[afro-nets] BMJ: Call for papers

[Dr Tessa Richards <trichards@bmj.com>]

BMJ: Call for papers
--------------------
 
Source: hif-net@who.int
 
Dear All
 
The BMJ is publishing a special issue on "Learning from less de-
veloped countries" on 13 November. This aims to draw attention 
to examples of innovative, effective, low cost models of health 
care established in developing and transitional countries and 
discuss their potential for wider disemmination/transfer to 
richer countries (as well as others with a similar socio eco-
nomic status) We published an editorial about this on 31 Jan 
2004 which I have attached at the end of this e mail.
 
Identifying these models is not easy and so we are inviting peo-
ple to alert us to them and share their experiences. It would be 
marvellous to get input from the members of HIF-net so may I 
urge you to look at the editorial and then go to the following 
URL and submit a letter to the BMJ web site? Health care can be 
interpreted widely to cover policy/education and development as 
well as medical practice. If you have any trouble posting your 
letter to this URL please send it directly to our letters editor 
Sharon Davies at sdavies@bmj.com
 
http://bmj.bmjjournals.com/cgi/content/full/328/7443/DC1?ck=3Dnck
 
Best wishes
 
Tessa
 
Dr Tessa Richards
Assistant Editor
BMJ Editorial
BMA House
Tavistock Square
London WC1H 9JR
Tel: +44-207-383-6150
Fax: +44-207-383-6418
mailto:trichards@bmj.com
 
[HIF-net at WHO profile: Tessa Richards is an Assistant Editor 
with the BMJ. She previously trained as a general practitioner 
and rheumatologist. <trichards@bmj.com>]
 
****
 
BMJ 2004;328:239-240 (31 January), doi:10.1136/bmj.328.7434.239
 
Editorial
Exchanging health lessons globally
 
BMJ issue will focus on lessons rich countries can learn from 
poor ones
 
The link between expenditure on health and health outcomes is 
not straightforward. Despite burgeoning health budgets, few 
countries in the developed world can claim to be delivering uni-
versally high quality, equitable health care. Could they have 
something to learn from less developed countries, whose meagre 
resources have long ensured that cost effectiveness is a domi-
nant consideration?
 
Certainly, massive health bureaucracies and well endowed re-
search institutions do not have a monopoly on wisdom. Examples 
of industrialised countries adopting treatments and strategies 
that were developed or pioneered in developing countries range 
from oral rehydration therapy (which was developed and widely 
used in Bangladesh before its slow but now global uptake) to 
limited lists of essential medicines. The experience in low and 
medium income countries of introducing national policies based 
on restricted lists of cost effective, affordable medicines over 
two decades prompted Australia to follow suit in the 1990s, and 
such a move has been mooted as a solution to escalating costs of 
medicines in the United States.[1 ,2]
 
Identifying promising initiatives in health practice, policy, 
education, and development should not be difficult. The Global 
Health Research Policy Network, led by the Center for Global De-
velopment, a think tank based in Washington, is about to publish 
an evidence based list of 20 successful, large scale global 
health interventions (http://www.cgdev.org/). Defining the rea-
son for success is a lot harder. Emphasising this, Nancy Bird-
sell, an economist at the centre, called for more research into 
"why programmes succeed when they do" at the Global Forum On 
Health Research in December.
 
Hardest of all is to recognise the lessons learnt from success 
or failure, see their wider potential, and successfully adapt 
them to other healthcare settings. Among the many factors that 
influence any project, sound management, good leadership, and 
active community participation are likely to be important. Bra-
zil, for example, has succeeded in reaching and sustaining very 
high childhood immunisation rates against nine diseases. The 
last indigenous case of measles was reported in 2000.[3] Public 
support for vaccination campaigns has been strong; temporary 
shortages of vaccines in 1997 resulted in public protests. This 
is in sharp contrast to the situation in several developed coun-
tries, where intense media coverage of possible side effects of 
vaccines and failure to mobilise public support have contributed 
to falls in immunisation rates.
 
The reluctance of health professionals in developed countries to 
abandon established treatments in favour of simpler low cost op-
tions may be one of the many barriers to adopting practices pio-
neered in less developed countries. Kangaroo care - keeping very 
low birthweight infants upright on their mother's chest in di-
rect, skin to skin contact, marsupial style - may be an example. 
It was developed more than 20 years ago in Colombia in response 
to overcrowding and lack of resources in special care baby 
units. Further evidence is needed to confirm promising results 
of its effect on reducing infant mortality, but it seems to of-
fer additional benefits to mothers.[4]
 
In November the BMJ will publish a theme issue on "learning from 
developing countries." Its aim is to flag up innovative, cost 
effective health initiatives and interventions in developing 
countries, which have or show clear promise of having useful 
lessons for health professionals, policy makers, and researchers 
in the developed world. It also hopes to draw attention to ini-
tiatives that may promote learning between developing countries 
and discuss what we can learn from interventions that have 
failed.
 
Original papers for this issue should reach us by the end of 
May. Authors should discuss the potential of their work for 
wider learning and adaptation, and suggest what further research 
is needed to explore this. We also welcome submissions for other 
sections in this issue. In an increasingly globalised world we 
have much to learn from each other.
 
Tessa Richards, assistant editor
mailto:trichards@bmj.com
 
----------------------------------------------------------------
Competing interests: None declared.
Advice to contributors is provided on bmj.com. Submissions 
should be made to http://submit.bmj.com/ and the covering letter 
should make it clear that the article is intended for the 
"Learning from developing countries" theme issue.
 
The guest editors for this theme issue are Rashad Massoud, di-
rector, Quality and Performance Institute, University Research 
Co, LLC/Center for Human Services, 7200 Wisconsin Avenue, Suite 
600, Bethseda, MD 20814, USA; Cesar G Victora, professor of epi-
demiology, Federal University of Pelotas, CP 464-96001-970 Pelo-
tas, RS, Brazil; James Tumwine, associate professor of paediat-
rics and president of FAME (Forum of African Medical Editors), 
Makere University, Kampala, Uganda; and Zulfiqar Bhutta, Husein 
Lalji professor of paediatrics and child health, The Aga Khan 
University, Karachi 74800, Pakistan.
 
References
 
1. Smith AJ. National drug policy: "an Australian response." 
Australian Prescriber 1991;14(suppl 1): 21-5. 
 
2. Ellner A. Rethinking prescribing in the United States. BMJ 
2003;327: 1397-400.[Free Full Text] 
 
3. Fundação Nacional de Saúde. Países latino-americanos reforçam 
medidas para a erradicação do sarampo, 21 May 2003. 
www.funasa.gov.br/not/not422.htm (accessed 26 Jan 2004). 
 
4. Tessier R, Cristo M, Velez S, Giron M, de Calume ZF, Ruiz-
Palaez JG, et al. Kangaroo mother care and the bonding hypothe-
sis. Pediatrics 1998;102: 1-8.[Abstract/Free Full Text]
 
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