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Even after years of receiving considerable foreign aid, Haiti remains an impoverished, tremendously fragile state. Over a span of ten years, the United States spent over $4 billion in aid to Haiti, yet the average Haitian still has to survive on one dollar a day. Why has assistance been so ineffectual, and what can we learn from Haiti's plight about foreign aid in general? Haiti in the Balance tackles those questions by analyzing nearly twenty years of Haitian history, politics, and foreign relations. Terry Buss and his colleagues at the National Academy on Public Administration found a general failure to reinforce the capacity of institutions at all levels of Haitian government. Building up that system of institutions appears to be a necessary precursor to a nation using foreign aid in the most effective manner. Such an effort demands improved security, a more professional (and less corrupt) bureaucracy, and eventually decentralization and perhaps even some privatization. Different levels of government must be willing to learn how best to work with one another: according to Buss, Haitian governments seemed consumed by politics, rather than good governance. People still matter, and so does administration. Until we learn that lesson, even the most generous foreign aid will not fulfill its intent.