Making Development Dollars Work: Bottom Up or Top Down?

Two recent posts from William Easterly's blog I found interesting. One pointing out the importance of context in interventions - context you don't get when you fork money over to governments and hope for the best, and the second, asking why the British Government increasingly favors top down approaches.

I'm not afraid to say that I'm something of a free market ideologue (doesn't that just mean consistency in ideas?). I don't think it's inconsistent to believe that interventions (if they must happen) should be designed to fit the local contexts as Easterly proposes. Markets are bottom up approaches to solving the needs of the poor as market prices and the very willingness to pay also implies the prioritization of competing needs.

I wonder though if increased interest in top down approaches is one of those unintended consequences of people pushing for spending to meet "Millenium Goals" (UN) without considering efficiency or effectiveness? After all, you can tell people you're meeting those goals allowing them to sleep better at night despite the fact those same funds are literally killing the people they're supposed to help.