Lancet Offline: Science is not a luxury - The global evidence ecosystem, HIFA and WHO

12 March, 2024

Below are the citation and selected extracts of an article by Richard Horton, editor-in-chief of The Lancet, and comments from me below.

CITATION: Offline: Science is not a luxury

Richard Horton

The Lancet, COMMENT| VOLUME 403, ISSUE 10429, P794, MARCH 02, 2024

Published:March 02, 2024 DOI:

Almost 20 years ago — on Nov 16–20, 2004 — a small group of advocates for health research, led by Tikki Pang (then WHO's Director of Research Policy and Cooperation), met in Mexico City to persuade ministerial delegations from 58 countries to sign up to a declaration in support of knowledge for better health. The result was the Mexico Statement on Health Research... This momentum led to the creation of Health Systems Global, an organisation to “support health systems to attain better health, equity, and wellbeing by strengthening the health policy and systems research, policy, and practice communities”...

The 20-year milestone of the Mexico Statement is an opportunity to pause and reflect on the achievements of science as a catalyst for advancing health. It is a moment to re-energise WHO's leadership, ensuring that countries put knowledge — and the generation of knowledge — at the centre of policy making...


1. The most important failing in modern medicine is not the generation of evidence (although that has many failings of its own) but the application of evidence in practice, whether by health workers, the public, or policymakers. Every health worker, every person, every policymaker requires access to the reliable healthcare information they need, in a language and format they can understand, with content that is relevant to their current context (availability of medicines, equipment, resources...). This in turn is dependent on the integrity of the global evidence ecosystem. All of these points have been repeatedly emphasised among and by HIFA members, most recently through our global survey for WHO (we are now finalising the report and will get back to you soon).

2. Tikki Pang is the person whom I met at WHO in 2006, when he was Director of Research Policy and Cooperation. I discussed with him the Lancet paper I had co-authored and in particular our invitation for WHO to champion the goal of universal access to reliable healthcare information. He provided us with a letter of support for me and two of my colleagues (Rachel Stancliffe and Fred Bukachi) to take this forward.

From a starting point of £0, we raised £2k from The BMJ and used this money to develop and launch HIFA on 26 October 2006 in Mombasa, Kenya. Since then, WHO has been our main strategic partner and we have been in official relations with WHO since 2022.

3. Our recent global survey has confirmed overwhelmingly that now is the time for WHO to explicitly commit to champion the goal of universal access to reliable healthcare information, and convene stakeholders to develop a global strategy to accelerate progress. WHO is uniquely positioned to leverage the high-level political and financial support that is needed for universal access. HIFA is uniquely positioned to support this by promoting communication, understanding and advocacy across the global evidence ecosystem. Together, WHO, HIFA and partners can realise a shared vision: a world where every person, every health worker and every policymaker will have access to the information they need to protect their own health and the health of others.

Best wishes, Neil

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: