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For Richer For Poorer in the World of Clinical Pharmacology
- Barbara Ameer (13 August 2007)
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HINARI for health researchers. TALC for health workers.
- David C Morley, William AM Cutting, Mark Summers, Hilary Heine, Gerald Dingley (13 August 2007)
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HINARI has empowered us
- Arjun Karki, MD (15 August 2007)
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'Separation' of content relevant to developing countries - a clarification
- Neil Pakenham-Walsh (16 August 2007)
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Barbara Ameer, Adjunct Associate Professor of Medicine UMDNJ-Robert Wood Johnson Medical School, New Brunswick, NJ 08903
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The Health InterNetwork Access to Research Initiative (HINARI) inspired the governance of the American College of Clinical Pharmacology (ACCP) to provide a greatly reduced dues structure to colleagues residing in developing economies. The low membership dues are tied to the World Bank economic categorizations and are associated with electronic publications from the ACCP to its “electronic” members(1). In so doing, the ACCP took a leadership role among its peer organizations in being responsive to professional colleagues in developing economies(2). If other medical and healthcare organizations follow this lead, important contributions to world health will be made through educational programs, publications and international professional networks. As chair of the organization’s International Development Committee, I see this pricing approach as a first step in strengthen the capacity of clinical pharmacologists worldwide in pursuit of the College's mission of “improving health by optimizing therapeutics." References: (1) Ameer B. Extending Worldwide Clinical Pharmacology Education Through a Pricing Approach. Journal of Clinical Pharmacology 2005; 45:982-6 (2) "The ACCP strives to close the 10/90 gap between rich and poor nations" http://www.eurekalert.org/pub_releases/2005-10/sp-tas100105.php Barbara Ameer, PharmD, MBA, BCPS, FCP Competing interests: None declared |
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David C Morley, Founder and President, TALC TALC, PO Box 49, St Albans, Herts AL1 5TX, William AM Cutting, Mark Summers, Hilary Heine, Gerald Dingley
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Two cheers for HINARI (“Health Internetwork Access to Research Initiative”), the WHO and publishers of many important medical journals. This distribution of scientific information targets the medical research institutions and workers in the poorest developing countries. Now they can read on the internet articles from many key journals soon after publication. This is an important advance in distribution of information. However, even its strongest supporters admit that there are problems; limited numbers of institutions registered, poor internet connectivity, it may take a whole afternoon to download a single article, passwords that don’t work and librarians who “control” access. HINARI does not target the training of health workers and those actually caring for the sick in the hospitals and health centres in the poor countries. These people, particularly those working outside major centres, will play a major role if the Millennium Development Goals for health are to be met. They comprise a much larger group than the researchers. The NGO TALC (Teaching Aids at Low Cost www.talcuk.org) currently tries to fill an information gap for health workers and their teachers in the poorest countries with its (6 thousand) free CDs, e-TALC, twice a year when we receive sponsored funding. When considering HINARI Pakenham-Walsh observed that “If health workers don’t have access to the information they need at the point of care, then the direct health benefits are limited.” Computers are now increasingly available to health workers in the poor countries, but until more reliable internet access is widely available they cannot connect. Moreover, they require selected, practical information that is based on sound science and not commercial interests. The e-TALC discs provide carefully selected information with a search engine built into each CD. Pakenham-Walsh also points out that many of the workers require “electronic textbooks and other non-journal resources.” Again, this is something that e-TALC can provide. For example, the latest, e-TALC 9 contains, along with much other material, the whole of the new WHO pocket book, “Hospital care for children”, illustrated with a series of coloured images. Hopefully HINARI will gradually extend to more health personnel in a wider range of countries, but for the intermediate future, e-TALC will work in parallel to provide practical, selected material on CDs for teachers and health workers who are on the job. 1 Brown H. FOR RICHER FOR POORER. BMJ.2007; 335:280-3. (11 August) 2 Pakenham-Walsh N. Quoted by Brown H. in FOR RICHER FOR POORER. Competing interests: Members of TALC team |
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Arjun Karki, MD, Internist Patan Hospital, Kathmandu, Nepal
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Providing good clinical care services to the poor needy patients attending the public hospitals in a poor country like Nepal is a constant struggle. Work overload, low salary, inefficient bureaucracy and violent behavior of the public when system cannot meet their expectations are some of the challenges that we need to deal with on a daily basis. With the rapid expansion of cable TV and internet connection, while the public became more informed and more demanding, we physicians did not have the means to benefit from the advancement in medical science and clinical wisdom. That used to make us feel intellectually isolated and professionally disempowered. To our great delight, however, the availability of the HINARI system has changed our lives. Even with a computer in our hospital library with not that fast internet connection, we have been using the HINARI system to access and benefit from the biomedical journals both for our own professional growth, teaching medical students and physicians in training and pursuing research. Our librarian has also provided the password to the clinicians who wish to use the system from their personal computers at home. And we now feel that we have been empowered tremendously. Hence I would like to take this opportunity to express our gratutude to all those who made HINARI a reality. Finally, I would like to make a point in response to the idea of separating the contents that have a relevance to the needs of developing countries. My own feeling is that those of us who live and work in the developing parts of the world are smart enough to analyze the quality and relevance of the accessible biomedical literature and select those which are of local interest and relevance. Competing interests: None declared |
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Neil Pakenham-Walsh, Coordinator, Global Healthcare Information Network Oxford OX7 3SE
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Dear Editor, Arjun Karki said: "Finally, I would like to make a point in response to the idea of separating the contents that have a relevance to the needs of developing countries. My own feeling is that those of us who live and work in the developing parts of the world are smart enough to analyze the quality and relevance of the accessible biomedical literature and select those which are of local interest and relevance." I was the person who was quoted in the article as saying "Because most journals are published in developed countries, the content is high tech. It might be good to separate out the developing country-relevant stuff." I would like to make it clear that this quote does not clearly represent what I was trying to say to Hannah Brown when she interviewed me on the phone for the article. What I was trying to say was that it might be useful to find ways to make it easier to identify articles in the global literature that are likely to be of direct practical relevance to the vast majority of health workers who work in low-resource settings, especially perhaps those working in primary and district health care. Regrettably such articles are few and far between. Dozens of groups worldwide - ranging from the library staff at the WHO African Regional Office in Brazzaville, the Cochrane Developing Country Interest group, and producers of secondary publications such as Africa Health and CME Uganda - are doing important work in identifying and synthesising such material. Best wishes, Neil Neil Pakenham-Walsh MB,BS
Join HIFA2015 and CHILD2015 - send your name, organisation and brief description of your professional interests to hifa2015-admin@dgroups.org and child2015-admin@dgroups.org (or direct to Neil PW at neil.pakenham- walsh@ghi-net.org ) "Healthcare Information For All by 2015: By 2015, every person worldwide will have access to an informed healthcare provider" Competing interests: None declared |
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