Attendees of the I Regional Coordination Meeting of the Virtual Health Library (VHL), and the VII Meeting of the Latin American and Caribbean Health Sciences Information System, both held at the Pan American Health Organization Headquarters (PAHO) in
Washington DC, on Novermber 30 - December 3, 1999,

TAKING INTO CONSIDERATION:

1- that VHL is a common space for producers, intermediaries and users of scientific and technical information for the development of health;

2- all basic principles on which VHL is developed, as follow:

• promotion of the equitable access to health-related information;
  
• promotion of alliances and consortia aiming to maximize the shared use of resources;
  
• promotion of the cooperative work and exchange of experiences;
  
• decentralized development and operation in all levels;
  
• development based on local conditions;
  
• establishment and application of integrated mechanisms for quality control and evaluation;

3- all experience accumulated in the process of developing VHL, mainly the following achievements since its official launching during the IV Regional Congress on Health Sciences Information (CRICS) held on March 1998:

• dissemination of the VHL in nearly all countries of the Region, including the formation of National Consultancy Committees;
  
• 14 countries have started the VHL development;
  
• 14 Brazilian health sciences journals, 4 Chilean health sciences journals, and 5 Ibero-American leading journals in the public health field are being published on the VHL;
  
• about 40 library, computing and health sciences professionals from all over the Region have attended formal training programmes in the VHL development;
  
• thematic areas such as adolescence, public health and toxicology are already in operation through the VHL, and will serve as a model for the development of similar initiatives in the near future;
  
• health legislation, mainly the advancements in legislation concerned with innocuous food accomplished by INPPAZ;

RECOMMEND:

The adoption of the following actions considered as the four strategic stages in the process of developing and operating VHL within the Region:

I- POLITICAL SUPPORT

A decisive and explicit support from a variety of social sectors, particularly from governmental organizations, is an indispensable condition for the VHL advancement and consolidation. Aiming at increasing such a support, it is recommended that:

• the VHL proposal and advancements be presented to the PAHO Directing Council with the purpose of obtaining a resolution which shall be approved by the Ministries of Health in the countries of the Region, expressing their endeavour and support to the VHL development;
  
• VHL development activities form an explicit part of the PAHO technical cooperation tools at country levels (AMPES), appealing to PAHO representatives in the countries to defend the inclusion of such activities and their respective resources in the negotiations with national authorities for the definition of the PAHO cooperation programme in the country;
  
• - all promotion activities keep going, and be strengthened continuously, in relation to both national and international, governmental and non-governmental institutions; in the same direction, the participation in all forums, congresses and meetings which are relevant for disseminating VHL, and raising resources to support it, shall be encouraged.

II- FINANCIAL SUPPORT

Taking into account that information is an essential component for the development of health, and that VHL is becoming more and more strong as the primary strategy for a broad and equitable dissemination of the health information at regional level, it is recommended that:

• all national authorities in charge of negotiating official borrowings with multilateral finance organizations, such as the Inter-American Development Bank (IDB) and the World Bank, include a special issue regarding the VHL financial support in such borrowings destined to the field;
  
• all VHL national coordination boards develop their capabilities for raising and managing financial resources, including national plans and projects, as well as the establishment of self-sustaining programmes for the VHL components as electronic publications, document delivery services, etc.;
  
• the establishment of national plans for raising financial resources from national and international organizations includes specific projects, which may require the support of BIREME for their design and development.

III- TECHNOLOGICAL DEVELOPMENT

All technologies that support VHL are changing fast, requiring a strong capacity for maintaining and reinforcing all technological tools, as well as special capabilities for identify, evaluate, select, adapt, and develop such technologies, with the purpose to bring VHL up to date regarding technological development, and to enhance its increasing potential. Taking into account the significant innovative capacity of the Regional System's members, and the need of using common standards and methods, it is recommended the:

• use of the VHL tools in all its national and thematic components;
  
• establishment of a Regional System network for the cooperative development of methodological and technological innovations;
  
• regular training of producers, intermediaries and users in the operation of all methodological and technological components.

IV- COORDINATION

The adoption of the VHL paradigm demands a gradual redefinition of functions, structures and mechanisms regarding the coordination process for its own development and operation. With regard to such a coordination process, it is recommended the:

• increasing and diversification of the national network members, so that it is possible to develop from networks predominantly integrated by information intermediaries, to networks which also include producers and users;
  
• redefinition of the coordination functions, which besides traditional tasks like delivery services and indexing, shall include features such as information quality control on the Web, identification of new information demands and users, promotion of innovations, users education and training, and others;
  
• creation of coordination levels such as National Consultancy Committees (NCC), which shall count with the representation of the institutions that are taking part of the VHL building and operation; Committee constitution shall develop in accordance with VHL implementation in each country; NCC shall constitute a mechanism for the establishment of consensus among all players involved in such a work, with the purpose to assign responsibilities, as well as a means for providing technical and political support to the executive coordination units; such units already exist in most countries, and shall be re-evaluated by BIREME together with national authorities, taking into consideration all new demands and functions of the coordination.

At last, it is recommended that BIREME undertakes the responsibility of defining all procedures for the accomplishment of these recommendations; it is also recommended that BIREME undertakes the task of presenting a report describing the recommendation accomplishments at the I Coordination Meeting of the Virtual Health Library to take place in Cuba in 2001.