Intended for healthcare professionals

Education And Debate

HINARI: bridging the global information divide

BMJ 2004; 328 doi: (Published 13 May 2004) Cite this as: BMJ 2004;328:1190
  1. Srinivasa Vittal Katikireddi (, final year medical student, University of Edinburgh1
  1. 1Liverpool L18 9XN

    Health care is unequally distributed between the developed and developing worlds, which is matched by unequal distribution of health information. The information gap between rich and poor countries is so great it has been argued that “providing access to reliable health information for health workers in developing countries is potentially the single most cost effective and achievable strategy for sustainable improvement in health care.”1 So far, the most successful initiative to bridge this gap is the Health InterNetwork Access to Research Initiative (HINARI).

    A short history

    “In HINARI lies the seed of a knowledge revolution,” said Gro Harlem Brundtland, director of the World Health Organization. “The knowledge gap between rich and poor must be overcome if we are to reduce poverty. The information made available through HINARI will help developing countries in improving skills, developing research and, by extension, to save lives.”2

    In April 2000, a group of researchers from developing countries, convened by the World Health Organisation (WHO), concluded that the best way to help with their information problems was to improve their access to the published literature (Aronson B, personal communication). At that time, 56% of institutions in the lowest income countries had no current subscriptions to international journals and 21% averaged only two journal subscriptions.3

    WHO realised that the recent revolution in information technology had opened up an opportunity for addressing information poverty. Compared with the £50 or more that it costs to send a paper copy of a weekly journal to an institution in Africa for a year, it costs publishers virtually nothing to give that same institution free access to an electronic edition of a journal.4 Publishers in the developed world are unlikely to incur significant financial loss by offering free or reduced price access to their online material, but they may benefit from …

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