Foreign ministers and aid groups leading the effort to help Haiti recover from the devastating earthquake met today for their first conference on how to channel aid into a country that has lost much of its already poor infrastructure.

Haiti's magnitude 7.0 earthquake on 12 January killed an estimated 200,000 people and left the poorest country in the western hemisphere virtually without a functioning government. It wrecked the presidential palace, parliament, government ministries and the UN headquarters, among thousands of other structures.

The Haitian prime minister, Jean-Max Bellerive, told the Montreal conference that his government needed to rely strongly on its partners but said Haiti was able to lead the rebuilding effort.

"Haitians continue to work in precarious conditions but it is in the position to assume the leadership expected of it by its people in order to relaunch the country on the path to reconstruction," he said. However, Bellerive admitted the government was facing serious legitimacy issues as people question whether it exists at all. The destruction of key government buildings has hampered the work of what was already a weak and inefficient state.

Bellerive said while Haiti needed help from abroad, it had to do more with less and work in a different fashion. He said in the short term, it needed to help people with water, food and housing.

"The people of Haiti, the Haitian community, will need more and more and more in order to complete the task of reconstruction," he said.

He said Haiti's government had set up six groups to deal with issues such as humanitarian aid, housing and security. He said each group was being led by a minister as well as an international party. But the Italian government official who led the country's response to the L'Aquila earthquake condemned the relief efforts in Haiti as a disorganised "vanity parade". Guido Bertolaso, the head of Italy's civil protection service, said there had been a fundamental lack of leadership thus far in foreign aid missions to Haiti, warning also that the large US military mission in the country was not entirely helpful.

"The Americans are extraordinary, but when you are facing a situation in chaos they tend to confuse military intervention with emergency aid, which cannot be entrusted to the armed forces," Reuters reported him as saying.

Italy's foreign minister, Franco Frattini, swiftly distanced the government from Bertolaso's comments. He had "attacked American and international organisations head on. The Italian government does not share these statements," Frattini said.

The Canadian prime minister, Stephen Harper, and ministers from more than a dozen countries, eight international bodies and six major non-governmental organisations attended the conference.

The US secretary of state, Hillary Clinton, told reporters that international donors and organisations had been mapping out a plan for Haiti development for months before the quake. She indicated it could be the basis for a revised plan.

"I don't want to start from scratch, but we have to recognise the changed challenges that we are now confronting," she said.

Governments have pledged nearly $1bn (£616m) in aid to Haiti, according to an Associated Press estimate.Today's meeting came as a global army of aid workers was delivering more food into people's hands in Haiti, but the efforts were still falling short.

Paul Conneally, spokesman for the International Red Cross, said there was a growing need to bring in heavy equipment to take down damaged buildings, some of which could collapse at the slightest aftershock.