Tom Moberly, UK Editor, BMJ writes: 'Decades of improvements in mortality are coming undone as public health funding is eroded and trust in evidence based treatment is undermined. At the same time, commercial interests are pushing people away from healthy lifestyles, as companies work to ensure that government policies don’t undermine their business models (doi:10.1136/bmj.r487). And millions of the most powerless people in the world will be harmed in the wake of the US’s sudden withdrawal of foreign aid (doi:10.1136/bmj.r518).'
Seeking lightbulb moments
BMJ 2025; 388 doi: https://doi.org/10.1136/bmj.r617 (Published 27 March 2025)
Cite this as: BMJ 2025;388:r617
COMMENT (NPW): 'Trust in evidence based treatment is undermined' - There can be no doubt that several factors, notably disinformation and distruct in science generally, are undermining trust in evidence-based treatment. Are we also seeing an overall reduction in trust in evidence based treatment? In which countries and which social groups are people losing such trust and why? I remember reading about Cochrane in my late 20s - long after medical school! - and understanding for the first time how evidence-based policy and practice is dependent on systematic review. Systematic reviews remain at the heart of the global evidence ecosystem: https://www.hifa.org/about-hifa/hifa-vision-mission-strategy
Ever since then, the beauty and unassailable logic of the global evidence ecosystem has been a driving light for HIFA and our work to ensure that every person worldwide has access to reliable healthcare information. One of the reasons that HIFA uses such a simple graphic to describe the global evidence ecosystem is that other representations are typically abstract and hard to grasp. What can we do to make people appreciate the basic principles of evidence-informed policy and practice?
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