According to the authors of an important article published in the Lancet last year, information flow could be one of the most important factors for improving health and development in resource-poor settings. However, it would seem that until now development organizations have not been responsive to this truism.

It is hoped that at the start of the information age, the importance of information will now be better understood. The millennium assembly of the UN emphasized this point in their statement on the right of access to information and communication. Information underpins the learning, research, and debate that drives a country forward. Access to information is essential for describing and understanding the deficiencies of the present, building visions of a better future, developing practical ways to achieve those visions, and educating and inspiring those who must make the future. Information empowers, and those who work with information flow in the rich world should find ways to enhance the flow, recognizing that the flow, like good communication, must be two way.

The information gap between the rich and the poor worlds is widening, both between and within countries. The digital divide is more striking than any other inequity in health or income. Those medical libraries in sub-Saharan Africa that have had no current journals for years still do not have them. Meanwhile, the electronic revolution is providing scientists and health workers in the developed world with unprecedented access to information. Whereas doctors in rural Africa may not have access to any information apart from outdated textbooks, doctors in the USA or the UK may be able to access hundreds of journals and other data bases from their homes and hospitals.

The information flow should not be one way. The appearance of PubMed Central, BioMed Central, and eprint servers at The Lancet and British Medical Journal makes it easier for scientists from the developing world to bring their research to the world’s attention. BioMed Central also offers free technical support and can act as host to people wanting to start new electronic journals or to move existing journals to the web.

The electronic revolution should improve information flow in all directions, and many regions are establishing free networks for the exchange of health information. Good examples include the Scientific Electronic Library Online (www.scielo.org), Bioline International (http://bioline.bdt.org.br), and African Journals Online (www.inasp.org.uk).

Those who would like to continue discussions might join the Health Information Forum-net at WHO, a dedicated e-mail discussion list run by the Health Information Forum (which includes INASP-Health and International Network for the Availability of Scientific Publications) and the WHO. To join, send an e-mail to INASP_Health@compuserve.com with your name, affiliation, and brief description of your professional interests.

Reference: Fiona Godlee, Richard Horton and Richard Smith. Global information flow. Lancet, 356: 1129-1130 (2000).