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					The WHO AFRO Library and Partnerships for Delivering Health Information on
Emerging and re-emerging diseases


Pascal MOUHOUELO
Reference Librarian, Email: mouhouelop@afro.who.int
Marie-Paule KABORE
Head librarian, Email: kaborem@afro.who.int
Emil ASAMOAH-ODEI; Email: asamoahodeie@afro.who.int
Medical Officer
Knowledge Management and Sharing
World Health Organization Regional Office for Africa (AFRO)


Abstract


The mission of the WHO Regional Office for Africa is the attainment by all Africans of
the highest possible level of health. Its Library is the heart of health information in Africa
in the sense that it receives and collates information from the body, that is Africa, and
pumps it back to the various parts of the body in a more utilizable form. The creation of
the Knowledge Management and Information Technology Area of Work which
coordinates the Informatics and Communication Technologies Unit and the Library has
strengthened this role. The Library’s activities were manual for a long time. Its
computerization and the arrival of the Internet have changed data processing and
information dissemination methods. Many health emergencies such as emerging diseases
and disasters are devastating Africa and threaten the world. This is a new challenge for
the Library, which has strengthened its partnerships with a range of organizations,
including other libraries, to collect, manage and disseminate information and to
contribute to the response to such emergencies.




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1. Introduction
2. Overview of the Library
3. Using Internet to improve access
4. Partnerships for delivering information on emergencies
5. Conclusion




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1. Introduction


The World Health Organization is the United Nations specialized agency for health. Its
objective, as set out in the Constitution, is the attainment by all peoples of the highest
possible level of health. Health is defined in WHO's Constitution as a state of complete
physical, mental and social well-being and not merely the absence of disease or infirmity
(http://www.who.int/about/en/). WHO is governed by 192 Member States through the
General Assembly. Forty six of them are members of the WHO Regional Office for
Africa based in Brazzaville, in the Republic of Congo. Most of these countries are facing
economic problems and emerging diseases. Health systems in most of these countries
need to be strengthened. One of the key weaknesses in health systems is inadequate
access to information and knowledge required for improved performance, especially at
district and peripheral levels. “Improving access to health information and knowledge is
a core function of WHO, and is enshrined in the WHO Constitution” says WHO
(Knowledge Management Strategy, page 12). The WHO AFRO Library is playing a key
role in delivering health information in Africa and could not do so without partnerships.
This paper describes the role of the WHO/AFRO library in disseminating information on
emerging and re-merging diseases in collaboration with partners.


2. Overview of the WHO/AFRO Library


The WHO AFRO Library collects, organizes and disseminates medical and health related
literature to respond to the information requests from the Regional Office and field staff;
other United Nations institutions and international organizations; and health
professionals, researchers and patients from Member States of the WHO African Region.




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It is led by a chief librarian, who is assisted by a Cataloguing librarian, a Reference
librarian, three library assistants, a Computer specialist and a Secretary.
The WHO/AFRO Library works closely with the WHO Library, WHO Press and eHealth
Department in Geneva, and with all the WHO Libraries in other Regions.




This Library is a hybrid of information resources.. Books and periodicals are ordered
through the Supply Unit. It receives a lot of publications from WHO Headquarters in
Geneva, in Switzerland, from African ministries of health, NGOs, the WHO Country
Offices in the Member States and from several partners. All these materials are processed
using the Medical Sub-Headings (MeSH) and the National Library of Medicine
classification from the United States of America. The internet is one of the means it uses
to disseminate information. Guidance is also given to health authorities and other
institutions on effective use of the Internet and web-technologies.
The WHO Library uses both manual and electronic systems to acquire material, to
process data and to disseminate information.




3. Using Internet to improve access



The WHO AFRO Library has being using the Internet since 1997. This tool has totally
changed the way of processing data and dissemination health information in the African
Region.

It is known that the majority of Africans have no access to international scientific
information because of unaffordable costs. WHO initiated projects such as the Health
InterNetwork Access to Research Initiative (HINARI) and Global Information Full Text
(GIFT) to address this. The HINARI program, set up by WHO together with major
publishers, enables developing countries to gain access to one of the world's largest
collections of biomedical and health literature. Over 3750 journal titles are now available
to health institutions in 113 countries worldwide, benefiting many thousands of health
workers and researchers, and in turn, contributing to improved world health.



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Most African countries, countries with GNP per capita below $1000 are eligible for free
access to HINARI. Some countries such as Algeria, Cape Verde, Equatorial Guinea,
Namibia and Swaziland with GNP per capita between $1000-$3000, have to pay a fee of
$1000 per year / institution to access HINARI. Countries like Botswana, Gabon,
Mauritius, Seychelles and South Africa with GNP per capita greater that $3000 are not
eligible. They may however take advantage of the free materials provided by the Open
Access Directory (http://www.doaj.org/), PUBMED, BIOLINE and other resources.

The WHO Regional Office Library is involved in the HINARI project. It encourages
African medical libraries in eligible countries to subscribe to HINARI. The Library is
involved in the training of researchers who use HINARI. In 2005 the Library organised a
training of trainers workshop in Rwanda for users of HINARI from Burundi, the
Democratic Republic of Congo and Rwanda.                 This workshop was organized in
collaboration with the WHO’s e-Health department in Geneva and ITOCA (Information
Training and Outreach Centre for Africa) members based in South Africa.


Global Information Full Text (GIFT) was initiated in 2002 for the WHO staff in Regional
and Country Offices. They have access to more than 2000 scientific journals online. The
WHO Regional Office for Africa library is also aware of the lack of libraries giving
access to the Internet in the Republic of Congo where its Office is based. For this reason,
in 2004 a multimedia centre was created within the Library. Twenty computers are
connected to the Internet where       medical students, doctors and other researchers can
retrieve information for free. The installation of this multimedia centre has increased the
number of visitors to the Library. Before its creation around 10 persons were coming
daily to the Library. Today, more than 60 persons visit the library. This increase is
explained by the fact that users can take advantage of the Internet. This is the first time in
Congo that readers retrieve information through the Internet for free. It is very interesting
that even patients visit the Library in order to get information related to their diseases.
The Library receives users’ requests by e-mail from the whole continent and abroad.
Searches are done through the online databases and the results are sent to the users. Apart
from the international databases, AFRO library uses its own databases which are
AFROLIB         (http://afrolib.afro.who.int),     the      African       Index       Medicus
(http://indexmedicus.afro.who.int) and WHOLIS (http://dosei.who.int/uhtbin/webcat), the


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WHO Headquarters Library database. The African Index Medicus –AIM- has been
integrated into the Global Health Library –GHL-, www.globalhealthlibrary.net. The
objective of this Library is to contribute to radically increase access to information and
scientific evidence on health, particularly in developing regions. This project is promoted
and led by WHO as part of its strategy of knowledge management in global public health.


4. Partnerships for delivering information on emergencies


Emerging and re-emerging diseases are one of the priorities of WHO in general and
WHO AFRO in particular. It is for this reason that a Unit called Communicable Diseases
Surveillance and Response (CSR) was created within the Communicable Diseases
Division. Newly emerging diseases are diseases that have never been recognized before.
HIV/AIDS, severe acute respiratory syndrome (SARS), Nipah virus encephalitis, and
variant Creutzfeld-Jakob disease (vCJD) are newly emerging diseases. Re-emerging, or
resurging, diseases are those that have been around for decades or centuries, but have
come back in a different form or a different location. Examples are West Nile virus,
monkey pox, and dengue rebounding in Brazil and other parts of South America and
working its way into the Caribbean. Deliberately emerging diseases are those that are
intentionally introduced. These are agents of bioterror, the most recent and important
example of which is anthrax. Newly emerging, re-emerging, and deliberately emerging
diseases are all treated much the same way from a public health and scientific standpoint.


The CSR unit works closely with ATM (AIDS, Tuberculosis and malaria Division)
which is in charge of AIDS and HIV, Malaria and Tuberculosis. The first alert or rumour
that an emerging or re-emerging disease is occurring may originate from a wide range of
sources, some of which are not always reliable. WHO has developed protocols on
“Emergency Preparedness and Response” which give details on a rapid health
assessment. Its information section summarizes the key items of information necessary to
collect during a rapid assessment of potential or actual health emergency. It gives an
example of a fax (or e-mail) to be transmitted to the regional office and WHO
Headquarters, which includes key information required at theses levels to support
national emergency response.



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The WHO AFRO Library disseminates official information from the Headquarters, the
Regional Office and the WHO Country Office which works closely with the ministry of
health. Information on diseases such as Bird Flu, Cholera, SARS, Ebola and other
Hemorrhagic Fevers is very sensitive which might cause panic at national and
international levels. For this reason, the WHO/AFRO Library works with all the partners
from all over the world to collect reliable information. In each WHO Country Office,
there is a librarian or an information officer in charge of the management of health
information in WHO at the national level. He or she works with national health or
medical librarians and information officers from UN Agencies, Humanitarian agencies or
NGOs. Information provided mainly by email by the national librarians is analyzed by
the division in charge before being delivered. The WHO AFRO Library also disseminates
press releases published by the Information department at the national, regional or
Headquarters levels.


AIDS continues to devastate Africa and access to information is vital to address the
pandemic. The WHO Regional Office for Africa uses international databases, UNAIDS
and WHO resources to inform researchers, health professionals, patients and other users.
The Library cannot provide this information without international partnerships.


Email discussion lists such AHILA-net, afro-nets, HIF-net and HIFA2015 are also used
to bring together the full range of stakeholders to help meet the information needs of
different end-user groups. AHILA-net is the email discussion list for the Association of
Health Information and Libraries in Africa (www.ahila.org). HIF-net looks at information
for health researchers and healthcare providers (www.dgroups.org/groups/hif-net).
HIFA2015 (www.dgroups.org/groups/hifa2015) is a goal-oriented email forum that
focuses on healthcare information and learning needs at community level: individuals,
families, and primary and district health workers in developing countries. The goal of
HIFA2015 is ‘Healthcare Information for All by 2015’ - by 2015, people will no longer
be dying for lack of knowledge.




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5. Conclusion


The world and particularly Africa are threatened by emerging and re-merging diseases.
Sharing information on such situations is one of the roles that WHO libraries play. But
rumors are not disseminated. Only official information provided by WHO, regular
sources and other international partners is delivered to researchers, national authorities
and other users. The WHO AFRO Library has strengthened its partnership with both
regional and international institutions for better collection and delivering of information.
Its website (http://afrolib.afro.who.int) provides users in Africa and beyond with a wealth
of information to face the health challenges of the 21st century.




References
1. World Health Organization. Emergency preparedness and response. Geneva: WHO,
2006. 2 p.
2. World Health Organization. Global surveillance of emerging and re-emerging
diseases. Weekly Epidemiological Record, 2001, 76 (29). P.217-224
3. World Health Organization. Knowledge Management Strategy. Geneva: WHO, 2005.
24 p.




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