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Evidence and Globalisation
16th Cochrane Colloquium


Let’s celebrate the death of
the medical journal


Richard Horton
October 6, 2008
A revolution in knowledge
• Science is a catalyst
  for policy change

• Global partnerships
  deliver more impact
MDGs

1. Eradicate poverty
2. Achieve universal education
3. Promote gender equality
4. Reduce child mortality
5. Improve maternal health
6. Combat HIV, malaria, TB
7. Ensure environmental
   sustainability
8. Develop global partnerships
Global Development Organisation
What does globalisation
                                   •   Sustainable human development
 mean to medicine?
                                   •   MDGs

“To advocate for global            •   Collect evidence
action on human development;       •   Build institutions
to be the lead scientific and
technical agency for               •   Create partnerships
development; to co-ordinate        •   Disseminate information
bilateral and multilateral
development programmes; and        •   Promote research
to set standards for development   •   Strengthen information capacity
work.”

                                       Lancet 2002; 360: 582-83
MDG 4               MDG 5
Reduce child mortality Improve maternal health

Reduce under 5 mortality rate   Reduce maternal mortality ratio by
by two-thirds (1990-2015)       three-quarters (1990-2015)

                                Achieve, by 2015, universal access to
                                reproductive health
Child survival:
science, advocacy, and a call to action

                “We, a group of concerned scientists
                and public-health managers, call
                on: WHO, UNICEF, the World
                Bank, the UNDP, and their other
                UN partners to act on behalf of
                children by putting child survival at
                the top of their list of priorities.”

                                Lancet 2003; 362: 323-27
The result?
Countdown 2005       Newborn health
                     • Profile
                     • Policy
                     • Partnership
                     • Financial support
                     • Programme monitoring


                                     Lawn JE et al
                                     Lancet 2006; 367: 1541-47
Maternal and child undernutrition
Strategic partnerships

        • Ministerial Summit on Health Research



        • Global Forum for Health Research



        • Mexico: Nov 2004
September 25, 2008, UNGA, NY
Global science for global policy

 • Chronic disease (2005, 2007)
 • Indigenous health (2006)
 • Energy and health (2007)
 • Health and human rights (2007)
 • HIV prevention (2008)

  Pipeline: 12 global health reports in progress (2008-2009)
Mental health
    Lancet Mental Health Steering Group


      1.   No health without mental health
      2.   Resource scarcity, inequity, inefficiency
      3.   Treatment evidence
      4.   Mental health systems
      5.   Barriers to change
      6.   Call to Action



Partners:     MacArthur Foundation; KCL; WHO; LSHTM
“And fast
by hanging in
a golden chain
This pendent world…”
Let’s celebrate the death of the medical journal

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Let’s celebrate the death of the medical journal

  • 1. Evidence and Globalisation 16th Cochrane Colloquium Let’s celebrate the death of the medical journal Richard Horton October 6, 2008
  • 2. A revolution in knowledge
  • 3. • Science is a catalyst for policy change • Global partnerships deliver more impact
  • 4. MDGs 1. Eradicate poverty 2. Achieve universal education 3. Promote gender equality 4. Reduce child mortality 5. Improve maternal health 6. Combat HIV, malaria, TB 7. Ensure environmental sustainability 8. Develop global partnerships
  • 5. Global Development Organisation What does globalisation • Sustainable human development mean to medicine? • MDGs “To advocate for global • Collect evidence action on human development; • Build institutions to be the lead scientific and technical agency for • Create partnerships development; to co-ordinate • Disseminate information bilateral and multilateral development programmes; and • Promote research to set standards for development • Strengthen information capacity work.” Lancet 2002; 360: 582-83
  • 6. MDG 4 MDG 5 Reduce child mortality Improve maternal health Reduce under 5 mortality rate Reduce maternal mortality ratio by by two-thirds (1990-2015) three-quarters (1990-2015) Achieve, by 2015, universal access to reproductive health
  • 7. Child survival: science, advocacy, and a call to action “We, a group of concerned scientists and public-health managers, call on: WHO, UNICEF, the World Bank, the UNDP, and their other UN partners to act on behalf of children by putting child survival at the top of their list of priorities.” Lancet 2003; 362: 323-27
  • 8. The result? Countdown 2005 Newborn health • Profile • Policy • Partnership • Financial support • Programme monitoring Lawn JE et al Lancet 2006; 367: 1541-47
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  • 14. Maternal and child undernutrition
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  • 18. Strategic partnerships • Ministerial Summit on Health Research • Global Forum for Health Research • Mexico: Nov 2004
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  • 23. Global science for global policy • Chronic disease (2005, 2007) • Indigenous health (2006) • Energy and health (2007) • Health and human rights (2007) • HIV prevention (2008) Pipeline: 12 global health reports in progress (2008-2009)
  • 24. Mental health Lancet Mental Health Steering Group 1. No health without mental health 2. Resource scarcity, inequity, inefficiency 3. Treatment evidence 4. Mental health systems 5. Barriers to change 6. Call to Action Partners: MacArthur Foundation; KCL; WHO; LSHTM
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  • 26. “And fast by hanging in a golden chain This pendent world…”