Thank you, Dr. Ichikawa and thanks to the membership and Executive Committee of ISN for honoring me as a co-recipient of the Jean Hamburger Award for 1999. In doing so you of course honor all those who have worked with me, now more than two hundred talented young men and women whose efforts and successes have brought distinction to themselves and to the school of nephrology that has grown up around me, initially in San Francisco and for the past 23 years, in Boston. Rather than use my allotted three minutes to single out and recognize my mentors, trainees, coworkers, and family, as I have had the pleasure of doing many times previously, I would instead like to speak to this ISN audience about our collective responsibility for advancing medicine in general, and nephrology in particular, in regions of the world where medical manpower, expertise, and financial resources are still sub-optimal. Wherever John Dirks and I travel, as co-chairs of COMGAN, ISN's Commission on Global Advancement of Nephrology, we are presented with the same recurring problems, namely inadequate medical and nursing manpower, a knowledge base often two to three decades behind that present here today, outdated or inoperable technical resources, and limited drug availability, to name a few. COMGAN's courses and workshops, site visits and senior scholar exchanges, together with ISN's substantial fellowship program and initial attempts at sister center linkages, have proven to be an excellent start, but much, much more is needed. Today, patients in rural areas throughout the world are unaware of their hypertension or maturity onset diabetes, and therefore go untreated, resulting too often in clinical presentation in end-stage renal failure with renal replacement therapy still an unaffordable and therefore uncommon option. In addition, epidemic forms of post-streptococcal and other post-infectious glomerulonephritides, malarial and other causes of membranous nephropathy, as well as IgA, Hepatitis C and HIV nephropathy contribute to hundred of thousands of undiagnosed and untreated cases progressing to renal failure. My point then is simple: whereas ISN has already taken bold and unique steps in addressing many of these global shortcomings, far more is needed. Each of you, coming largely from well-developed programs in advanced countries, must consider ways in which your expertise, together with your institution's resources, can help to bridge the wide gap between haves and have-nots in nephrology, and to encourage your colleagues in other areas of medicine and surgery to do likewise in their particular specialty or subspecialty. After all, isn't this what an International Society should be all about—information and resource transfer from those with more to those with less. I would especially urge you to transfer books, periodicals and what you consider to be outmoded dialysis equipment, office equipment including personal computers and fax machines, and any surplus laboratory gear you can spare. To those in need, nothing is outmoded! Finally, as roving ISN ambassadors, please help by actively soliciting financial and material contributions to ISN from publishers, pharmaceutical companies, dialysis and other equipment and supply manufacturers. Simply direct names of potential corporate donors to members of the ISN Executive or to Dr. Dirks or me. In closing, let me again express my deep appreciation to ISN for its generous recognition of my program's contributions to nephrology and for the opportunity to personally serve the Society in several capacities over the past three decades.