No one who has seen the impact of Cyclone Nargis can help but be disgusted by the response of the junta, which has spent three weeks doing its level best to block, delay and control foreign aid intended for the desperate victims.

The international community today has a well-drilled, efficient relief operation that can deliver food, medicine and experts at short notice around the world. Most of that assistance is still prevented from reaching the estimated 2.4 million people made destitute from the cyclone. The toll of dead and missing could rise sharply without moves to prevent disease.

The regime’s response has been to declare that relief operations are over, but that it still wants £5.5 billion in foreign assistance. The cynicism might seem appalling to outsiders, but for veteran aid workers the behaviour is not untypical of the impact that a huge influx of foreign aid can have on a poor, corrupt, developing country where government officials are more concerned with their own wellbeing than the fate of their countrymen.

In the aid world, corruption, blackmail and negligence – and having to act through intermediaries such as Serge Pun – are simply the byproducts of disaster relief work, where it is assumed a certain percentage of aid will always go astray.

A quarter of a century ago Western public opinion was galvanised as never before by the Live Aid appeal for the victims of famine in Ethiopia. Concerts were given, records sold and, thanks to Bob Geldof, the international community intervened in one of the first truly global acts of charity. Out of public view some unpleasant compromises had to be made with the regime of Colonel Mengistu, who enforced by gunpoint Marxist doctrine on his luckless population.

To ensure that food reached those it was intended for, most aid agencies held their noses and looked the other way as the dictatorship used the arrival of food, equipment and funds to bolster the regime.

A decade later, a US-led humanitarian intervention in Somalia drew American forces into a bloody civil war. The Americans ended up fighting and killing the very people they had sought to help.

More recently millions, possibly billions, of pounds disappeared during the largest relief effort in history when donations for tsunami victims in Sri Lanka and other areas ended up in the pockets of corrupt officials and greedy contractors. Similar stories have been repeated more recently in Sudan, where the authorities have hampered aid work in Darfur.

There have been success stories, often when aid can be delivered directly to the victims. The survivors of the earthquake in Pakistan’s Kashmir region received prompt help, ranging from the US military to Islamic charities. Those who lost their homes were given cash to rebuild them.

No such access will be given in Burma while the current regime remains in power. The international community, in particular the West, has three unpalatable choices. It can deal with the regime in a tortuous process that could leave aid undistributed and money diverted, while those in need risk disease and death. It could ignore the whole problem, refusing on principle to cooperate with such a government. Or it could mobilise the American, British and French warships off Burma’s coast and order the distribution of aid by air and sea with or without consent.

None is a good solution, but no one said that it would be easy.

Times Recommends

• The story behind the picture: American elections, 2008
• The Get Out of Jail Free gene
• Caught on camera: hippos kill crocodile in rare clash