The European Investment Bank (EIB) differs from most other international financial institutions (IFIs) in that it lends in all of its member countries, not only in its poorer members. It does lend throughout the world, but most of its lending is within the European Union (EU). A significant share is within some of the world's wealthiest countries. There is nothing new to this situation, and the EIB has survived as the oldest of the regional IFIs. What has changed is the speed of economic integration in Europe. The Single Market, eliminating barriers to intra-EU trade in financial services, has been put in place, and the end of this year will see the launch of EMU. The question of the appropriate role for the EIB in the next century would seem to be even more challenging than that of other IFIs, operating exclusively in countries where substantial poverty continues to exist (1). Though this paper does not address the particular role of the EIB, this has nonetheless led us back to first principles and a consideration of how IFIs can add value in general. Certainly, this exercise runs the risk of existentialist angst, but when looking to the future we do have to face the possibility that euthanasia may be one of the best solutions to the problems of ageing.