The humanitarian response undertaken in Haiti after the earthquake that struck on 12 January 2010 has been one of the most complex ever. However, as the first anniversary of the quake approaches, the Haitian state, together with the international community, is making little progress in reconstruction. The Haitian authorities need to show greater strategic leadership and take decisions that reflect the priority needs of the Haitian population. They need to initiate public infrastructure projects that put people to work and build skills; support people to return home or allocate land for new houses; and invest in agriculture. The international community should do much more to support these efforts by increasing the capacity and accountability of Haitian institutions.