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WHO's Guidelines Lack Evidence, Lancet Says

The Lancet, the prestigious medical journal, has charged that the World Health Organisation (WHO) has consistently failed to produce enough evidence to back up any of its guidelines.

As it happens one of WHOs main jobs is to produce guidelines on everything from fighting the spread of bird flu and malaria control to enacting anti-tobacco legislation.

This is a pretty seismic event, Lancet editor Dr. Richard Horton, who was not involved in the research for the article. It undermines the very purpose of WHO.

The study was conducted by Dr. Andrew Oxman and Dr. Atle Fretheim, of the Norweigian Knowledge Centre for Health Services, and Dr. John Lavis at McMaster University in Canada.

They interviewed senior WHO officials and analyzed various guidelines to determine how they were produced. What they found was a distinctly non-transparent process.

Its difficult to judge how much confidence you can have in WHO guidelines if youre not told how they were developed, Oxman said. In that case, youre left with blind trust.

WHO issues about 200 sets of recommendations every year, acting as a public health arbiter to the global community by sifting through competing scientific theories and studies to put forth the best policies.

WHOs Director of Research Policy Dr. Tikki Pang said that some of his WHO colleagues were shocked by The Lancets study, but he acknowledged the criticism had merit, and explained that time pressures and a lack of both information and money sometimes compromised WHO work.

We know our credibility is at stake, Pang said, and we are now going to get our act together. WHO officials also noted that, in many cases, evidence simply did not exist. Data from developing countries are patchy at best, and in an outbreak, information changes as the crisis unfolds.

To address the problem, they said, WHO is trying to develop new ways to collect infor
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