Vision is needed to address problem of global health

On 4th January this year, Peter Singer posted an
article on 'HIF-net at WHO' on the subject of 'Global Alliance for Health Information'. The following letter is from this week's BMJ (17 March) under the title 'Vision is needed to address problem of global health information'

If the problem were a new opera house for Sydney, we would hold a competition for architects to show 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 that international agencies, non-governmental organisations, publishers, libraries, training schools, and others all are seeking to improve access to information for healthcare workers.[1]
Collectively they bring a wealth of skills, but their overall effectiveness has been limited by, ironically, lack of communication. Tan-Torres Edejer observes that the long list of initiatives is impressive but asks whether
any effort has been been made to get them to work synergistically.[2] That role, she says, is most appropriate for the nations themselves with the
cooperation of international organisations and donor agencies. We now need a vision for how these organisations might work together, and to what end. The
global health information problem is so complex and formidable - far more so than the Sydney opera housethat providing a focused, 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 identify two key criteria by which such a vision should be judged sustainability and multidirectionality of information flow (for
example, 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, director.
University of Toronto Joint Centre for Bioethics, Toronto, Canada M5G-1L4
[email protected]
Competing interests: PS is the author of 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 (30 September.)
2. Tan-Torres Edejer T. Disseminating health information to developing
countries: the role of the internet. BMJ 2000; 321: 797-800 (30 September.)
3. Godlee F, Horton R, Smith R. Global information flow. BMJ 2000; 321:
776-777 (30 September.)
4. Singer PA. Medical ethics. BMJ 2000; 321: 282-285

[HIF-net at WHO profile: Peter Singer is Sun Life Chair and Director of the
University of Toronto Joint Centre for Bioethics; Professor of Medicine,
University of Toronto; Canadian Institutes of Health Research Investigator;
and Associate Editor of the Canadian Medical Association Journal. He is a
leading proponent of free access to biomedical information. Examples of his
work in this area include http://www.cma.ca/cmaj/vol-162/issue-4/0517.htm
and http://www.biomedcentral.com/info/singer-ed.asp