The governments of the poorest countries have more power than they realize when talking with partners from the rich world about development programs.
Interesting point from Joy Phumaphi, who used to be the Minister of Health in Botswana and who is now at the World Bank. "What I didn't appreciate while I was in government was the power of government," Phumapi says. "Developing country governments do not appreciate the extent to which they have the authority to direct the conversation. They tend to look for complete guidance from their development partners instead of realizing they can guide the development agenda themselves."
Phumaphi suggests governments of developing countries should be more assertive in saying, as she puts it, "This is not useful to me. This is what I need." She predicts much more effective results in global health programs if governments of developing countries claimed their authority to speak out and direct planning efforts more actively, rather than just listening quietly to what donors think they want to do.