Why do people question the necessity of poverty alleviation? Here we should perhaps distinguish between two types of alleviation, which to an extent follow the two types of poverty. In some contexts, alleviation efforts are essentially humanitarian assistance for those in urgent need of extraction from absolute poverty. Those in the greatest poverty may face imminent threat to life, due to the inability to obtain medication, food, or adequate shelter. In other contexts, entrenched relative poverty may require more than the ‘simple’ provision of basic necessities. In these cases, efforts to help start to take the form of structural reform. When support for those in need graduates to a more complex political, social and economic process, anti-poverty practice becomes complicated or even alienated. Controversies may thus arise.