HINARI – still needed and active after more than 10 years

How do you keep a key programme active and vibrant over the course of a decade? Over time, the environment changes, partner representatives are replaced, users become more engaged and vocal, volunteers come and go, visibility rises, opinions solidify, and different resources are incorporated. After all this, do you still have the same programme that you started with?
When the HINARI programme for Access to Research in Health began, it was a direct response to a WHO-led workshop in which low- and middle-income country researchers "agreed that without access to top quality, timely and reliable information of the kind exemplified by the major journals, it is very difficult to do quality research or train researchers." (1)
Quickly following this expression of need came an idea: that the internet could make it possible for publishers to offer research literature to LMICs for free. (2)
So, in July 2001, WHO and six major biomedical publishers joined forces in the HINARI partnership which rapidly expanded in terms of countries, publishers, and journal titles. HINARI launched first in 69 countries, with almost 1500 journals from six initial publishers. A decade later, HINARI is available in more than 100 countries, and over 8000 e-journals and 6000 online books are offered by more than 150 publisher partners.
The users in LMICs are at the heart of the programme as it continues to evolve. More than 5200 institutions have registered to gain access to the content, and this number is growing at a steady pace.
How has HINARI adapted to change in the past 10 years? When the programme began, the internet and ICT infrastructure was still new and fragile in LMICs, and researchers could barely make use of the wealth of resources offered through HINARI. However, remarkable improvements to ICTs have taken place in many cities and institutions. Today, researchers may still be frustrated by bandwidth limitations, but they can see what is available to them and develop creative solutions to get the content they need through the still narrow pipelines.
The partnership itself has evolved and changed. For instance, worries about intellectual property rights, secure transmission of articles, or concerns about the researchers’ ability to make use of the content used to preoccupy the partners. These issues have now been replaced with challenges such as donor fatigue and partner representative replacements. By providing a newsletter about latest events and feedback from the user community, we inform new representatives and reinforce the commitment of long-standing partners. All of this builds enthusiasm and ownership as we jointly plan for the future.
With LMICs achieving uneven advances in development, the partnership has also adapted by adding the Human Development Index to the Gross National Income criteria for eligibility. This ensures that countries that need access despite their improving economies can still benefit from the programme. As the basic access issues in institutions are resolved, HINARI has developed and expanded training for researchers to make the best use of the medical content provided. Training modules in multiple languages are available on the website, and training courses are held throughout the world. This is a key component of the programme – because just turning on access does not ensure that people are comfortable triaging the information for what is truly useful in their own work.
Throughout all the change, HINARI participation is growing and usage is rising slowly and steadily. Yet, success is not measured by how big HINARI has become, nor by how the programme positively reflects on the partnership. The only worthwhile measure of success is improvement in health in the Member States. All researchers from all Member States should be equal partners in the international scientific community, and HINARI is helping to bring that about, now more than ever.

(1) Aronson, Barbara; Glover, Steve. "Journal Access Initiatives: Where Are They? Why the World Health Organization? And What Is HINARI?" Serials Review 2005;31:279-283.
(2) Godlee, Fiona; Horton, Richard; Smith, Richard. "Global Information Flow," BMJ 2000;321:776-777

Reference: HIS Newsletter. WHO Cluster of Health Systems and Innovation. January 2013, Issue 1.

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