Peggy McDowell Curlin, 65, a leader in international women's health initiatives, died of pancreatic cancer Sept. 24 at Georgetown University Hospital.

Ms. Curlin was the president of the Centre for Development and Population Activities in Washington from 1989 until her retirement in 2003. She also co-founded what is now known as Concerned Women for Family Development, a grass-roots women's health cooperative in Dhaka, Bangladesh.

She became involved in women's health issues while her husband, a physician with the U.S. Public Health Service, was assigned to Bangladesh. During a smallpox epidemic in 1974, she realized that all government vaccinators were men, and Muslim practices prohibit men from touching women who were not relatives. "There was enormous mortality" among women and children as a result, she said.

Ms. Curlin and Mustari Khan, a Bangladeshi woman whom she met while their husbands studied together at Johns Hopkins University's medical school, formed teams of female volunteers to vaccinate women and children. "In almost every house, the women would take you aside and say, 'Sister, can you tell us how not to have babies?' We said, go to the clinics. And then we found the clinic was 12 miles away and they never left the house," Ms. Curlin told The Washington Post in 1994.

The pair started an urban team to deliver family planning to women in their homes. "Everybody told us it would be difficult, but the first woman to accept our services was the wife of a mullah in Dhaka. Women just acted on their own self-interest," Ms. Curlin later said.

In time, Concerned Women for Family Development became a basis for women's empowerment initiatives and micro-credit projects, and it now works on education and income-generating projects as well as programs on reproductive health and AIDS.

She joined CEDPA upon her return to Washington in 1978. In 1994, she was a member of the U.S. delegation to the U.N. International Conference on Population and Development in Cairo and its five-year follow-up conference.

Ms. Curlin was a member of the U.S. Agency for International Development's Advisory Committee on Voluntary Foreign Aid and on the board of numerous international health and family planning organizations. She was named an honorary chief of Nigerian tribes four times.

She was a native of Harlan, Ky., and a graduate of Centre College in Danville, Ky.

Survivors include her husband of 43 years, Dr. George T. Curlin of Bethesda; two children, Meg Artley of McLean and Mac Curlin of Santa Monica, Calif.; and two grandchildren.

Peggy M. Curlin led international women's health initiatives.