Transforming healthcare through collaboration, knowledge sharing, and innovative digital platforms
Picture this: a researcher in a small clinic in Bolivia is trying to understand a mysterious fever outbreak. A doctor in rural Peru seeks the latest treatment protocols for a complex case. A public health official in Jamaica needs to develop an effective response to a looming dengue threat. For decades, these professionals faced a common barrier—limited access to the scientific information needed to make life-saving decisions. This was the stark reality across much of Latin America and the Caribbean, where fragmented health information systems and economic disparities created a profound knowledge gap that hampered health development 1 3 .
Enter BIREME, the Latin American and Caribbean Center on Health Sciences Information. Established in 1967 in São Paulo, Brazil, as the Regional Library of Medicine (Biblioteca Regional de Medicina), this specialized center of the Pan American Health Organization (PAHO)/World Health Organization (WHO) emerged as a beacon of hope 1 3 .
For over half a century, BIREME has pioneered a revolutionary model of cooperation, proving that when it comes to health, collaboration trumps competition. In an era of climate change, emerging pandemics, and persistent health inequalities, BIREME's mission has never been more critical: to democratize access to health knowledge across borders and languages, empowering a continent to heal itself 3 .
BIREME Established
Countries Served
Years of Service
The cornerstone of BIREME's transformative impact is the Virtual Health Library (VHL), launched in 1998. Imagine not just a single website, but an interconnected ecosystem of over 100 specialized portals spanning institutions, nations, and health themes across 30 countries 3 . This isn't a traditional library with physical books; it's a dynamic digital space where knowledge is collaboratively produced, organized, and shared.
The VHL operates on a profoundly democratic principle: scientific knowledge is a public good that should be freely accessible to all. By providing a common technological framework and methodology, BIREME enables ministries of health, research institutions, universities, and hospitals to collectively manage and disseminate health information. This cooperative approach ensures that a nursing guideline developed in Mexico can inform practice in Argentina, or that research on vector-borne diseases in the Caribbean can benefit scientists in Paraguay 3 .
Visualization of BIREME's collaborative network across Latin America and the Caribbean
One of the VHL's most significant achievements is addressing the linguistic bias in global science. While major international databases often prioritize English-language literature, the VHL ensures visibility and access to knowledge produced in the region's four official languages: Spanish, Portuguese, French, and English 1 . This is crucial because local research addresses local priorities—whether it's dengue fever, Chagas disease, or healthcare models for remote Amazonian communities.
The VHL's collection is both vast and diverse, comprising databases, scientific journals, books, practice guidelines, educational resources, legislation, and even multimedia content. Through this infrastructure, BIREME coordinates access to approximately 30 million references to scientific and technical literature, creating an unprecedented flow of health information across the Americas 1 3 .
Perhaps the most compelling example of BIREME's collaborative model in action is LILACS (Latin American and Caribbean Literature on Health Sciences), the most comprehensive index of scientific and technical health literature published in the region. For over 31 years, LILACS has addressed a critical gap: while international databases like MEDLINE index approximately 90 Latin American journals, LILACS indexes articles from 932 journals and includes over 780,000 documents, including journals, theses, monographs, and governmental reports 3 .
The "experiment" of LILACS lies in its innovative methodology—a decentralized network of over 900 institutions across Latin America and the Caribbean, each serving as a cooperating center. These institutions, ranging from major universities to health ministries, are responsible for identifying, cataloging, and indexing relevant scientific literature produced in their countries according to common standards and methodologies developed by BIREME 3 .
LILACS vs. MEDLINE: Indexed Latin American Journals
Local institutions identify significant scientific literature published in their countries.
Documents are described using a unified methodology and controlled vocabulary (Health Sciences Descriptors - DeCS).
National and thematic coordinators ensure consistency and quality.
Records are integrated into the centralized LILACS database.
The knowledge becomes searchable and accessible globally through the VHL interface.
The outcomes of this decades-long initiative have been transformative for health research and practice in the region. Of the total records in LILACS, 93% of recent publications provide direct links to full-text articles, reflecting a strong commitment to open access 3 . This stands in stark contrast to the global trend of scientific knowledge being locked behind expensive paywalls.
Total Documents
Indexed Journals
Cooperating Centers
Full-Text Availability
LILACS has become an indispensable resource for evidence-informed health decisions. It is regularly consulted in thousands of systematic reviews, ensuring that health policies and practices are informed by research relevant to the region's specific contexts and priorities 3 . By valuing and amplifying locally produced knowledge, LILACS has fostered scientific identity and pride, while addressing what some call "scientific dependency" on knowledge produced in high-income countries.
Behind BIREME's successful cooperation model lies a sophisticated "toolkit" of resources and technologies that enable seamless collaboration across vast distances and different languages. These tools ensure that a researcher in Haiti can find and understand a research paper originally published in Portuguese in Brazil, or that a public health official in Chile can incorporate epidemiological data from Colombia into their disease surveillance system.
A common digital infrastructure supporting over 100 instances (national, thematic, institutional) with standardized architecture that ensures interoperability between systems 3 .
A trilingual controlled vocabulary that enables effective and consistent indexing of health literature across Spanish, Portuguese, and English 3 .
A specialized platform for managing the scientific journal production process, supporting regional journals in achieving international quality standards.
A unified search technology that allows simultaneous querying of multiple information sources, saving researchers valuable time and providing comprehensive results.
Perhaps the most innovative "tool" in BIREME's arsenal is its governance model, which includes:
Provides strategic guidance on regional priorities and policies 3 .
Offers technical expertise on methodological aspects and emerging trends in scientific information 3 .
Ensures decentralized management and local relevance of initiatives while maintaining regional coherence 3 .
In a world confronting complex health challenges—from climate-sensitive diseases spilling over from altered ecosystems to the stark health inequalities laid bare by the COVID-19 pandemic—the need for cooperation over competition has never been clearer 2 4 5 . BIREME stands as a powerful testament to what becomes possible when a region decides that health knowledge should be a bridge, not a barrier.
The center's work through the Virtual Health Library, LILACS, and its extensive cooperative networks has created a self-reinforcing ecosystem of knowledge sharing.
This ecosystem is now proving essential as the region faces new threats. Recent summits, like the 2025 Global Virus Network meeting in Jamaica, highlight how BIREME's foundational work enables rapid mobilization against emerging viral threats through shared genomic surveillance, joint vaccine research, and coordinated public health strategies 5 . Furthermore, the growing adoption of "One Health" approaches—which integrate human, animal, and environmental health—depends precisely on the kind of cross-sectoral, transdisciplinary collaboration that BIREME has championed for decades 4 .
The story of BIREME is more than a history of a specialized information center; it is a blueprint for a more equitable global health future. By proving that diverse nations can come together to create, share, and apply knowledge for the common good, it offers inspiration far beyond the shores of Latin America and the Caribbean. In democratizing access to knowledge, BIREME has ultimately democratized the power to heal, proving that when it comes to health, our best hope lies not in working alone, but in working together.