For personal use. Only reproduce with permission from Elsevier Ltd
10 years ago, a meeting to review global access to healthinformation concluded that most health professionalsin developing countries had inadequate access toinformation and that the information available to themwas often unreliable or irrelevant.
At that time, therewas optimism that, by 2004, all—or nearly all—healthprofessionals in developing countries would haveaccess to the information they needed to provide themost effective health care possible with the resourcesavailable. The world was at the cusp of the informationage: information and communication technologieswould mean that lack of access to reliable relevantinformation would no longer be a barrier to effectivehealth care. Although other factors such as lack of drugs and infrastructure might hinder provision of health care, this would not be the case withinformation. What then has been achieved in the past 10 years?What have we learnt? And if providing access to reliableinformation is the single most cost-effective andachievable strategy for sustainable improvement inhealth care,
what steps can we now take to bring usnearer to health information for all (panel)?
What has been achieved?
Important progress has undoubtedly been made.Information and communication technologies areincreasingly available; more and better content isavailable to a growing number of people, especially thosein tertiary hospitals, academic institutions, and urbansettings; there are more and better free resources on theinternet; there is a larger and wider range of health-information support programmes; an internationalcommunity has evolved that is committed to improvinghealth-care information, with governments and otherbodies in developing countries playing an increasinglyactive part; and politically, access to health-careinformation has become a key international developmentissue. Equitable and universal access to health-careinformation is recognised in the latest draft of WHO’s
World Report on Knowledge for Better Health
as animportant part of worldwide strategies to reduce globaldisparities in health and to achieve the health-relatedMillennium Development Goals. Progress has been patchy, both geographically (withsub-Saharan Africa generally falling far behind mostother regions) and across different health sectors(specialist and academic health care is much betterserved with information than rural primary care), andoverall there is little if any evidence that the majority of health professionals, especially those working inprimary health care, are any better informed than theywere 10 years ago. The few empirical studies weidentiﬁed
and many anecdotal reports suggest thatlack of physical access to information (absent, slow, orunreliable internet connectivity, expensive paper, andhigh subscription cost of products) remains the majorbarrier to knowledge-based health care in developingcountries. However, there are now many successful initiativesthat could be extended or replicated. An example isBIREME (http://www.bireme.org), the Latin American
Can we achieve health information for all by 2015?
Fiona Godlee, Neil Pakenham-Walsh, Dan Ncayiyana, Barbara Cohen, Abel Packer
Universal access to information for health professionals is a prerequisite for meeting the Millennium DevelopmentGoals and achieving Health for All. However, despite the promises of the information revolution, and somesuccessful initiatives, there is little if any evidence that the majority of health professionals in the developing worldare any better informed than they were 10 years ago. Lack of access to information remains a major barrier toknowledge-based health care in developing countries. The development of reliable, relevant, usable information canbe represented as a system that requires cooperation among a wide range of professionals including health-careproviders, policy makers, researchers, publishers, information professionals, indexers, and systematic reviewers.The system is not working because it is poorly understood, unmanaged, and under-resourced. This Public Healtharticle proposes that WHO takes the lead in championing the goal of “Universal access to essential health-careinformation by 2015” or “Health Information for All”. Strategies for achieving universal access include funding for research into barriers to use of information, evaluation and replication of successful initiatives, support for interdisciplinary networks, information cycles, and communities of practice, and the formation of national policieson health information.
Published online July 9, 2004http://image.thelancet.com/extras/04art6112web.pdf See
CommentBMJKnowledge, BMAHouse,Tavistock Square, LondonWC1H 9JR, UK
;INASP, Suite B, 58StAldates,Oxford OX11ST, UK
;Durban Institute of Technology, POBox 1334,Durban 4000, South Africa
(Prof DNcayiyana PhD Med)
;Public Library of Science, 185 Berry Street, Suite 1300,San Francisco, CA 94107, USA
; and BIREME,Rua Botucatu 862, 04023-901Sao Paulo, Brazil
(A Packer MLS)Correspondence to:DrFionaGodlee, Head of BMJKnowledge, BMJ PublishingGroup, London WC1H 9JR, UK
Published online July 9, 2004 http://image.thelancet.com/extras/04art6112web.pdf 1
This paper is adapted from a discussion papercommissioned by WHO in preparation for the MexicoSummit on Health Research in November, 2004.Publication in
coincides with the launch of theGlobal Review of Access to Health Information inDeveloping Countries (http://www.inasp.info/globalreview). Building on a series of existing conferencesworldwide in 2004–05, the review will bring togetherpeople from all stages of knowledge creation anddissemination, to understand more about progress, lessonslearned, and ways forward. To get involved, join the e-mailforum HIF-net at WHO (email@example.com).