Intended for healthcare professionals


Health workers need information from countries with better health indicators than Britain and the US

BMJ 1997; 314 doi: (Published 10 May 1997) Cite this as: BMJ 1997;314:1418
  1. Akira Sekikawa, Fellowa,
  2. Ronald E Laporte, Professora,
  3. Toshihiko Satoh, Assistant professorb,
  4. Genro Ochi, Associate professorc
  1. a Department of Epidemiology, University of Pittsburgh, Diabetes Research Center, 3460 Fifth Avenue, Pittsburgh, PA 15213, USA
  2. b Department of Hygiene and Public Health, Tokyo Women's Medical College, Tokyo 162, Japan
  3. c Department of Emergency Medicine, Ehime University School of Medicine, Ehime 791-02, Japan

    Editor—Meeting the information needs of public health workers in developing countries is an urgent problem.1 Information has to be provided, but how best can this be done? The first public health institutions were established in England in the 19th century after the health effects of the Industrial Revolution were experienced. The advances in public health there had a strong influence in Europe and the United States. The approaches towards public health in the 20th century have been dominated by Britain and the United States. During the past 20 years, however, health in these two countries has lagged behind that in many other countries. For example, Japan's life expectancy and infant mortality have been the best for many years, whereas infant mortality in Britain and the United States did not even rank in the top 10.2

    We argue that information flowing into developing countries should come not only from Britain and the United States but also from countries with successful public health programmes. In Medline during the past decade, however, more than half of the information on public health was from Britain and the United States, yet only 1.7% was from Japan and 0.01% from Iceland, the countries with the highest life expectancy. It might be better to model at least part of the public health programmes in Africa on the successes of Japan. These success stories can potentially be best told through the internet. We have described several possible ways of dealing with the language barrier to globalise health data.3

    There are other key issues. Firstly, people working in public health should become familiar with information exchange through the internet. For this purpose we have conducted several training courses world wide such as the World Health Organisation/global health network joint programme internet training course in Japan ( Secondly, world wide web mirror sites should be set up so that people can have faster access to the information. The global health disaster network was set up in this manner (http://hypnos.m.ehime-u.acjp/GHDNet/ in Japan, and in the United States). Thirdly, we have to discuss how we can develop an infrastructure for the information with low band width connectivity, because only information with low band width reaches most of the developing countries that have access to the Internet.

    There is little question that we have learnt much through the enormous amount of public health information from Britain and the United States. We can also, however, learn much from the areas with the best health indicators, which disproportionately provide less information than these two countries.


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