Malnutrition is crippling Bolivia, afflicting approximately one in four babies born there each year. Despite high annual expenditures on improving nutrition and food security, and twithstanding some stunning successes in the past two decades, the fundamental problem is still t improving. This work begins by defining the nature and extent of the malnutrition problem in Bolivia, its causes, and its occurrence relative to wealth, location and ethnicity. It goes on to identify the underlying reasons for the failed response, asserting that the most fundamental barrier to progress is a general misunderstanding about the causes of malnutrition and its solutions. The result is that resources are spent on the wrong programmes and the wrong segments of the population.