Africa is at a crossroads. Despite the development efforts of the past two decades, Africans are getting poorer. Over 300 million people live on less than US$1 dollar per day. Life expectancy is 48 years and falling. Twenty-eight million people are living with HIV/AIDS, and 40 per cent of children are out of school. The responsibility for this crisis lies within the continent and outside it. There is a glaring absence of accountable governance at national, regional, and global levels. Only by ending the 'business as usual' approach to Africa can the situation change.