The majority of the world's population now lives in countries with governmental family planning policies, many of which have explicit demographic goals. Nearly all these programmes are recent, difficult to evaluate and carry on them the imprint of political and religious pressures stretching back over many decades. On the whole the initial results of governmental planning in the private, individual domain of fertility have been disappointing. The range of fertility regulation options needs to be widened and management skills and philosophy improved both nationally and internationally. There is a need and opportunity for continued non-governmental activity. The demand for family planning services outruns supply in nearly every country. The resources currently invested in family planning at a world level, if reallocated, are probably sufficient to meet latent demand. But it will require political will, some straightforward technical insights and the elimination of redundant activities to achieve this goal. Once the basic human right of men and women to control fertility has been realistically extended to the world's population, further review will then be necessary to determine if additional motivational and educational efforts are necessary to achieve desired demographic goals. There are many uncertainties on the road ahead, but the immediate choices that need to be made are obvious.