We hope to organize team residencies and a conference bringing together professionals from Latin America and from other groups around the world who are also focusing on this issue. We want to bring them together so we can learn from each other, and then widely publicize our conclusions.

A longer time perspective is needed because we face a daunting task both in an intellectual and practical sense.

If you are the kind of person who listens to conservative advice, you may do okay in life, but you probably won't ever be a fantastic leader. You have to take risks, and you also have to go against conventional wisdom, because conventional wisdom doesn't make for startling advances in society.

High level policy makers and program managers do not normally listen to the voices of local people, local providers and local program managers when they make decisions about contraceptive introduction or other aspects of program development in reproductive health.

In the late 60s, 70s and possibly early 80s, social scientists were interested in researching the diffusion of innovation and studying the link between applied research and policy and program development. Recently there has been less interest in these issues and we feel that this interest must be rekindled.

Strategies for research and policy development must simultaneously address people's needs, the capacity of programs to provide good quality of care, and the range of technological options available.

There are hundreds, even thousands of remarkable pilot or experimental projects in all fields - in agriculture, health, education. But where do these pilots take us? Do they lead to change on a broader scale? If not, how can we ensure that they have broader impact?