PIP: In late 1965, when he presented himself to the International Planned Parenthood Federation headquarters in London weeks after founding the Profamilia Foundation, Dr. Fernando Tamayo was an unknown Colombian physician with a mission to modify Colombia's very rapid rate of population growth. Colombia in 1964 has a population of 17.5 million growing at an annual rate of 3.4%. By 1973, the population was 22.9 million and growing at 2.7%. Cultural, religious, and moral obstacles precluded an aggressive family planning campaign, which would have aroused violent resistance. Profamilia personnel worked discreetly but persistently, convinced that they would see few short term results but that their effect would be immense in the long run. Family planning is partly a process of educating families in the health, socioeconomic, and psychological benefits of smaller families. Profamilia has a centralized organization which administers 3 main programs, the clinical program with 40 traditional clinics in major cities and 8 well-accepted male clinics, the sterilization program in clinics and mobile units, and the community-based distribution program which distributes pills, condoms, and IUDs through 3000 community posts under the direction of 120 instructors. Between 1964-90, Colombia's total fertility rate declined from 9.2 to 4.4 in rural areas, from 5.2 to 2.2 in urban areas, and from 7.0 to 2.8 overall. The rate of population growth declined from 3.4 to 1.8%. It has been estimated that over half the decline is due to Profamilia services. The total investment by Profamilia during its history was US $100 million. The average cost of protecting a couple against unwanted pregnancy is US $5.26 per year. Colombia's population is projected to increase from 30 to 54 million between 1985 and 2025 even if the growth rate declines from 1.8% in 1990 to 1.3% in 2025. The most worrisome aspect of the projected growth is its concentration in urban areas, which are already beset by poverty, inadequate basic services, and a limited potential water supply already threatened by deforestation. It is clear that the work of family planning in Colombia is not done and that much remains to be accomplished.^ieng