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.

If you want to scale-up, the first thing you have to do is to expand your own team.

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.

Bureaucratic systems are not set up to be what we refer to as human service organizations. They were established to collect revenue and maintain law and order and they used a law and order approach in providing family planning services.

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.

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.

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.