About the Latin American and Caribbean Center on Health Sciences Information

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The Latin American and Caribbean Center on Health Sciences Information, also known by its original name Biblioteca Regional de Medicina (BIREME – Regional Library of Medicine), is a specialized center of the Pan American Health Organization/World Health Organization (PAHO/WHO), oriented to technical cooperation in health scientific information. The Center was located on the central campus of the Universidade Federal de São Paulo since its inception in 1967, according to an agreement between PAHO and the Government of Brazil. Since March 2016, it is located at Rua Vergueiro 1759, 12th floor, 04101-000, São Paulo, SP, Brazil.

Mission

The mission of BIREME is to contribute to the development of health in the countries of Latin America and the Caribbean through the democratization of access, publication and use of scientific information, knowledge and evidence.

The main groundwork for BIREME’s existence is the following:

Access to scientific and technical health information, which is essential to the development of research, education and healthcare systems;
The need for technical cooperation in order to develop and strengthen national and regional capacities and infrastructure for scientific and technical information in the countries of Latin America and the Caribbean, in accordance with the international state of the art;
The need to increase, in a sustainable way, visibility, accessibility, dissemination, use and impact of scientific information generated at national, regional and global levels.

Objectives

BIREME’s objective is to contribute to develop the health of the population of the Americas, promoting cooperation between the countries, the democratization of access to scientific and technical information and to legislation, as well as sharing knowledge and evidence in order to support continuous improvement in health, education and research systems.

In order to attain its objectives, BIREME executes the following technical cooperation functions, included in the Regional Strategic Plan of the Pan American Health Organization/World Health Organization (PAHO/WHO):

Support and strengthen health information systems in PAHO Member-States;
Contribute to develop and strengthen public health initiatives, policies and national and regional capacities, as well as developing the necessary infrastructure for the acquisition, organization, access, publication and use of scientific information, knowledge and evidence on health processes and decision-making;
Contribute to develop and strengthen networks of institutions and individual producers, intermediaries and users of scientific, technical, legal and factual information in health, through the cooperative management and operation of information products, services and events in the common forum of the Virtual Health Library (VHL), in cooperation with complementary national, regional and international networks;
Contribute to the global development of information and communication in health sciences through partnerships, programs, networks and projects between international, regional and national institutions, with the objective of increasing visibility, access, quality and production of developing countries and regions;
Contribute to the development of health science and technical terminology in English, Portuguese, Spanish and French;
Contribute to the development of distance learning systems in the Region of the Americas, through infrastructure and training for access and dissemination of information as part of PAHO’s Virtual Campus in Public Health;
Support and promote collaboration between governments, health professionals, consumers, scientific institutions, international organizations and society in general, in order to establish and strengthen national health information systems, which promote continuous education and research through innovation and the application of information and communication technologies.

Projects and Programs

BIREME/PAHO/WHO develops technical cooperation projects based on its biannual work program. This line of action is a priority in order to respond to the growing demands for the development of the VHL and its associated networks, as well as for operating the networks of sources and flows of scientific, technical and factual information in health.

The methodology developed by BIREME is oriented to the management of VHL projects by the entire network. This is aligned with PAHO’s technical cooperation strategy for the development of health in the countries of Latin America and the Caribbean, contributing to the development of institutional, local, national and regional policies and capacities for the publication, organization and equitable access to scientific information.

VHL – Virtual Health Library

The VHL (http://bvsalud.org/en) is the main Strategy and Model for technical cooperation on scientific and technical health information management in LA&C. It is promoted and coordinated by BIREME since 1998. It is a regional public good, built and operated by a network of institutions and professionals from 30 countries that work with production, intermediation and use of scientific and technical health information.

The key objectives of the VHL are:

Creating, improving and disseminating scientific and technical information sources to attend the needs of governments, health systems, workers and researchers on publication, preservation and/or access to relevant information on health;
Coordinating, executing and promoting bibliographic control, dissemination, evaluation and improvement of the scientific and technical literature published in the countries of the Region of LA&C; and
Promoting and facilitating equitable access to information, so that health decisions are based on/informed by scientific knowledge (evidence).

The VHL Model

The application of the VHL Model reflects on the development of information sources and the building of web portals, also called VHL Instances, which can be regional, national, thematic or institutional. Currently, the VHL Model is applied to over 100 VHL Instances, which, in turn, make up the VHL Network, along with the libraries that cooperate with the development of the information sources that compose those Instances.

The VHL, in its library dimension, is expressed by a collection of information sources defined as any resource – databases, catalogues, Websites, books, journals, practice guides, open education resources, legislation, courses, events, practice communities, videos, experience reports, news, etc. – which can meet the users’ information needs.

The contents of the VHL are gathered and structured in different information sources, according to the nature and specific characteristics of each type of content which, in turn, are presented in the portals of the VHL Instances. This presentation follows an information architecture that is in accordance with the VHL Model standards and that facilitates interoperability among the systems, access to regional sources of information (e.g. LILACS), and accessibility to content on different devices.

LILACS – Latin American and Caribbean Literature on Health Sciences

LILACS (http://lilacs.bvsalud.org/en) is the most relevant and comprehensive index on scientific and technical health literature published by the countries of LA&C. For over 31 years, LILACS has contributed to increase visibility, access and quality of the scientific output in health in the Region. LILACS emphasis is on public health publications and has as target audience students, researchers, health professionals and managers.

LILACS brings together over 780 thousand documents published in the Region of LA&C, indexes articles of 932 journals, theses, monographs and non-conventional literature. In fact, LILACS complements MEDLINE, which indexes approximately 90 Latin American journals. LILACS is cited in thousands of systematic revisions as a research source for primary studies in Latin America and offers contextualized evidence for the health priorities of LA&C.

LILACS contains primary studies such as clinical essays, cohort studies, case series, case reports and secondary studies such as clinical practice guides, systematic revisions, health economics assessments, sanitary technology assessments, and other types of content, all distributed in journal articles, theses and dissertations, non-conventional documents (gray literature) and monographs.

Of the total records in LILACS, over 380 thousand lead to a link with the full text of the articles, which corresponds to 48% of the LILACS records. If only records of the last 3 years are considered, 93% lead to the full text, reflecting a current criteria in which the journal, in order to be indexed in LILACS, must be published in open access.

LILACS has a collaboration network distributed in countries of LA&C, with over 900 cooperating centers, responsible for the bibliographic record and indexing documents on the database, applying LILACS Methodology and the Controlled Vocabulary of DeCS – Health Sciences Descriptors. Of these centers, over 500 have effectively contributed to LILACS. BIREME is in charge of the general coordination and there is a National Coordinating Center in each country. There is also a Coordinator for thematic areas, such as Nursing, Psychology and Dentistry. Since the end of 2012, LILACS is also powered by the automatic retrieval of metadata from electronic journals and direct loading of metadata from electronic journal editors.

DeCS – Health Sciences Descriptors

DeCS (http://decs.bvsalud.org/I) is a controlled vocabulary that maintains and periodically updates the terminology in health sciences in Spanish, Portuguese, English and French.

DeCS is available online in open access, especially for students, researchers, and health professionals, through a license of use that is granted upon demand, free of charge. It is the only vocabulary in the world which is updated annually for indexing scientific and technical health literature in Spanish and Portuguese. It includes the translation of the Medical Subject Headings (MeSH/NLM) in Portuguese and Spanish. It is an extensive thesaurus kept by BIREME and enriched with additional categories such as Public Health, Health Surveillance, Science and Health and Homeopathy. The translations of the MeSH/NLM in Portuguese and Spanish are integrated to the Unified Medical Language System (UMLS/NLM) of the United States. DeCS offers online services which facilitate the use of MeSH/DeCS for indexing content in sanitary information systems; it is a tool that allows users to search on MEDLINE, LILACS and other VHL information sources using descriptors in Spanish, Portuguese, French and English. The Spanish and French translations rely on collaboration with the Biblioteca Central de la Facultad de Medicina de la Universidad de Chile, the Biblioteca Nacional de Ciencias de la Salud (BCNS) del Instituto de Salud Carlos III (ISCIII) of the Ministry of Economy and Competitiveness of Spain, and the CHU Hôpitaux de Rouen, France. The MeSH terms are translated to French by the Institut National de la Santé et Recherche Médicale (INSERM), France. The DeCS website receives approximately 300.000 visits per month.

Governance

BIREME had its new governance framework renewed in 2009 through the establishment of three legal instruments: the Headquarters’ Agreement between PAHO and the Government of Brazil; the Facility Agreement between PAHO and the Government of Brazil; and the BIREME Bylaw, approved in the 49th Directing Council of PAHO (CD49.R5) in October 2009.

According to the Statute, the following governance structure was established as of 2010:

1. BIREME Members, defined in the categories:

a. Member States: all PAHO Member States. This includes Member States, Participating States and Associate Members of PAHO.
b. Participating States: WHO Member States which are not Members of PAHO.
c. Participating Organizations: Public international organizations with specific qualifications related to scientific and technical information and communication.

2. Advisory Committee

The Advisory Committee is composed of the Pan American Health Organization (PAHO) and Brazil as permanent members, and five other PAHO Member States selected by the Directing Council of the Organization for a three-year term, currently represented by Argentina, Jamaica and Peru (2016-2018) and Panama and El Salvador and Barbados (2018-2020). The functions of the Committee include making recommendations to the Director of PAHO on the program functions, work plan and financing of BIREME.

Ten sessions of the Advisory Committee have already taken place since its installation on August 31, 2010, as shown on Table 1.

Table 1. BIREME/PAHO/WHO Advisory Committee (AC) Sessions

Session	Date	Local	Participants
X Session	October 7, 2021	BIREME	PAHO (EIH, BIR) Countries (Brasil, Colombia, Costa Rica, Mexico, and Uruguay)
IX Session	December 17, 2020	Online	PAHO (EIH, BIR) Countries (Barbados, Brazil, El Salvador, Guyana, Mexico, and Uruguay)
Ad Hoc Session	July 30, 2020	Online	PAHO (EIH, BIR) Countries (Barbados, Brazil, El Salvador, Guyana and Uruguay)
VIII AC	October 24-25, 2019	BIREME	PAHO (BIR) Countries (Barbados, Brazil, El Salvador, Guyana and Uruguay)
VII AC	November 7-8, 2018	BIREME	PAHO (EIH, BIR) Countries (Brazil, Argentina, Jamaica, Panama, Peru, Trinidad and Tobago
VI AC	February 2, 2017	BIREME	PAHO (AD, KBR, BIR) Countries (Brazil, Argentina, Jamaica, Panama, Peru, Trinidad and Tobago)
V AC	December 3, 2014	BIREME	PAHO (AD, KBR, BIR) Countries (Cuba, Ecuador)
IV AC	November 26, 2013	BIREME	PAHO (KMC, BIR) Countries (Brazil, Bolivia, Cuba, Ecuador, Puerto Rico)
III AC	December 5, 2012	BIREME	PAHO (KMC, BIR) Countries (Argentina, Brazil, Bolivia, Chile, Dominican Republic, Suriname)
II AC	October 25, 2011	BIREME	PAHO (KMC, PWR/BRA, BIR) Countries (Argentina, Brazil, Chile, Dominican Republic)
I AC	August 31, 2010	PAHO/HQ	PAHO (D, AD, DD, AM, KMC, LEG, PWR/BRA, BIR) Countries (Argentina, Brazil, Chile, Dominican Republic, Jamaica, Mexico)

Note: Countries in bold indicate the Presidents of each Session.

3. Scientific Committee

The Scientific Committee (SC) is composed of five expert members nominated by PAHO Member States and the Director of PAHO and appointed by BIREME’s Advisory Committee. The Scientific Committee advises the Director of PAHO and the Advisory Committee of BIREME on the preparation and implementation of the work plan, making recommendations on the programmatic functions of the Center. The Committee is also responsible for recommending the adoption of innovations in information technologies for BIREME’s scientific communication products and services. For the 2017-2019 biennium, the Committee is made up of representatives from Mexico, Jamaica, Cuba, Colombia, Costa Rica and Brazil.

Seven sessions of the SC have already taken place since its inception on July 25, 2013, in a meeting held at BIREME’s headquarters, with the participation of experts from Brazil, Canada, Honduras, Trinidad and Tobago and the U.S. National Library of Medicine (NLM).

The seventh Session took place on September 30, 2021, virtually, and relied on the participation of experts from Argentina (Education), Brazil (Development, Operation and Financing for BIREME’s Projects, Products and Services and Evidence-Informed Health), United States (Information Management), The Netherlands (Information Technology), Scholarly Communication (Mexico), and Scientific Research (Peru). PAHO/WHO was represented by the Director of the Department of Evidence and Intelligence for Action in Health (EIH), Sebastián Garcia Saisó, by the Director, Diego González Machín, and the BIREME team.

The sixth Session took place on December 4, 2020, virtually, and relied on the participation of experts from Argentina (Education), Brazil (Development, Operation and Financing for BIREME’s Projects, Products and Services and Evidence-Informed Health), United States (Information Management), The Netherlands (Information Technology), Scholarly Communication (Mexico), and Scientific Research (Peru).

On August 28, an online Ad Hoc session was held to welcome the new members of the Scientific Committee, elected for a period of three years (2020-2022), which includes experts from Argentina (Education), Brazil ( Development, Operation and Financing for BIREME’s Projects, Products and Services and Evidence-Informed Health), United States (Information Management), The Netherlands (Information Technology), Scholarly Communication (Mexico), and Scientific Research (Peru).

The V Session took place on November 28 and 29, 2019, with specialists from Brazil (Technology and Information), Colombia (Education, Management and Knowledge), Costa Rica (Scientific Investigation), Cuba (Information Management), and Mexico (Scientific Communication). The specialist from Jamaica (Scientific Research) justified her absence, while sending her contributions.

The IV Session took place on December 3, 2018 at BIREME facilities, with representatives from Mexico, Jamaica, Cuba, Colombia, Costa Rica and Brazil, as well as the distinguished presence of the Director of PAHO/WHO, Dr. Carissa Etienne. In addition, Dr. Amanda Wilson, Coordinator of the National Network of the U.S. NLM participated as an observer at the meeting

The III Session of the Scientific Committee took place on December 7 and 8, 2017 at BIREME and was attended by representatives from Mexico, Jamaica, Cuba, Colombia, Costa Rica and Brazil, as well as by the Assistant Director of PAHO/WHO, Francisco Becerra, and the Consultant in Health Organization Services, Maurício Bustamente.

The II Session took place on August 14, 2014, also at BIREME, and was attended by experts from Brazil, Honduras, Trinidad and Tobago and the NLM.

4. Secretariat

The Secretariat is a permanent body of BIREME, composed of the Director of BIREME and the technical and administrative teams. It is responsible for the management and execution of the institution’s program functions.

5. Institutional Organization Chart

PAHO Director (Dr. Carissa F. Etienne)

Assistant Director (Dr. Jarbas Barbosa da Silva Jr.)

EIH Director – Department of Evidence and Intelligence for Action in Health (Dr. Sebastián Garcia Saisó)

BIREME Director a.i. (Dr. Sebastián Garcia Saisó)

COM – Scientific Communication in Health and Institutional Communication (Dr. Lilian Calò)

GA – Administrative Management and Planning (Silvia A. Valentin)

ADM - Administration (Silvia A. Valentin)
CPP – Controller (Adriano Rheder de Sá)
ITI – Information Technology Infrastructure (Marcia Y. Barretto)

MTI – Methodologies and Information Technologies (vacant)

DES – System Development (vacant)
RST – Technical Support Network (Marcos Mori)
DGI – Graphic Design and Interfaces (vacant)

AFI – Information Source Management (vacant)

OFI – Information Source Operation (Marcelo Bottura)
TCS – Health Terminologies and Classification (Ana Cristina Espindola Campos)

PFI – Information Source Production (Verônica Abdala, a.i.)

FIR – Information Referential Sources (Sueli Suga)
MIP – Monitoring of Instances and VHL (Juliana Sousa)

SCI – Cooperative Information Services (Verônica Abdala)

SAU – User Service (Rosemeire Rocha Pinto)
SCAD – Cooperative Service (Marilda Perez)

First period

From its creation in 1967, as Regional Library of Medicine, until the end of the 1970s, BIREME's model of technical cooperation was based on the essential functions of the medical libraries, including human resources education in management and operation of libraries and documentation centers, local collection development, shared use of the collections among libraries, user services, bibliographic searches in MEDLINE database and interlibrary loan.

Second period

Since the end of the 1970s until the end of the 1980s, the model of technical cooperation was expanded, on one hand, with the new function of bibliographic control and indexing of the health literature published in Latin American and Caribbean scientific journals, and, on the other hand, expanding the thematic coverage in order to comprehend the whole domain of health sciences, with emphasis on public health. In 1979, BIREME launched the Index Medicus Latino-Americano (IMLA), indexing nearly 150 journals, complementing MEDLINE, which then included 44 titles of Latin America and the Caribbean. With the IMLA, BIREME began its prominent role to give regional and international visibility to the health scientific and technical production of Latin America and the Caribbean. This expansion of the cooperation model transformed BIREME in an information indexing center for the Region, which was reflected in the change of its original name of Regional Library of Medicine to Latin American and Caribbean Center on Health Sciences Information in 1982, remaining the acronym BIREME. During this period, the IMLA evolved to the bibliographic database called Latin American and Caribbean Literature on Health Sciences Information (LILACS), with emphasis on public health.

Third period

At the end of 1980s, BIREME promoted the decentralization, at the country level, of the functions of bibliographic control and indexing of the scientific production, the bibliographic search services and training of human resources. This decentralization was shaped in the Latin American and Caribbean System on Health Sciences Information, with a national coordinating institution in every country. This movement has meant a notable progress for the development of the national information capacities and infrastructures as well as on the development of managerial and technical human resources. In this period the development of LILACS evolved to a cooperative endeavor. At the end of the 1980s, BIREME promoted the use of computers in the libraries, both for the decentralized production of LILACS database and for the bibliographic search in CDROM and subsequently on-line. LILACS CD-ROM launched in 1988 was one of the first CD-ROM titles on scientific information produced in the world. Also in this period, BIREME enriched the methodologies for scientific information management with the launch and annual updating of the vocabulary Health Sciences Descriptors (DeCS), which contains the translation of the Medical Subject Headings (MeSH) of the National Library of Medicine to Spanish and Portuguese languages, expanded with new descriptor categories in order to permit better indexing of the scientific and technical literature of the Region, especially public health and environment.

Fourth period

The period since the end of the 1990s and currently is well advanced and centered on the adoption of the Internet as the medium of production of information sources and flows. Technical cooperation is implemented by means of the Virtual Health Library (VHL), which was launched in March 1998, with the Declaration of San José Towards the Virtual Health Library, approved during the 4th Regional Congress on Health Sciences Information (CRICS4). In this Declaration the country representatives recognize that the access to information constitutes one of the central elements to reach equity in health; that the new information and communication technologies pose risks and opportunities for the human development in the Region and that the Latin American and Caribbean System on Health Sciences Information under the leadership of BIREME has the capability for the control of these technologies, adapting them to the reality of the region. Based on these premises, they made the commitment to cooperatively built the Virtual Health Library, in order to strengthen capabilities and infrastructures and to facilitate the broad access to the information for the permanent improvement of the health and for sustainable human development of the region. At the same time, BIREME cooperated with FAPESP (State of São Paulo Research Foundation) from Brazil, on the establishment the Scientific Electronic Library Online (SciELO) as a model for open access cooperative electronic publishing of scientific journals on the Internet.

The VHL represents a notable innovation that has contributed to systematically update of the Region research, education and health care systems scientific information, knowledge and evidence related methodologies, technologies, products and contemporary services and taking into consideration the social, economic and cultural conditions of the Region. The operation of the VHL and associated networks has radically contributed to the visibility, access, use, and impact of the information sources from Latin America and the Caribbean, as well as to the access to the international reference information sources.