We felt that the Gates Foundation looked at our track record and our publications and decided that "this is persuasive; this needs to be done. Let's see what they can do."

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?

Major changes become possible if you work in a participatory manner, listen to local people, diagnose what the problems are, provide training and identify where there are opportunities for mobilizing local resources to take action.

Fear of failure is the fuel of achievement. If you weren't afraid to fail, you probably wouldn't be highly motivated to work at the level that most of us have to work at to do well.

I would like to see policy makers and international donor agencies realize that it is not enough to give money for demonstration projects. From the very beginning plans should be made for the scaling-up of successful innovations.

It is not enough to give money for demonstration projects. From the very beginning plans should be made for the scaling-up of successful innovations.

If we succeed in learning more about how to expand program innovations from pilot projects so that they have broader program impact, this should be very relevant for public health initiatives in Michigan and elsewhere in the US.