Much of the information f lowing from North to South is not relevant to local needs, since applicability usually depends on 'fine grained structure of information use'. A number of people also stressed the need to raise awareness of existing information resources. It is important to get the basic clinical guidelines and primary health care information that are already available out to as many people as possible. Whether a ring bound file of paper that could be updated and amended, a version of the blue trunk library, or a CD-ROM containing key health reference materials, these core resources are not getting to the places most needed at present. It is vital that any initiatives around Internet connectivity, build on the need for such appropriate solutions to information access in remote or unconnected localities.
Different constituencies have clearly different needs.
The conference noted some tension between top-down international efforts and building local capacity and even demand, for good quality health information, the latter being crucial. These different needs should not be confounded. We have to begin from realities on ground, and find 'tools' for specific problems. In this context, while the announcement of major publishers to provide on-line access to major medical journals free to developing countries was widely applauded, it was noted that in some developing countries this would have little impact, as most clinicians spent less than half an hour a week reading. What is vitally needed is high quality and relevant summaries.