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Rapid Responses: Rapid Responses published:
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![[Read Rapid Response]](/icons/misc/sectionDOWN.gif)
Evidence of Lancet's Commitment?
- Chris W Green (30 September 2000)
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real standards and restraint help usability
- Adrian Midgley (1 October 2000)
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Global Alliance for Health Information
- Peter A Singer (1 October 2000)
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Re: Global Alliance for Health Information
- Pedro Urra (3 October 2000)
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BMJ's contribution to Global Health Information Flow
- Joe Thomas (4 October 2000)
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A proposal to provide access to the full-text of medical journals
- Aniruddha Malpani (4 February 2001)
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Chris W Green, AIDS Activist Jakarta, Indonesia
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Adrian Midgley, GP Exeter
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It is a good editorial, and correct. It is also on the whole a good thing that the Gates' foundation is helping information flow to the poor. However, here is yet another reason why providers of health information should avoid building sites that expect the user to have a particular browser, plug-ins or indeed which make any assumptions about the viewer's abilities. The NHS is on course to become notable among health information providers, despite its bizarre decision to hide most of its servers from doctors at home and the rest of the world, and the typical British public sector attitude that most things are best hidden or at least have to be signed for. However it persistently makes what is now less of a mistake and more of a partisan act in a commercial struggle by choosing to assume that users will have a late model Microsoft browser. The information revolution in the poor countries will not depend upon Windows, it will depend upon the Linux operating system ( http://www.linux.org Pronounced http://www.linux.org/info/sounds/swedish.au ) and upon applications sharing with Linux the characteristic of having open source code and being freely available and alterable. The American distinction: Free as in Speech not free as in beer, and the always logical French phrase "logiciel libre" rather than "gratuit" are important to bear in mind. Indeed, the same probably applies to this country. In the health area the Open Source Health Care Alliance aim to ensure that the possibility of benefitting from these technologies is spread as widely as possible. http://www.oshca.org/ Actions ----------- Owners of current and future health websites should ensure that there are no features in their sites that produce browser dependence. They should also ensure that the size of pages is kept small, as the time taken to download large pages is excessive for usrs dependent on low bandwidth connections, such as telephone lines in much of the globe. ( http://www.useit.com/about/nographics.html http://www.useit.com/alertbox/9511.html ) Interest: I paid my own way to the inaugural meeting of the OSHCA and am occasionally paid for consulting on how things should be done. |
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Peter A Singer, Sun Life Chair and Director University of Toronto Joint Centre for Bioethics
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Global Alliance for Health Information EDITOR -- If the problem were a new opera house for Sydney, we would hold a competition for architects to demonstrate their designs. These designs are visions of the future. Similarly, vision is what we need now to address the problem of global health information. Pakenham-Walsh notes “International agencies, non-governmental organizations, publishers, libraries, training schools, and others all are seeking to improve access to information for healthcare workers. Collectively they bring a wealth of skills, but their overall effectiveness has been limited by, ironically, lack of communication.”1 Tan-Torres Edejer observes that “The long list of initiatives is impressive but has any effort been made to get them to work synergistically? This role is most appropriate for the nations themselves with the cooperation of international organisations and donor agencies.”2 We now need a vision for how these organizations might work together, and to what end. The global health information problem is so complex and formidable –- far more so than the Sydney opera house -- that providing a focussed, realistic vision would make a useful contribution. Without a vision, effective action will be impossible. As the saying goes, “If you don’t know where you are going, any wind will take you there.” A coherent vision would provide focus for debate, and motivate subsequent concerted action on the part of key players. Godlee et al. correctly identify two key criteria by which such a vision should be judged – sustainability and multi-directionality of information flow (i.e., flow not only from developed to developing countries but also from developing to developed countries and perhaps most importantly among developing countries themselves).3 They are also right to suggest that the global inequities of health information are part of the problem of global inequities in health, arguably the most important ethical problem in the world.4 The next step towards a solution is to provide a vision of a Global Alliance for Health Information. Peter A. Singer, Sun Life Chair and Director University of Toronto Joint Centre for Bioethics, 88 College St., Toronto Canada M5G-1L4 peter.singer@utoronto.ca Competing interests: I have written an article containing a vision of a Global Alliance for Health Information. 1. Pakenham-Walsh N. Improving access to reliable information in developing countries. BMJ 2000;321:831 2. Tan-Torres Edejer T. Disseminating health information to developing countries: the role of the internet. BMJ 2000; 321: 797-800 3. Godlee F, Horton R, Smith R. Global information flow. BMJ 2000; 321:776-777 4. Singer PA. Medical ethics. BMJ 2000;321:282-285 |
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Pedro Urra, Infomed director Infomed. Cuban Health Network
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Congratulation for this great editorial. This are Public Global Goods for health and Development. We in Cuba had the chance to work in a national health Network from 1991, Infomed ( www.sld.cu) and we have been using the information from PubMed, BMJ, Lancet and many other sources of information that could be share with developing countries. We too have Cuban health information and and a human network learning and participating in this new way to share knowledge and information. We have been using too the Supercourse project of Ron Laporte in Pittsburg and many other initiatives. We agree that there is an incredible chance to use this opportunities and that the developed world has the chance to contribute with practical steps like the BMJ initiative. We have been doing a great effort at the national level in order to improve infrastructure, training people, developing local content, but it would be impossible the impact of the Infomed in Cuba without those public global goods that are today medline, BMJ, Scielo, and others. We have the chance to learn and we are now paying access to full text journals that are not free, with our full text journals that are on the Web since 1995. We have cuban doctors and health personal participating in international fora, discussion lists, chats and many other initiatives. We are building together a new approach to international collaboration with this new technologies looking for smart and appropiatte technologies. Best Pedro Urra
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Joe Thomas, Research Fellow Melbourne
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In the context of discussion on the role of Internet in disseminating health information, I would like to comment on the contribution of BMJ. I reckon, BMJ policy of providing access to full text for key articles and a provision for a rapid feed-back on those articles are a unique feature which facilitates rapid diffusion of innovations and ideas. Many of the e- discussion groups draw latest information on their area of iterest from such sources. Hope other major medical journals also would follow BMJs digital foot steps! Joe Thomas Conflict of Interest: The author is the moderator of AIDS-INDIA eFORUM |
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Aniruddha Malpani, Medical Director, HELP Bombay, India
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A major problem doctors in developing countries like India face is that they find it very difficult to access the full-text of articles from medical journals. Sometimes, instant access to the full-text of a medical article may spell the difference between life and death - and if the journal is not available, then a patient may die because of a lack of access to the information in the article.
I'd like to propose that all medical journal publishers be required or requested to produce an online version of their journals . While subscribers could be allowed free online access, ( and this would be a useful value-added service they could offer their subscribers ) , non-subscribers could be offered the option of paying online for access to a selected article. These articles could be published online as e-matter, very similar to the model which www.mightywords.com |
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