The Lancet is one of the top medical journals anywhere. When I saw the headline on BBC News, I wasn't expecting much. However, the article doesn't mince words. Here are a couple examples:

"The Lancet says that existing United Nations agencies are too big, too unwieldy, and constrained by UN politics.

It says there is no consensus on the best policies for development, as there has been no scientific analysis of what works and what does not."

It goes on to say:

"The work of agencies like the UN Development Programme is too constrained by politics. They can't lobby for the democratisation of the World Bank, for example, because they'll offend some important people."

Like dictators, tyrants, and corrupt potentates, I guess.