'Jamie Hayes and colleagues describe the history and sometimes personal significance of a go-to reference point for healthcare professionals in the UK and beyond'
This BMJ article describes how the British National Formulary has grown in size.
'The first edition (BNF No 1) of the new British National Formulary was bound in ultramarine cloth and distributed throughout the NHS in February 1981... It weighed 331 g and had a width of 16 mm... The 90th edition of the BNF, which covers September 2025 to March 2026, weighs 1170 g and has a width of 43 mm.'
The BNF was in my white coat pocket in the 1980s, constantly consulted. I'm glad I don't have to carry the print edition now.
The article does not try to describe the clinical impact of the BNF over this time period, including its impact in LMICs.
The Commonwealth Pharmacy Association continues to collect used copies and distributes them worldwide. They are highly popular and valued because they not only give information on individual drugs (which is easy to find on the internet), they give unbiased, objective guidance on how to select medicines for different contexts. The BNF must have empowere millions of health professionals to save the lives of tens of millions of patients.
Unfortunately, the BNF could have had a hugely greater impact on global health if it had focused on saving lives rather than profit. In the late 2000s and early 2010s, if I remember corerectly, the BNF was freely available to everyone via the internet. But then the publisher took the decision to stop free access, although it continues to be freely accessible to Hinari-registered institutions. If the content had been made open-access, with support for countries to use and adapt as needed, then this would truly have enabled universal access to reliable information for prescribers and users of medicines. I see this as a great lost opportunity, although I welcome inputs from others with more insight.
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: neil@hifa.org