Ned Breslin of Water for People tells it like it is: "Africa, Asia and Latin America have become wastelands for broken water and sanitation infrastructure."
He then goes on to condemn "head counts as a success metric" and the condescending attitudes of "we know better" aid agencies that deliver short term results and long term depression to "the needy."
Ned think that communities should have skin in the game -- not just sweat equity, but real money. He also wants local government to get involved in managing projects that are self-funded (at replacement cost) within 10 years. (It's interesting that many US communities complain that they do not have this kind of money; I think that we are exporting our own unsustainable water practices to these "developing" nations. Perhaps they would have a better chance without our help.)
Read the whole essay [pdf], and enjoy the hard thinking that went into it and hard work that it implies. I wonder if other organizations are willing to discard 80 percent of their flawed "wisdom" in the same way that Ned has.
Bottom Line: Development is not automatic, and it's certainly harder when outsiders "help." It's good to see some recognition of this fact.