ABSTRACT
The time scale for getting right is always too short. I f effectiveness comes from cycles of piecemeal testing and a dj ustment, then there must be room for making mistakes. If the best fixes are drawn from experience, they wil l rarely be quick. The design of interventions should include processes that support learning go along; otherwise, all of the mistakes will become ubvious at once, once the interven fails . Sim the assumption that one size can fit all tbat are standardized solu tions fur problems that appear familiar -- denies the need for adjustments to local con ditions and local knowledge. This, too; has led to fai lures in designs workable and effective . The adaptation community is facing pressure to provide fixes that can be readily disseminated and emulated. The lessons from public health experience in these circumstances, however, suggest that e ffectiveness v/iH prove illu sive until several rounds of learn ing from experience are permitted to occur. In any event, the way public health structured adaptation and responded to its demands offers lessons from its perhaps sparing others some of the trouble .
