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In 1987, World Development published a supplement entitled “Development Alternatives: the Challenge of NGOs.” Although this challenge now seems far more complicated, this paper suggests one way of giving meaning (and possibility) back to the juxtaposition of “development alternative” and NGOs. NGOs might benefit from rethinking the notion of development alternatives in terms of the politics and political economy of social change, of adopting a Gramscian reading of civil society and their role therein, and from reflecting that their role in realizing genuine alternatives has usually been in conjunction with political programs of social movements and/or developmentalist states. Such a rethinking will help define the contours of a theory for NGO action.