One of the things we have learned in the first year is that if you want to scale-up, the first thing you have to do is to expand your own team.

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?

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 often say that shareholders should feel very responsible for how responsive corporations are to the public trust.

My colleagues from the Department of Health Behavior and Health Education are working on participatory public health initiatives in Michigan, and there is much that we can learn from each other. 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.

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.

If policy makers and program managers participate in an interdisciplinary assessment team, make informal visits to local families and have in-depth conversations with local providers and health authorities, the real needs and complex challenges of organizing good reproductive health services become apparent.