Since Watson & Crick's 1953 description of the structure of DNA, significant progress has been achieved in the control of congenital disorders, most of which has benefited industrialized countries. Little advantage accrued to developing nations, most of which in the same time frame achieved a significant epidemiological transition, resulting in congenital disorders attaining public health significance. The burden of congenital disorders in these lower-resource countries is high and they need to develop medical genetic services. We present a new pragmatic approach for the care and prevention of congenital disorders in these countries, pioneered initially by the World Health Organization.