Tamoghna Biswas

Governments are legally obliged to ensure adequate access to health information.

Access to reliable, relevant, and implementable healthcare information has been identifi ed as one of the key determinants for reaching the Millennium Development Goals (MDGs). In 2006, Pang and coworkers noted that the challenge is to ‘‘ensure that everyone in the world can have access to clean, clear knowledge—a basic human right, and a public health need as important as access to clean, clear water, and much more easily achievable.’’ However, this challenge has repeatedly been put on the sidelines. The world has seen several high-profi le investments including the Global Fund to Fight AIDS, Tuberculosis and Malaria and The Global Alliance for Vaccines and Immunization, but no big investment has been made in the domain of making health information available for all. The issue of availability of relevant, reliable health information for all domains including education for patients and health-care providers, research accessibility, and application of available knowledge into best practices has not been adequately addressed by the international community. The Healthcare Information For All (HIFA) 2015 campaign was launched in 2006 with the shared goal that ‘‘by 2015, every person worldwide will have access to an informed healthcare provider.’’ Since its launch, HIFA2015 has grown to more than 6000 members representing 2000 organisations in 167 countries. External evaluation of the HIFA2015 programme concluded that HIFA2015 has achieved ‘‘an extraordinary level of activity on minimal resources from which many people around the world benefi t.” Article 25 of the Universal Declaration of Human Rights states that ‘‘everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.’’ So then, when a child dies of pneumonia because eight in ten caregivers in developing nations are unaware of the key symptoms, are we guaranteeing any “standard of living adequate for health?” When four in ten general practitioners in Pakistan prescribe sedatives as fi rst line drugs for treatment of hypertension because they do not have adequate information about medicines, what standard of medical care are we guaranteeing? Mismanagement of malaria, the third stage of labour, and sick children (at district hospitals) have all contributed to an unacceptably large burden of avoidable morbidity and mortality because proper health information was not available or implemented. The National Family Health Survey in India reported that even after decades of access to oral rehydration therapy, only 8% of children in India received increased fl uids and continued feeding during diarrhoea, whereas about 40% actually received decreased fl uids. Evidently, it is not an exaggeration to state that people are dying for lack of healthcare information—a social injustice that the global health community cannot aff ord to ignore. Should governments be held responsible for ensuring that every citizen and every health professional has access to the information they need to protect their own health and the health of those they care for? Should governments be held to account for, and to stop, any action that denies the availability of health information, or that misinforms the public or health professionals contrary to scientifi c evidence? The answers to these questions are yes and yes, as clearly stated in international human rights law. A 2012 analysis by the New York Law School and HIFA2015 concluded that ‘‘health information is an essential component of many identifi ed and established human rights. States party to treaties such as the International Covenant on Civil and Political Rights must provide and guarantee access to health information.’’ Sadly, however, many examples show that govern ments are getting away with failure to improve availability of information, failure to reduce misinformation, and, occasionally, deliberate, harmful misinformation. For example, public health researchers estimated that more than 330 000 people died unnecessarily because of the South African Government’s failure to accept HIV as the cause of AIDS, thereby delaying the introduction of antiretroviral drugs. HIFA2015’s new initiative, the HIFA-Watch campaign, is now monitoring examples of apparent progressive and regressive action by governments. Published Online August 2, 2013 http://dx.doi.org/10.1016/ S2214-109X(13)70043-3

Open Access: The changing face of scientific publishing

The debate on open access to scientific literature that has been raging in scholarly circles for quite some time now has been fueled further by the recent developments in the realm of the open access movement. This article is a short commentary on the current scenario, challenges, and the future of the open access movement.

Healthcare information and the rural primary care doctor

Health inequity and improper dispensing of social justice is a huge topic of which one aspect is healthcare information and access to it. Access to health information is a ‘prerequisite for meeting the Millennium Development Goals’, and lack of knowledge and information, especially in resource-poor settings, impedes the delivery of quality healthcare and contributes to many preventable deaths worldwide. Three out of four doctors responsible for care of children in district hospitals in seven less developed countries reported inadequate knowledge in managing common childhood illnesses such as childhood pneumonia, severe malnutrition and sepsis. A review concluded that information deficiency exists ‘right across the health workforce’ and can be associated with provision of suboptimal care.

Arsenic: the largest mass poisoning of a population in history

Millions of Indians are exposed to natural arsenic contamination in drinking water, leading to an array of health problems. But is the government doing enough, ask Parijat Sen and Tamoghna Biswas

India targets 243 million adolescents in new health strategy.

India has launched a national health programme aimed at improving the status of adolescent health in the country. Known as Rashtriya Kishor Swasthya Karyakram (RKSK), the programme is expected to benefit 243 million adolescents aged 10-19 years across the country. RKSK aims to reach all adolescents in the age group irrespective of their sex, place of residence, whether in or out of school, or whether married or unmarried. The …

Understanding Clinical Complexity Through Conversational Learning in Medical Social Networks: Implementing User-Driven Health Care

With the increasing pressures to keep up with the most current literature, skills such as the ability to be empathic with patients, emotional intelligence, the ability to collaborate, and well-rounded decision making may be set aside in the race for information mastery. This can affect patient care. It is well documented that a significant part of a patient’s recovery can be attributed to the dynamics between the patient and those they come to for medical care. In fact even placebo intervention is more successful when the patient trusts in and can form a therapeutic alliance with the treating professional [1].

Daniel Alcides Carrion (1857–1885) and a history of medical martyrdom

Daniel Carrion, a sixth-year medical student, died while investigating the effects of self-inoculation of the causative organism of Oroya Fever and Bartonellosis and thereby contributed to understanding of the disease before the organisms had been identified.

Lionel Charles Renwick (Rennick) Emmett (1913-96): physician and Olympian.

Lionel Charles Renwick Emmett, a physician who trained in pre-independent India as a medical student, participated in the 1936 Berlin Summer Olympics as a part of the Indian field hockey team that won the Gold Medal.

Health-care information: access or implementation?–Authors' reply

www.thelancet.com/lancetgh Vol 1 November 2013 e257 3 UNICEF/WHO. Diarrhoea: why children are still dying and what can be done. Geneva: World Health Organization, 2009. http://whqlibdoc. who.int/publications/2009/9789241598415_ eng.pdf (accessed Sept 9, 2013). 4 Pang T, Gray M, Evans T. A 15th grand challenge for global public health. Lancet 2006; 367: 284–86. Health-care information: access or implementation?