Abstract
An increasing number of 'third world' health development projects are proving to be unsustainable once foreign aid has been withdrawn. It is argued that this is partly due to the fact that such projects usually deliver health care free of charge rather than allowing communities to incorporate the costs of health care into their local economies. There should be more emphasis on health development projects paying for themselves from the outset. Such projects might also incorporate the extant community based infra-structure of traditional medicine through direct collaboration with its practitioners.

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