The term ‘appropriate technology’ is used for productive developments which are adapted to the special circumstances of underdeveloped countries. It is now generally accepted that, if the same criterion is to be applied to health policy, it will mean a shift to a mainly preventive service. Adopting a preventive policy will result in many countries having to retrace their steps, against resistance from those at home and abroad who have a vested interest in the status quo. These include the national hospitals which absorb the greater part of the countries’ health budgets (over 50 per cent, for example, in both Bahrain and Djibuti (WHO, 1987, p. 35); and well-heeled health professionals who congregate in the big towns, providing little or no service for the remoter areas. As we have seen, commercial interests in the North also have a stake in holding back progress.