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• Objective 1: Strengthen and expand global Office of Health Information access to the world’s health-related literature • Objective 2: Chart new routes to biomedical Programs Development knowledge and its use • Objective 3: Enable NLM to fulfill its inter- Elliot R. Siegel, Ph.D. national mission Associate Director The Panel’s report was published in the fall of 1998. NLM will be working to identify ways to International Programs implement the plan through collaborative partnerships with institutions, organizations, and The year 1998 saw continuing leadership by other entities around the world. the National Library of Medicine in several areas of international work: global Internet connectivity, Internet Connectivity at Malaria Research Sites in Internet connectivity and access to information for Africa malaria researchers in Africa, and the Board of Regents' approval of a Long Range Planning Panel What a pleasure for us and our on International Programs Report followed by collaborators to sit in our offices planning of the first meeting for its implementation. and browse the Web sites, being in Internet communications connectivity and contact with the world in a few access to information resources by malaria research seconds, looking for the hidden scientists in Africa is part of the Multilateral world. What a great potential we Initiative on Malaria, a multilateral initiative are discovering. undertaken in collaboration with the National Institute of Allergy and Infectious Diseases, the This testament of Dr. Yeya Toure Director Fogarty International Center, and the Office of the of the Malaria Research and Training Center in Director, National Institutes of Health. Bamako, Mali, reveals at once the excitement of Future directions of NLM’s international African scientists and the potential that Internet programs received substantial attention as a new access holds for scientific research. Since June 1998 long-range plan was approved by the NLM Board of he and his colleagues at the MRTC have had access Regents and plans for implementation began. Other to the Internet and the World Wide Web through international activities were carried out with microwave technology. The equipment (including a individual countries and governmental and local area network on site), installation, and training nongovernmental organizations. Information were funded by the National Institute of Allergy and management training was provided to colleagues Infectious Diseases, the NIH Office of the Director, from abroad, numerous professional visitors were the National Library of Medicine, and the World received from around the world, and publications Bank. were exchanged with libraries in other countries. This story from Mali is the first chapter in the work of the Multilateral Initiative on Malaria Long Range Planning Panel on International Communications Working Group (MIM CWG), Programs chaired by NLM. Featured prominently are the major MIM objectives—support for African scientists, the The NLM Board of Regents approved the ability of malaria researchers to connect with one NLM Long Range Planning Panel on International another and sources of information, as well as the Programs Report in 1998. This panel was chartered creation of new collaborations and partnerships. by the NLM Board of Regents in May 1995 to advise The initial meeting of the MIM CWG was NLM on the relative priority of its international held in January 1998 at the NLM. In attendance were activities and responsibilities and to assist in the malaria research scientists, health information development of appropriate strategies consistent with professionals, telecommunications experts and the Library’s statutory mission and available representatives of the major MIM funding agencies. resources. The Panel was chaired by former NIH In keeping with the underlying goal of supporting a Director Donald S. Fredrickson and consisted of 25 broad spectrum of basic and operational malaria distinguished members assisted by expert consultants research needs, the researchers requested in the fields of medicine, telecommunications, health communications and connectivity capabilities sciences librarianship, electronic publishing, and sufficient to provide, at a minimum: robust and related fields. The Panel, which met three times in reliable e-mail, links to other research sites, access to 1996-1997, made the following formal full text journal articles, database searching, recommendations to the Board on the future of exchange of large files and mapping data, and timely NLM’s international activities: access to electronic information resources worldwide. 1 In addition to the malaria research site in Bamako, international partners to test Internet pathways Mali, the MIM/CWG endorsed five more locations around the world. for the initial connectivity phase. They are: in Kenya, Currently, NLM monitors about 85 network the Centers for Disease Control/Kenya Medical paths to hosts (typically web servers) in 29 countries Research Institute (KEMRI) site in Kisian and the and in 14 time zones. Hosts are located in all major Wellcome Trust/KEMRI site in Kilifi, and in regions of the world. The monitoring includes Tanzania, three sites of the National Institute of locations in all G-7/8 countries. NLM is conducting Medical Research in Dar es Salaam, Ifakara, and symmetrical (two-way) and time zone testing with Amani. In several instances, sites have been provided three partners as part of the G-7/8 Internet with computer equipment and training, but since the connectivity initiative: the Western Universities majority of them are in relatively remote locations, Research Consortium at the University of Calgary, traditional means of connecting to the Internet are not Canada; OMNI (Online Medical Networked viable due to unreliability or bandwidth restrictions. Information) at the University of Nottingham, Subsequently, NLM supported site visits and England; and ForthNet, SA, in Crete, Greece. In assessments, consultancies, evaluation and testing of addition, NLM has conducted special testing of the extant technology. Related issues of user training, Internet pathways to sites in several sub-Saharan in-country licensure of technology, and allowances African countries and in Mexico and Russia. for future technological advances (such as predicted Results of Phase I of the Internet worldwide availability of low-cost commercial connectivity project were published by Fred B. satellite systems) all figured in the development of a Wood, Victor H. Cid, and Elliot R. Siegel, in draft implementation plan by the MIM/CWG. “Evaluating Internet End-to-End Performance: The plan recommends immediate use be Overview of Test Methodology and Results,” Journal made of the affordable technologies now available to of the American Medical Informatics Association, provide high-speed and reliable information and Vol. 5, November/December 1998, pp. 528-545. communication links in order to yield timely results in improving researchers' ability to do cooperative Activities With International and Multinational research and disseminate their results. Recommended Organizations technologies are VSAT, which uses a geostationary satellite and a small earth station, and microwave, Working in collaboration with the which uses radio waves. The latter is less expensive International Council for Scientific and Technical but is limited to line of sight transmission. The MIM Information, NLM helped to successfully conclude a sites that wish to operate a radio or VSAT link will pilot demonstration project to reduce existing have to gain permission from the relevant in-country technological and tariff barriers to the flow of authority. scientific and health-related information over the With the Mali model fully operational, Internet to developing regions of the world. Focused NLM/NIH has stepped forward with an offer to fund in the eastern Caribbean, this effort was carried out in the upfront equipment purchase and installation costs conjunction with the United Nations Educational, at these five sites, if partner funders can commit to Scientific, and Cultural Organization (UNESCO), the support ongoing operational costs. Sustainability is Pan American Health Organization (PAHO), the an essential ingredient if lasting connectivity is to be International Telecommunications Union, and the achieved for these research sites. In the case of the United Nations Development Programmes. CDC/KEMRI site in Kisian, Kenya, a funding In January 1997, NLM hosted the first U.S. partnership between the NLM and the CDC is firmly meeting of the national coordinators of the G-7 in place. Global Healthcare Applications Project. At this meeting, the coordinators approved a U.S. proposal Global Internet Connectivity for global Internet connectivity advanced by NLM. The premise of this proposal was that many G-7 In 1998, NLM continued and expanded its Global Healthcare Applications projects depend in end-to-end Internet connectivity testing and whole or in part on the availability of the Internet. As evaluation project. This project is intended to explore the preferred technical means for the exchange of the methods and metrics needed to better understand biomedical information with and among the G-7 the quality of Internet performance from the end user nations and beyond, the Internet is a critical perspective. To do this, NLM is using test methods component of the emerging global health information that measure, for example, the size of the Internet infrastructure. NLM has begun
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