The advent of genetic therapy has raised great hopes, but it is clear that for children and their parents, the primary benefit from recent progress is in the possibility of positive diagnosis and presymptomatic diagnosis allowing more adapted management. For the family, genetic counselling allows well informed family planning and birth of healthy children. For the child to be born, continuing progress in genotypic diagnosis often leads to very delicate questions during the antenatal period, especially since certain diagnoses are still difficult and prognosis less than sure. The wide range of tools in molecular genetics may provide the answer in many situations. The rapid development of genetic tools in developed countries should now raise the question of their use in developing countries. This point might have a particular impact in research on genetic factors and sensibility to frequent infectious diseases such as tuberculosis or malaria. In this case, the aim is not diagnosis but the discovery of genes regulating susceptibility which could lead to pharmaceutical developments. This is undoubtedly a long term objective, but should not be overlooked.