At a world level, the Seventh-day Adventist Church is run by a General Conference. Smaller regions are administered by divisions, union conferences and local conferences. It is present in over 200 countries and territories and is ethnically and culturally diverse. The church runs many schools, hospitals and publishing houses worldwide, as well as a famous organization that helps people in trouble, known as the Adventist Development and Relief Agency (ADRA). There are about 18.5 million people in the Seventh-day adventist church worldwide.