The management of international organizations is attracting growing attention. Most of this attention is highly critical of both the UN system and International NGOs. Sometimes, this criticism lacks depth or reflects insufficient understanding of these organizations, or is based on narrow, and sometimes biased, internal political concerns of a particular country. International relations theory has insufficiently studied the type of linkages that these organizations provide between international decision-making and Northern fundraising on the one hand, and practical action in the South on the other. As a result, current theory too rarely focuses on the inner functioning of these organizations and is unable to explain the deficiencies and negative outcomes of their work. While the authors identify and describe the pathologies of international organizations in, for example, international diplomacy, fundraising, and implementation, they also stress positive elements, such as their intermediary role. The latter form the basis for more efficient and effective policies and action that, in addition to some recent political trends also described in this volume, hold hope for a stronger functioning of these organizations in the future.