The budget of Britain’s Health Technology Assessment programme has grown from £13m in 2006 to £88m in 2010, and it has conducted a swathe of trials on new technologies, published dozens of papers, and supported a study that won the BMJ paper of the year. But could it do even better? This was the question addressed at its biannual meeting yesterday, which I chaired. more…

Last week’s conference to launch Edinburgh University’s Global Health Academy left me thinking that priorities in global health may be very wrong.

David Molyneaux from Liverpool said that an alien observing earth for the first time would think that it had only three diseases: AIDS, TB, and malaria. He is one of the “three dinosaurs of neglected tropical diseases (NTDs)” who spoke at the meeting, pointing out that sums that are very small by the standards of AIDS could make a huge difference in alleviating the suffering of the world’s poorest people from schistosomiasis, onchocerciasis, sleeping sickness, elephantiasis, and the other neglected tropical diseases. Some of these diseases can be treated very effectively and cheaply. Deworming people—as animals have long been dewormed—for 60 cents a year could make huge differences to child growth and development and levels of disability. more…

I’ve just spent five days—yes, five days—talking about health literacy. Before my five day conversation I’d never thought much about health literacy, but now I see myself as an expert. Pick a small enough subject and you can be a world expert in about 20 minutes. But health literacy is actually a big subject and increasing it could potentially make a huge difference to beleaguered patients and health care systems. Our marathon conversation took place in Frankfurt and included lots of grand and smart people, all of them grander and smarter than me. As in many conversations, we spent a lot of time talking across each other because we had different ideas of what we were talking about. more…

Something has just happened that will almost certainly end the tyranny of impact factors and may well mark another step towards the extinction of most scientific journals. Did you notice it? Probably not, and even if you did you may not have understood what it was or what it may lead to.

It was the appearance of something called rather clunkily “article level metrics.” These are a variety of scores and other bits of information attached to each article in the publications of the Public Library of Science (where I’m on the board). They shift attention from journals to articles, particularly for the academic bean counters anxious to find a convenient and low cost way of ranking academics. more…

WHO is currently setting priorities for research in chronic or non-communicable disease, and generally the first research question is “Will what has worked in rich countries work in low and middle income countries?” We know, for example, what to do to reduce deaths from heart disease and how to reduce tobacco consumption. But interestingly when it comes to nutrition we don’t know what to recommend. The advice for rich countries may be wholly inappropriate for poor countries. more…

At last I have online access to my medical records. I wrote a blog some six months ago about how a talk by Harold Shipman’s successor had convinced me that I should get access.  I do most of my work online, complete my tax return online, make all my travel arrangements online, bank online, and buy books and CDs online, so surely I should be able to access my medical records online and ideally interact with my doctor and other specialists. more…

The most interesting, and certainly the most chilling, experience I had in four days in Buenos Aires was to visit the memorial to “the disappeared.” more…

Firsthand personal experience of a great crime can make it real in a way that full intellectual understanding will not. Spend two hours in close contact with an African AIDS orphan, and you’ll know what I mean. more…

Imagine being at the 60th anniversary of an organization and hearing from the first head of the organisation. It seems impossible, but I’ve just had that experience - listening to Nevin Scrimshaw, aged 91, describe the challenge and the excitement of the early days of the Institute of Nutrition of Central America and Panama (INCAP). Almost as remarkable, all six of the directors of INCAP are still alive - perhaps a tribute to their knowledge of nutrition. more…

Today I feel deeply the shame of a monoglot. I’m at a meeting in Guatemala, and the organisers of a meeting of perhaps 200 people have had to hire two translators—for the benefit of me and one American. And tomorrow he departs, meaning that the two translators will be working just for me. How pathetic. more…