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NLM International Programs

As the world's largest biomedical collection, the National Library of Medicine (NLM) has a mission which has been extended to encompass its international activities:  to assist the advancement of medical and related sciences through the collection, preservation, dissemination and exchange of information important to the progress of medicine and health.

NLM Background

In 1865, John Shaw Billings, first director of the library, turned to the international community as he built a world-class compilation of medical books, journals, and an international index to the world's biomedical literature of the day: Index Medicus®. In the early 1960s Index Medicus production was computerized; this led to the development of the electronically searchable MEDLINE® and a comprehensive Medical Literature Analysis and Retrieval System: MEDLARS®. Beginning in the late 1960s and up until the mid-1990s, bilateral agreements with International MEDLARS Centers (expanding to include centers in 20 countries) resulted in licensed and distributed MEDLINE tapes and also provided online access to MEDLINE and other databases to citizens in selected countries. These quid pro quo arrangements provided NLM with valuable assistance in indexing non-English literature and collecting database searching fees. In 1997, PubMed® on the Web made it possible for anyone with Internet connectivity to access and use all of the NLM databases for free.

The NLM collection retains a strong international character with holdings in over 80 languages.  Sixty-two percent of MEDLINE journals are published abroad, and MEDLINE/PubMed receives substantial use from outside the U.S. Each day a total of 23 million pages of PubMed data are viewed by an international community of users including health professionals, scientists, students, librarians and the general public. PubMed contains more than 26 million bibliographic citations dating back to the mid-1940s (and sometimes much earlier as a result of digitization projects). Of these, more than 16 million have author abstracts. PubMed, including MEDLINE over the years, cites journals published in about 160 countries while currently indexed MEDLINE journals are published in about 85 countries. MEDLINE, the largest subset of PubMed, covers over 5,600 currently indexed journals for which Medical Subject Headings (MeSH) are applied to citations for the articles. PubMed also provides linked access to related genomic and molecular sequence data.  Since the 1980s NLM and organizations in Europe and Japan have exchanged sequence data as part of the International Sequence Database Collaboration, long considered a model for international cooperation in the life sciences.

MedlinePlus® is the National Library of Medicine Web site for consumer health information.  It also offers a Spanish language version.  Other databases provide information on cataloging and serials, toxicological and environmental health data, AIDS, and other specialized areas.

PubMed Central® (PMC) is the NIH free, full-text digital archive of biomedical and life sciences journal literature.

International Partnerships

The NLM international partnerships strengthen and expand global access to the world's health literature.  These partnerships include:

  • PubMed Central International (PMCI) is a collaborative effort among NLM, the publishers whose journal content makes up the PMC archive, and organizations in other countries that share the NLM interest in archiving life sciences literature. The long-term goal of PMCI is to create a network of digital archives that can share some or all of their respective locally deposited content with others in the network.  The first PMCI site was launched in the UK in January of 2007 by the Welcome Trust in partnership with NLM and the British library; it is now called Europe PubMed Central. PMC Canada was launched in 2009 in collaboration with CISTI (Canada Institute for Scientific and Technical Information) and the Canadian Institutes of Health Research (CIHR).
  • The African Journal Partnership Project Program has been supported by NLM and Fogarty International Center since 2003. It consists of nine African journals (the Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Malawi, Mali, Rwanda, Sierra Leone, and Uganda), and six partner journals from the US and UK (Annals of Int Med, BMJ, Environmental Health Prospectives, JAMA, The Lancet, The New England Journal of Medicine).  The project's goal is to promote wider dissemination of African health and medical research published in African health and medical journals.
  • The Central American Network for Disaster and Health Information (CANDHI), is supported by NLM, the Pan American Health Organization (PAHO), and the United Nations International Strategy for Disaster Reduction and the Regional Disaster Information Center for Latin America and the Caribbean. This disaster preparedness outreach program strengthens health information infrastructure and improves access to health-related disaster information in Central American countries that are vulnerable to hurricanes, earthquakes and other natural disasters through database and web development, document collection and digitization training, and information sharing.
  • Interlibrary loans to non-US institutions are supported through partner libraries in in Antigua and Barbuda, Australia, Austria, Brazil, Canada, Chile, China, Croatia, Czech Republic, Denmark, Estonia, Finland, France, Germany, Hong Kong, Iceland, India, Israel, Italy, Japan, Korea, Latvia, Lithuania, New Zealand, Norway, Poland, Russia, Slovakia, Slovenia, South Africa, Spain, Sweden, Switzerland, and the UK. NLM has agreements with the Canada Institute for Scientific and Technical Information and the German National Medical Library to provide document delivery services via DOCLINE® should any of the three institutions be incapacitated by a disaster. Also, the Emergency Access Initiative (EAI) provides temporary free access to full text article from major biomedicine titles to healthcare professionals, librarian, and the public affected by disasters throughout the world.
  • NLM has cooperative agreements to translate MeSH (Medical Subject Headings) for inclusion in the UMLS®: BIREME (Biblioteca Regional de Medicina, Brazil)  translates MeSH® into Portuguese and Spanish; Institut National de la Santé et de la Recherche Médicale (INSERM) into French; German Institute for Medical Documentation and Information (DIMDI) into German; Central Medical Library into Russian; Central Medical Library of Poland into Polish; Zagreb University School of Medicine into Croatian; National Medical Library into Czech; Slovak Medical Library into Slovak; Italian National Institute of Health into Italian; and Norwegian Knowledge Centre for the Health Services into Norwegian.

    In addition, The Karolinska Institute indexes some Scandinavian journals for MEDLINE and BIREME does the same for South American journals.
  • Health Data Standards: NLM supports the development, ongoing maintenance, and coordination of international standard terminologies designed for use in electronic health records and health information interchange and contributes to the development of US policy on health data standards.   NLM helped to establish and is the charter US Member of the International Health Terminology Standards Development Organisation (IHTSDO), a not-for-profit association in Denmark that now owns and maintains SNOMED CT.  The IHTSDO was founded to provide international governance and promote international adoption of SNOMED CT, which was originally created by the College of American Pathologists (CAP) through the merger of previous terminologies developed in the US and the United Kingdom.  A list of current member countries is available on the IHTSDO website. Membership is open to any country.  Licenses to use SNOMED CT are free in member countries, in countries designated as low-income by the World Bank, and for approved research purposes in any country. NLM also provides funding for the maintenance and free dissemination of Logical Observation Identifiers, Names, Codes (LOINC), which is produced by the Regenstrief Institute and the LOINC Committee, and used internationally in the electronic exchange of clinical test data.

For more specific information regarding NLM International Programs, please contact:
Chief, Office of International Programs, OHIPD
National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894