supported local efforts to resolve public health problems. Western aid for long-term development of Ethiopia's health sector was modest, averaging about US$10 million annually, the lowest per capita assistance in sub-Saharan Africa. The main Western donors included Italy and Sweden. The UN system led by UNDP and including such agencies as FAO, UNESCO, UNICEF, UNIDO, UNFPA and WHO, continued to extend assistance as they had to the Emperor's regime. In the early 1980s, at least one UNDP representative, a former minister in a Caribbean country, had the credibility to get access to Mengistu, and may have moderated his excesses in some instances. The World Bank also continued to provide assistance during his rule doubtless recognising the surprisingly conservative and prudent fiscal discipline the regime tried to follow. Failures and collapse Ethiopia had never recovered from the previous great famine of the early 1970s, which was the result of a drought that affected most of the countries of the African Sahel. The famine was also caused by an imbalance of population which was concentrated in the highland areas, which were free of malaria and trypanosomiasis. Both the Emperor's and Mengistu's regimes had tried to resettle people in the lowlands, but the Mengistu regime came in for heavy international criticism on the grounds that the resettlements were forced. There has been an approximately decade long cycle of recurrent droughts in this part of east Africa since earlier in the 20th century and by the late 1970s signs of intensifying drought began to appear. By the early 1980s, large numbers of people in central Eritrea, Tigray, Welo, and parts of Begemder and Shewa were beginning to feel the effects of renewed famine. A drought that began in 1969 continued as dry weather brought disaster to the Sahel and swept eastward through the Horn of Africa. By 1973 the attendant famine had threatened the lives of hundreds of thousands of Ethiopian nomads, who had to leave their home grounds and struggle into Somalia, Djibouti, Kenya, and Sudan, seeking relief from starvation. By the end of 1973, famine had claimed the lives of about 300,000 peasants of Tigray and Welo, and thousands more had sought relief in Ethiopian towns and villages. The PDRE's limited ability to lead development and to respond to crises was dramatically demonstrated by the government's reliance on foreign famine relief between 1984 and 1989. By 1983 armed conflict between the government