1. HINARI: What have we learned? World Health Organization Trieste, October 2003

2. What is HINARI ? HINARI is a programme administered by the World Health Organization to support health sector efforts in developing countries by enabling access to high quality, timely, relevant scientific information, via Internet, at affordable prices.

3. What is HINARI (in plain language)? HINARI is a huge online library of full-text resources in biomedicine and related social sciences. It is designed to support developing country health / medical researchers and academics, and through them to support improvements in health services in their countries.

4. Why does HINARI exist ? WHO questionnaire to developing country health / medical researchers + follow-up consultations in 1999-2000 told us: The most pressing “information problem” for developing world health researchers and academics is access to the priced literature, particularly journals.

5. How does HINARI work ? Partnership Publishers (full text journals + other resources) WHO (administration) Yale University (site architecture) NLM (tailored PubMed links) Training partners (workshops, trainers)

6. Who benefits ? All staff and students of national institutions: Universities Schools of medicine, nursing, public health, pharmacy, dentistry Research institutes Government offices Teaching hospitals National medical libraries

7. Two groups of countries GNP per capita < $1000 (phase 1) from January 2002 free access 69 countries GNP per capita $1000 - $3000 (phase 2) 2003 year-long free trial from 2004 costs $1000 / institution / year 44 countries

8. Pre-HINARI access to international journals (survey results to date) Institutions from phase 1 countries: 56% had zero paid subscriptions 21% had 2 - 5 paid subscriptions (average = 2) Institutions from phase 2 countries: 34% had zero paid subscriptions 34% had 2 - 5 paid subscriptions (average = 2)

9. What have we learned ? 1. The HINARI model works.

10. Demand is high Registrations to date: Phase 1: 591 institutions 61 countries (of 69 total) Phase 2: 436 institutions 38 countries (of 44 total)

11. Librarians can assure local administration of HINARI Distribute and administer passwords Promote the service and train users Assure institutional compliance with the license agreement Liaise with HINARI help desk for technical problems (authentication, HINARI site, publishers’ sites) Form local networks of HINARI users

12. Publishers’ experience has been positive HINARI framework developed by the publishers Fees from phase 2 donated for in-country training and promotion New publishers joining continually To date 2278 journals + other resources Commercial, learned society, SPARC Free online journals make a point of joining (CMAJ, BMJ, e-MJA, etc.)

13. What have we learned ? 2. The high cost of Internet access appears to be the significant limiting factor to accessing journals through HINARI. 3. Institutions are making strong efforts to obtain good equipment and improve their connectivity.

14. Usage patterns Are erratic compared to what publishers see from their usual clients Appear to depend mainly on good access to connectivity (i.e. do not vary directly according to relative economic strength) Overall usage is growing steadily and….. No serious attempts to abuse the system

15. What have we learned ? 4. The HINARI model is replicable. (Hear all about this tomorrow morning…..)

16. What have we learned ? 5. The HINARI model is sustainable.

17. Sustainability Not dependent on central donor funding Decentralised organization: Framework developed by the partners Responsibility for different parts of the programme (content, administration, menu architecture, training materials / translation, promotion, etc.) shared among partners Direct response to an expressed need: Participating institutions assume direct costs (connectivity, equipment, phase 2 payments)

18. What have we learned ? 6. We need to do a lot more.

19. What’s needed ? Find solutions to include countries not yet eligible Promotion Training Evaluation Include locally produced journals Improve coordination with other initiatives (health, development, information, etc.)

20. Visit HINARI http://www.healthinternetwork.org hinari@who.int