This study evaluates progress under the HIPC initiative since IEG's 2003 evaluation. It finds that the Enhanced HIPC initiative cut debt ratios in half for 18 countries, but in eight of these countries, the ratios have come to once again exceed HIPC thresholds. Debt reduction alone is not a sufficient instrument to affect the multiple drivers of debt sustainability. Sustained improvements in export diversification, fiscal management, the terms of new financing, and public debt management are also needed, measures that fall outside the ambit of the HIPC initiative.