the team offers advice are ones with which the Fund staff and management struggle every day—how to better integrate social considerations into the fabric of a macroeconomic program, how to promote ownership of the sometimes radical policy changes needed, how to gauge progress toward external viability, and how to coordinate with other key players, especially the World Bank, to improve policy advice. The report makes a number of useful recommendations for change and, where conflicting considerations preclude unambiguous positions, places in sharp relief the dilemmas often faced by the Fund staff.