Ronald E. LaPorte from Pittsburgh wrote:
>
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> -- from "Ronald E. LaPorte from Pittsburgh" <[log in to unmask]>
>
> Friends.  We just had a successful Global Health Network meeting at the
> World Bank, lead by Eugene Boostrom from the World Bank.  At the meeting
> we became convinced that it is feasible to break down the scientific
> information blockade for developing countries for not only medical
> journals, but also for the hard sciences, social sciences, agriculture,
> etc.  Tony Villasenor from NASA has developed the plans for a restricted
> access server which is described below.  Moreover, NASA has perhaps the
> best information on connectivity across the world, and Tony has been
> responsible for much of the connectivity in Africa and around the world.
> We can bring his abilities to help us get essential information into
> developing countries.  The timing is right as the British Medical Journal
> just published an excellent article on the problems of obtaining
> information in developing countries.  Enclosed is a copy of the editorial.
> We are just about to submit for publication a letter to the editor of the
> British Medical Journal.  Using this methodology the journals lose almost
> nothing as they can provide their articles for free to developing
> countries who do not buy the journals anyway.  The journals that we have
> approached have been very positive.  We need to obtain a small amount of
> funding to develop the server, during this time we will approach journals
> to start to have them open up their information to developing countries.
>
> We would appreciate if you could review the letter and give your opinion
> as to the best way to procede.
>
> Jan.1997
>
> Sir:
>
> Patient: Developing Countries
>
> Diagnosis:  Information Deficiency
>
> Prescription:  An Internet Server with Limited Access
>
> As pointed out in the editorial, the developing world has only limited
> access to information in health.  However, this deficiency cuts across all
> sectors including agriculture, education, social sciences, the basic
> sciences, etc.  How best can this condition be corrected?  It can be
> ameliorated through the Internet.
>
>         The optimal way to channel journals into developing countries is
> the Internet.  The Internet is rapidly reaching third world nations.  All
> of the major health journals are moving onto the Internet.  Soon one will
> be able to obtain full text articles through the Internet.at a price.
> However, the price is too high for developing countries.  Moreover,
> journals are afraid to put their work onto the Internet, thinking that
> this will be accessible to the world for free and that their paid
> subscription base would go down.
>
>         There is a solution: a limited access, country- selective Internet
> server is being developed.  Thus the British Medical Journal could permit
> Uganda, Bolivia, and Peru to read the journal on the Internet.  A Journal
> of Agricultural Research might permit Mongolia, parts of the Sudan, and
> Liberia to read their journal, and the American Journal of Psychology
> could be open electronically to Mexico, Rwanda, and parts of Poland.
>
>         This system is quite secure in that a person in London could not
> go electronically to Rwanda to read Nature for free.  Preparation cost
> will be very low, because much of the information is already on line or
> soon will be.  This mechanism is just opening up the door to developing
> countries a little bit.  It is unlikely to affect journal revenues, as the
> countries selected would be those to which there are few if any
> subscriptions, and little or no hope of future sales.  It is flexible, in
> that at any point new countries could be added or subtracted and the
> selection of information can be changed on the basis of what articles are
> called up by people in developing countries.  Finally, and most important,
> it is humane.
>
>         The Global Health Network has already contacted certain Journals
> in health, and 10 have expressed an interest in "opening the door" to
> developing countries, to start the information in journals flowing.  We
> are connecting many countries in Africa, and we have the most up to date,
> and comprehensive data on connectivity. The Global Health Network will
> continue to approach journals in all disciplines to open the door, as for
> the first time in history we have the opportunity to bring up to date
> knowledge into the areas that need it the most.
>
>         There is the important decision as to what might be delivered into
> developing countries.  One approach would be to have the developed and
> developing countries decide what information might be needed in the
> developing countries.  A second would be to put as much information onto
> the computer as now information transport costs are approaching zero.  A
> third would be to put everything up, and then look to see which articles
> and journals are accessed, then one decides what areas are of most
> interest to developing countries, and these can be expanded, and perhaps
> those low-usage areas could be dropped.  It is likely that researching the
> usage patterns will the best approach for determining the type of
> information of most use to developing countries.  This can be readily
> updated as the usage patterns change over time.
>
>         The model of the restricted area server is presented below.  By
> the end of 1997 essentially all journals will be connected, and the
> information will flow.  If you would like to help in this effort, please
> contact a member of the Global Health Network on their home page.
>
> The Global Health Network
> (http://www.pitt.edu/HOME/GHNet/GHNet.html)
>
> ----------------------------------------------------------
> BMJ No 7074 Volume 314
>
> Editorial Saturday 11 January 1997
> ----------------------------------------------------------
>
> Meeting the information needs of health workers in developing countries
>
> A new programme to coordinate and advise
>
> Health workers in the developing world are starved of the information that
> is the lifeblood of effective health care.(1)(2) As a direct result, their
> patients suffer and die. In the words of the late James Grant, former
> executive director of Unicef "The most urgent task before us is to get
> medical and health knowledge to those most in need of that knowledge. Of
> the approximately 50 million people who were dying each year in the late
> 1980s, fully two thirds could have been saved through the application of
> that knowledge."(2)
>
> 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. Cost
> effective because the amounts of money required are negligible compared
> with those invested in health services. Achievable because providers of
> health information have the will and commitment to make it happen, and
> because information technology presents exciting new opportunities to
> complement conventional methods of dissemination. And sustainable because
> information access is the sine qua non of the professional development of
> all health workers-the most vital asset of any healthcare system.
>
> In 1994 and 1995 the BMJ hosted international meetings to look for ways to
> improve the dissemination of health information to, from, and within the
> developing world.(1) The meetings showed that the overall impact of
> providing health information would be greatly enhanced by increased
> coordination, analysis, and funding. A new programme was needed to serve
> as a point of reference for those who supply and receive information, to
> build a global picture of their activities and needs, and to argue their
> case with others. This programme is now being introduced within an
> existing non-profit organisation, the International Network for the
> Availability of Scientific Publications (INASP).  Founded in 1991 by the
> International Council of Scientific Unions, INASP is a cooperative network
> of providers and recipients of science information, promoting the exchange
> of quality information (both printed and electronic) between and within
> the developed and developing world.
>
> The new programme, INASP-Health, serves three main functions. Firstly, it
> provides a referral and advisory service for information providers and
> potential recipients. For example, institutions seeking health information
> can approach INASP directly and be put in touch with the organisations
> most likely to help. INASP-Health acts as a catalyst for new
> collaborations and initiatives and will soon be launching a dedicated
> email discussion list to facilitate cooperation and debate.
>
> Secondly, INASP-Health aims to build a global picture of health
> information priorities in the developing world and the most appropriate
> ways of addressing them. It is developing a specialised database of needs
> assessments, evaluations of cost effectiveness, and other material related
> to the provision of health information. These data will be made freely
> available to help with the planning and setting up of new programmes, to
> provide support for funding applications, and to help develop future
> strategies.
>
> The third function of INASP-Health is advocacy, both at a specific and a
> general level. For example, it works with organisations such as the
> Association for Health Information and Libraries in Africa (AHILA)  to
> promote their needs to a wider audience, negotiating with publishers and
> others on their behalf. On a wider scale, INASP-Health will work
> increasingly with international organisations like the World Health
> Organisation and World Medical Association and with governments and
> funding agencies to promote the development of cost effective strategies
> and to strengthen political and financial commitment
>
> INASP-Health aims,to ensure that the developing world does not get left
> behind by the information revolution. Rather, it wants to harness the
> enormous potential to provide the developing world with the information
> that for too long it has lacked.
>
> Supported by the Overseas Development Administration (UK) and the BMA
>
> Neil Pakenham-Walsh Programme manager, INASP-Health
> Carol Priestley Director
> The International Network for the Availability of
> Scientific Publications
>
> PO Box 2564, London W5 1ZD
>
> Richard Smith Editor, BMJ
>
> London WC1R 9JR
>
> References
>
> 1 Kale R. Health information for the developing world. BMJ
> 1994;309:939-42.
>
> 2 Grant J. Opening session, world summit on medical education, Edinburgh
> 8-12 August 1993. Med Educ 1994; 28(suppl 1):11.
>
> ----------------------------------------------------------