I have been working with the World Health Organization since 1989 in an effort to redefine approaches to contraceptive introduction. This has given me the opportunity to insist that 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.

We are trying to discover where this approach could have the greatest possibility of large-scale impact. We have to choose wisely and see where there is greatest interest and need.

It's very important in a leadership role not to place your ego at the foreground and not to judge everything in relationship to how your ego is fed.

In fact it is essential that we strengthen efforts to learn from each other, and stop considering public health in the third world and in the U.S. as separate intellectual and practical endeavors.

We have emphasized the importance of applied action research because it allows evidence-based policy and program development and a focus on learning. We are also committed to using a participatory approach in which local people, local program managers and providers, local researchers, women's health activists, and national decision-makers play the leading role. International "experts" from technical assistance agencies or universities can make important contributions, but they certainly don't have all the answers.

I would like to make it possible for many women and men in Latin America to win the lottery and receive the type of reproductive health services they so urgently need.

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