As we approach the end of this first month in the penultimate decade of the twentieth century, it is altogether fitting that we are meeting to consider the special health problems of smaller states and to discuss methods which can be utilised to alleviate or resolve those problems. Criticism, as many of you are aware, has been expressed in a number of quarters regarding the 1978 Declaration of Alma Ata which states, inter alia, that “a main social target of governments…should be the attainment by all peoples of the world by the year 2000 of a level of health that will permit them to lead a socially and economically productive life.” Without entering into that debate, it appears most unlikely that smaller states will achieve this “main social target” by the beginning of the next century unless special attantion is given to their unique problems.