President Bush called for a major change in U.S. foreign-aid policy with the development of a $5 billion Millennium Challenge Account to “encouraging developing countries to make the right choices for their own people”. In return for additional funds, recipient nations would be expected to adopt reforms and policies making development effective and lasting. Will result-oriented assistance lead countries on the path to prosperity or is it just paternalistic meddling in the affairs of foreign nations? Is the pay-for-performance process advanced by Millennium challenge accounts the answer to foreign aid concerns or another example of well-meaning but flawed foreign policy?