In 1980s a comprehensive, organized, and modern cardiovascular care ,in less developed countries, was initiated by the Establishment; i.e. National Heart Center (Indonesia) and National Heart Institute (Malaysia). Although surgery of congenital heart disease (CHD) were scarcely performed, previously, the center/institute did focus on managing coronary heart disease. This task was in response to public health surveys that coronary heart disease became the number one cause of death in the region. At the other end, advanced management of congenital heart disease [(CHD) albeit constant in prevalence] were slow to gain momentum. Lack of expertise, as well as limited funding, were considered to be primary reasons. Nevertheless, despite more than two decades of progress, expert-shortages continued to alter the end-result of medical/surgical care of infant/children with CHD. Unattractive financial rewards were also felt to have a negative impact on the recruitment process of young medical graduates to excel as pediatric cardiologist and/or pediatric cardiac surgeon. Alternative solution to provide a sustainable care to those infants and children with CHD, to a more developed neighboring countries, were short-termed and unpopular. Such measure challenged the existence of highly specialized, centralized health-care system. This paper is an appeal, to the World Society for Pediatric and Congenital Heart Surgery, for reformed service development and quality management policies for less-developed countries in the current global financial turmoils.