The idea of distributing cash relief in famines is controversial. Although it is increasingly recognised that food aid serves not purely as a nutritional intervention, but also as a transfer of an economic resource, there is considerable reluctance to distribute cash in place of food. Indeed, since the monetisation of food aid is now accepted as important in strengthening livelihood strategies, it is surprising that the idea of direct cash transfers is so rarely thought of as a practical alternative by the relief community. Nonetheless, there appears to be a growing willingness to at least consider the use of cash as an alternative to either direct food aid delivery or the delivery of non-food relief items, and as the medium of support in safety nets.