—Our article stated that USAID and PAHO were the main organizations to respond quickly to the new situation in 1990. We also mentioned USAID's valuable support for family planning, provision of essential medicines, and responses to regional emergencies. The letter from Dr Ballantyne details these and other important activities.In our conclusions, we discuss the importance of cooperation among international organizations and agencies to support primary care development. The USAID is working closely with the Ministry of Health to promote decentralization of health services and primary care through the strengthening of local health systems throughout the country. This experience and these models will likely be of keen interest to other developing countries in the coming years.