This paper discusses the use of Total Quality Management (TQM) in the Third World with a focus on Process Management. Existing examples from developing countries are mostly from emerging economies and very little is found from Sub-Saharan Africa (SSA). Looking into the strength of TQM-drivers as a function of national indicators highlights possible reasons for the lack of TQM. Generally, the drivers are found to be very weak, especially in SSA, and give a low probability for management commitment. In order to test whether process management in a TQM-framework would be feasible, provided there was management commitment, a process view has been overlaid on the functional organisation of a cement plant in SSA. The performance of a more processfocused management is described in a number of case studies. The conclusion is that, technically, First-World process management could function and give good results, but that in practice this will seldom take place due to a lack of management commitment.