Since almost 20 years, New Zealanders have had free access one of the most trusted medical libraries in the world.
The Cochrane Library has been hailed as the gold-standard in health research.
It is a globally recognized source of independent and peer-reviewed evidence on health. It provides systematic reviews, rigorous summaries, and information about clinical trial that helps guide decisions regarding everything from mental health treatments to cancer treatments.
Reviews are trusted as they are transparent and unaffected by commercial interests. Full access to the site is under threat now as a new license would restrict it only to health professionals from September.
This change will save money but could have wider implications. In this age of misinformation and a lack of reliable evidence, accessing health information is not a luxury. It’s a necessity.
Restricted access
In the restructuring of the New Zealand health system, Health New Zealand was given the responsibility of continuing to fund access to the Cochrane Library. Health New Zealand decided that the national license would be downgraded to only serve healthcare professionals.
Access to the Health New Zealand website and primary care providers will be limited under this new license. The new license will restrict access to Health New Zealand staff and primary care providers only.
The fact that New Zealanders are losing access to evidence that allows them to make informed health decisions is the most alarming.
New Zealanders downloaded over 100,000 Cochrane Reviews in the past year alone – 276 per day. This is not a niche resource. This library is a valuable national resource.
Restricted access brings us back to an era when medical knowledge was tightly held by professionals and the public was expected to trust them. This move is a step backwards in today’s society, where transparency, empowerment, and good health outcomes are important.
New Zealand is falling behind
New Zealand is stepping back while other countries are moving forward. Australia, Brazil and South Africa are among the countries that receive funding for national subscriptions to Cochrane Library.
Even countries with low and middle incomes have accessibility through international programs. New Zealand is at risk of falling behind wealthy nations and those with less resources. This is a sobering fact for a country that once had a -led health system.
The cost to maintain the national license is modest, particularly when compared with other innovations in health. Prior to the introduction of the universal national license, each institution, university, hospital and government agency paid separately for the access. This increased the burden on public finances.
In 2006, the national license was introduced because it was cost-effective in general. As a bonus, the license did not just consolidate expenditures, but also expanded access. All New Zealanders now have access to the same high-quality health information as researchers and clinicians, at a lower cost.
New Zealand is the only country that produces more Cochrane Reviews per capita. If we lose national access, it would be as if our voice were silenced in the global discussion.
It may appear that the decision to downgrade Cochrane Library’s license is a minor change. Its impact on people is profound. The doctor-patient relationship is affected by the fact that both parties are not receiving the same information. This also affects students who are learning how to care for their patients, health policy makers and parents who are trying to understand the diagnosis.
It is not acceptable to lock away health evidence behind institutional walls. The evidence should be available to everyone, especially if the country values fairness and transparency, as well as informed decisions.
I believe that retaining the national license would be an inexpensive, but high-impact choice. It’s not just about money. Full access promotes trust and equity.
Vanessa Jordan is the director of Cochrane Collaboration, a UK-based charity. She was also funded by the New Zealand Ministry of Health for promoting access to the Cochrane Library.
