The fact that over 4 million African children die each year is tragic but not inevitable. As demonstrated at the Dakar Conference which had as its title "Africa's Progress for Child Survival," solutions do exist; at times they involve new drugs, institution-building, awareness-building methods, behavioral changes, and greater involvement and interaction among governments, international organizations, NGOs, and communities. Despite the many constraints, PLAN Saint Louis is optimistic that the situation can be changed. PLAN'S primary health care program works on a range of issues including training and health education, potable water, nutrition, immunization, malaria control, diarrheal disease control, hygiene and sanitation, maternal care, and the prevention of sexually transmitted diseases, including HIV/AIDS. The financial support provided by PLAN, however, cannot ensure the total sustainability of health facilities and activities. The social cost must be borne by both the state and individuals. However, establishing sustainability as a prerequisite is unrealistic for African nations because of their present level of development. Health for All by the year 2000 is one of the greatest challenges of the modern era. It can, however, be achieved only if governments, international organizations, the private sector and NGOs, and all the other actors accept the challenge.