Tag Archives: health

Mobilising the resources to sustain libraries: why the G7 tax agreement matters for our field

Last week, a big story in many media outlets was the agreement between finance ministers of G7 countries to act to counter tax avoidance by major multinational companies. When this issue comes to the G20 later this year, it will be a truly global concern.

This blog looks a little further at the issues, why fighting tax avoidance could be part of library advocacy work, and why there is a particularly strong argument for multinational digital companies to pay their share.

Mobilising resources to pay for development

Tax avoidance is not a new issue of course. For years, there have been concerns about the ability of firms to exploit loopholes and inconsistencies between corporation tax (i.e. taxes on profits, rather than taxes on sales or turnover) rules in different jurisdictions to limit how much they need to pay.

By (nominally) locating key assets such as intellectual property in low-tax countries, or using complicated systems of loans or holding companies, highly profitable companies can make much of their fiscal liabilities disappear.

A lot of the focus has been on the practices of major internet companies, but they are not alone. Any company operating in different jurisdictions may be able to benefit, with Starbucks, care home operators, and even publishers such as Pearson being accused of this.

While, to some extent, it may be a question of political choice how much a country wants to rely on tax-funded public services or rather leave things to the market, it is undeniable that such decisions, when they affect corporate taxation, do have effects on others.

As such, it is a key part of ‘resource mobilisation’, the term used in the context of the Sustainable Development Goals to describe efforts to ensure efficient and effective taxation systems. Getting an international agreement is particularly important, given that while governments are responsible for tackling corruption or other failures to ensure that domestic actors contribute to public services and investments, they can do little once profits are ‘moved’ abroad.

The 2008 crisis intensified focus on these issues, as governments faced the question of how to pay the cost of the financial crisis. Useful work was done around tax transparency and combatting tax havens. In the wake of the pandemic, this focus seems likely only to intensify, and perhaps explains the G7 announcements themselves.

A pre-condition for sustaining library budgets

It’s not hard to imagine why this matters for libraries, at least those which rely to a greater or lesser degree on central government funding. It also matters for the achievement of many of the goals that libraries seek to support, such as education, connectivity or research.

For example, in the education sector, the Global Partnership for Education places a strong emphasis on resource mobilisation as the one sustainable way to support education funding sustainably into the future. Education International has explicitly called for stronger efforts against tax avoidance.

Similarly, the World Health Organization, back in 2018, also highlighted the importance of action on tax to support the delivery of global health goals. Organisations working on broader development, such as Oxfam, have also been strong on the topic.

Clearly, campaigning for more effective taxation is a less direct means of ensuring that libraries have adequate resources than working directly to influence how spending is structured, although it would be an area where libraries would find allies.

Moreover, the availability of funds to spend on libraries depends on funds being there in the first place, which is a tax question. In short, it becomes easier to call for stable, or increased spending on libraries when overall budgets are healthier.

Digital dividends

The argument is particularly strong in the case of libraries and digital companies, given the strong role of libraries in helping people to get online in the first place.

In the case of internet service providers, including phone companies, there are sometimes even dedicated taxes which feed into universal service and access funds. These can be (but are not always) used to help libraries provide wider connectivity.

As such, they help deliver what is increasingly recognised as the human right to connectivity, while also, arguably, helping to create new customers in the future for these same firms.

Yet digital content companies arguably benefit even more directly from when more people are brought online, along with anyone involved in eCommerce. You cannot buy things online, use social media for whatever reason, host websites, use cloud services or whatever else without being connected.

This makes it all the more relevant to argue that they should be paying their part, as much out of enlightened self-interest as because of a wider duty to support public services.

A long way to go

The welcome for the G7 announcements from organisations campaigning for effective action on tax avoidance has been lukewarm. The minimum tax rate set out has been seen as lacking ambition, and of course the deal only covers a few countries, even if they are rich.

Nonetheless, it is arguably a step in a positive direction, even if the final destination is unclear. As such, there is still plenty to do, both when the question comes to the G20, and beyond.

Clearly libraries must make choices about how to allocate time and effort around advocacy. The nature of our institutions mean that we have arguments to make across a wide range of policy fields – many more than we can feasible engage in.

Nonetheless, calling for action on tax avoidance in order to support libraries and other public services – especially those supporting connectivity, and alongside partners – is certainly worth thinking about as part of our advocacy work.

Partners in Building a Healthier, Fairer World: Recognition of Libraries in the World of Public Health

The COVID-19 pandemic has further underlined an issue that was already painfully clear around the world – that health is too often an equalities issue.

Yet it has also made clear that without action to improve the health and wellbeing of all, we cannot overcome challenges. This is the case both in the shorter term in the form of the pandemic, and longer term in the shape of non-communicable diseases and other causes of suffering.

To respond, and so build a healthier, fairer world – the theme of World Health Day 2021 – action is needed to ensure that everyone can live healthier lives, reducing the risk of falling ill – public health.

Libraries themselves are aware, through their own experience, of how much they are used to access health information. As noted, for example, in a survey of Philadelphia librarians, each member of staff was receiving on average ten health-related queries a week, underlining that regardless of whether they are formally involved in planning, libraries are part of the health infrastructure. There are plenty of articles and presentations from the field, setting out ideas and experiences – see our own article from 2019.

This blog, however, looks at what public health professionals themselves are saying about libraries. This matters, because for our institutions to be part of plans to promote better health and wellbeing, libraries need to be recognised by the people preparing them. Therefore, all the links in this piece point to research or actions taken by actors outside of the library field.

We hope that they can help you in your advocacy.


Priorities for Public Health

In working to understand health inequalities, a key area of focus are the social determinants of health. A piece in the Journal of Community Health in 2019 set out ten of these, based on a previous study – transport, addiction, stress, food, early life, the social gradient (education), social exclusion, work, unemployment and social support.

Each of these has an impact on the likelihood of people getting ill, and then of getting treated (including preventative measures). Action can rely on efforts outside of traditional health policy – almost all of the issues  set out above are not usually immediately associated with health – but their impact is significant.

A second concern is around how to reach out into communities, the focus of a whole book. Many people will go out of their way to avoid formal health institutions such as hospitals, but even health professional themselves may struggle to reach people.

As we have seen in the pandemic, a particular tragedy has been where people with COVID have not wanted to admit that they are ill or seek medical attention for fear of losing their jobs. In other situations, cultural factors may play a role, there may be distrust of officials, or simply language barriers.

Finally, there is the importance of health literacy – the ability to understand and use information concerning health (for example, from the Urban and Community Studies Institute at the University of New Brunswick). As opposed to the other two issues, which are more about the context determining health, this focuses more on the skills of individuals and communities. It represents a key goal of course, with a health literate population more able to look after themselves and cope with new threats.


Where do Libraries Fit In?

Even from a relatively superficial look at the literature, the potential of libraries is recognised through experience.

Concerning the social determinants of health, as a University of Pennsylvania study underlined, libraries’ work to build basic literacy and support lifelong learning is already a key contribution to supporting better health outcomes. Beyond this, wider programming to support employability and inclusion should also make a positive difference. There is also of course the role of libraries, alongside other institutions, in using their hiring and purchasing power to support local economies and create jobs, where this is possible.

There are also more specific interventions, such as those promoted in libraries in Norfolk, in the UK, in partnership with local public health authorities in order to encourage health eating and promoting wellbeing. Indeed, such initiatives showed the power of libraries to mobilise other local stakeholders, such as supermarkets to get involved. Similarly in Redbridge, London, UK, collaboration with sports and physical activities teams led to efforts to promote healthy cooking and eating, especially in school holidays.


Libraries also have reach into communities, often disproportionately serving more vulnerable populations. From simply being an effective place to display relevant information to the wider community (as noted by Public Heath England), they can also actively contribute insights about what people in situations of marginalisation may need, based on their experience and the questions they receive.

For example, people in rural areas or the unconnected may have few ways other than libraries of gaining access to key health information. For others, they will feel far more comfortable coming to the library than going to the doctors or a formal health centre. The nature of libraries as a public space, open to all, can be powerful. Libraries can also train (or host training for) people who can then take key information out into the community, or be a base for health professionals to work with people in a more comfortable environment.

The unique role of libraries around literacies can also make them useful partners in building health literacy. At a fundamental level, there is provision of relevant information and collections, potentially in collaboration with national public health authorities (for example in the United States or United Kingdom).

Combined with their ability to reach out to vulnerable groups, it is recognised that libraries can help overcome stigma, and even build comfort around more difficult questions such as clinical trials and preventative interventions.

Through this work, libraries can play a key role in delivering on the promise of eHealth in general, as illustrated by the Australian Digital Health Agency’s partnership with the Australian Library and Information Association.


In short, as noted in a Journal of Community Health article, libraries can be a key ‘meso’ level actor in promoting population health, working between national or regional health agencies and individuals.


What More is Needed?

As set out in the previous section, libraries are well placed to support action in key areas of focus for public health professionals – the social determinants of health, meaningful outreach, and building health literacy. As highlighted at the beginning – and indeed recognised by the Robert Wood Johnston Foundation – they are already part of the ‘community’s health enhancing environment’.

Nonetheless, more can be done. While the links in this article do lead to evidence of public health professionals and other non-LIS experts recognising the value of working with libraries, it is clear that more can be done to convince public health planners.

To a large extent, this will be down to libraries themselves being able to show how their unique characteristics can help them contribute meaningfully. This work can be helped, however, through more systematic evaluation of interventions, as well as bringing public health researchers into libraries in order to see for themselves the work that libraries do, as well as to plan activities collaboratively.

A further area of focus could be on building knowledge and skills among library professionals (also underlined in CDC work on preventing chronic disease), in order to help them better to fulfil the role that they often already have in providing advice and information to users. Clearly, access to resources also matters here.


As we look beyond the pandemic, and make plans for the healthier, fairer world highlighted for World Health Day, the potential of libraries to contribute is clear.

With wider recognition of this role in the health field, building on existing evidence, and work to improve libraries’ own ability to provide information and services, there is scope for libraries to play a much more central role in public health policy planning and delivery around the world.

SDG Success in the Balance: Lessons from the 2020 Goalkeepers Report

As world leaders prepare to participate in the United Nations General Assembly, the Gates Foundation has released its 2020 Goalkeepers Report.

Focusing on a subset of indicators and themes featured in the UN’s 2030 Agenda, it looks to trace progress on key issues linked to the work of the Foundation, in particular health, poverty, education and equality.

These are, of course, also areas which can be determining for overall development – illness, low-education, and the exclusion of whole parts of any population represent a serious drag on progress in any society.

The Report has received widespread attention in the media, especially that focused on development, with its warnings around the risks that the COVID-19 pandemic poses to progress towards achievement of the Sustainable Development Goals (SDGs).

For libraries, as institutions committed to promoting progress in the communities they serve, the report is worth reading in order to understand the state of the world now. A number of conclusions in particular stand out – this blog explores just five:

The COVID-19 Pandemic stands to send us backwards in delivering on the 2030 Agenda: the first five years of the SDGs had, at least until the arrival of the pandemic, seen useful progress in fighting poverty and disease around the world. However, as the Report underlines, this progress has stopped in many areas. Indeed, we risk seeing 25 years of progress disappear in the space of 25 weeks when it comes to vaccinations. This needs to serve as a wake-up call for all those working to deliver stronger, fairer, more sustainable societies – we need to be careful to ensure that this set-back is not permanent.

We are facing a set of ‘mutually exacerbating catastrophes’: the Report underlines that the crisis is a complex one. While the immediate challenge is of course to restrict the spread of the virus until a vaccine can be found and deployed, there are already economic, social and educational catastrophes. Indeed, the loss of livelihoods, closure of schools and other steps may in turn create new health challenges outside of COVID-19, not least as concerns other vaccination and public health programmes.

The risks are highest for those already facing marginalisation: the Goalkeepers initiative, from its creation, has focused strongly on the situation of those most at risk of marginalisation. The 2020 edition underlines emerging signs that the pandemic will make inequality worse. For example, reduced demand and rules on distancing have made impossible many of the jobs – often informal – on which people facing poverty, and in particular women, depend. There are also concerns that when children start to return to school, girls will be held back, and of course children living in households without broadband access have been unable to benefit from distance learning in the same way as better connected peers.

In tough times, we cannot necessarily count on more money: the Report makes the stark warning that it is often the countries that need help most that are least able to provide it. Whereas already rich countries can borrow money for stimulus programmes, poorer ones face much higher interest rates, reducing their options. Yet even in richer countries, debts incurred today will need to be paid back tomorrow. Part of the response will, as the Report suggests, need to be a new mobilisation at the international level to get help to where it is needed. But implicit in this also is the need to make best use of the resources and infrastructures that we already have.

Libraries are in a position to help: in many of the areas highlighted by the report, the potential for libraries to contribute to the response is clear. Indeed, the support offered by the Gates Foundation over many years to libraries has made it possible to show what can be done. As pre-existing, familiar institutions around the world (there are 430 000 public and community libraries, one for every 15 000 people in countries for which we have data), working through libraries represents low-hanging fruit.

Graph from Goalkeepers Report showing risk of regression in literacy levels among childrenThe most obvious area where libraries can support progress is on education, where different projections all anticipate a drop in the share of children at the end of primary education able to read and understand a simple text. Clearly schools are at the heart of the response, but libraries can complement this by helping children engage with language from a young age, drawing on well-established expertise, as underlined by UNESCO.

Another potential area is reproductive health. Again, this is an area where health professionals themselves will take the lead, but where information – and access to this – is a key part of the response, as set out in IFLA’s response to a consultation by the UN’s Human Rights Council.

A third area is around financial services to the poor. Clearly, libraries themselves are not in a position to offer loans or protect savings, but can help provide the connectivity necessary for any digital banking services to reach people. The role of libraries in providing public access to the internet is well-recognised, and was even, in 2015, identified as the single most cost-effective way of bringing the next billion online.


There is much more in the Report, as well as great tools for exploring the data and understanding where your country stands on the indicators selected. There is also strong potential to draw on the key messages highlighted above, both to focus reflection within the library field, and underline how libraries can be part of the solution, if they are properly included in policy planning.

At the Heart of the Response: Health Librarians Support Better Decision-Making around COVID-19

For library and information workers around the world, the main challenge faced is how to continue providing usual services in extraordinary times. In order to minimise disruption to education, research and access to culture, great efforts are being made to address legal, financial, technical and practical challenges.

Yet for some in the library field, these extraordinary times have also brought extraordinary demands and pressures. Health librarians – working in hospitals, research centres and governments – are having to deliver more than ever, even as they face the same restrictions and rules as everyone else.

With today – 7 April – being World Health Day, it is therefore a good opportunity to look at and celebrate their work.


Supporting the Decisions that Matter

It was the coming into force of the Constitution of the World Health Organization (WHO) on this day in 1948 that provides the justification for 7 April being World Health Day.

The WHO itself has a strong focus on the importance of information in effective health policies, as well as a very active library which not only acts as a hub for knowledge, but also for its dissemination and application through partnerships and networks globally. This work has been essential as eyes turn to the WHO’s own website, and the advice given there, all based on scientific literature gathered by the team there.

Elsewhere, librarians at the National Library of Medicine in the United States – in particular through the PubMed Central platform, have been supporting vital access to evidence for decision-makers. They have also worked closely with publishers in order to make articles and collections open that would otherwise have been paywalled.

Crucially, they have also worked to underline that collections need to be available in machine-readable format through the COVID-19 Open Research Database. This is essential if researchers are to be able to carry out text and data mining in order to identify potential treatments or cures.

Furthermore, the Library has also acknowledged the importance of discoverability, highlighting tools available for identifying relevant sources on its website.

Clearly, a key contribution to the discovery and application of information comes from it being presented in ways that work for those who need to use it. Here too, health librarians are playing a key role.

From daily briefings to both government and medical decision-makers to more in-depth reviews of the literature on emerging issues, librarians are helping to inform choices made. For example, Public Health England’s Knowledge and Library Services team is producing regular reviews of emerging evidence, while the Irish National Health Library and Knowledge Service is sharing rapid evidence reviews, and the Health Libraries Group of the Australian Library and Information Association has compiled live responses to key literature searches. In Iran, librarians are also supporting efforts to make sense of the existing literature around coronaviruses.


An Informed Public

One of the key lessons already from the response to the COVID-19 Pandemic has been the importance of the actions of individuals. With health systems struggling with the rapid spread of the virus, it has been clear that people need to change their habits and behaviours, distancing themselves from others.

Public health ministries and agencies – again with the help of librarians – have been working hard to produce clear and meaningful information for the public, explaining the situation and the responses needed. This has, for example, been helpful for the library field in understanding the risk of contagion via surfaces such as books or computer mice.

There is also a role – not just for health librarians, but for the library field as a whole – in promoting wider health literacy. When people can understand the global situation, and how and why they should act themselves, the job of those in charge of ending the pandemic is clearly easier.

Of course – just as in the case of decision-makers – the spread of this information and these skills depends often on how well adapted they are to the target audience. Simply placing things on a website may not be enough, especially for users who may have limited digital skills or even no access to a computer.

This is of course another area where libraries have a unique role to play as community organisations. It is also the subject of a webinar organised by IFLA’s Evidence for Global and Disaster Health Special Interest Group and Health and Bioscience Libraries Section, due to take place on 23 April. This will look at the lessons that can be learnt from past practice, and what more libraries can do to make sure that all members of society have the information they need to cope in these difficult times.

Join us, find out more, and share your ideas on 23 April!

The 10-Minute Library Advocate #24: Think What Your Audience Wants to Hear

The 10 Minute Library Advocate number 24 - Think What Your Audience Wants to Hear. Picture of a person speaking at a lecternAdvocacy is about getting people to agree with you.

When you talk with someone, you want them to understand that you have shared goals, and that you can help them.

Especially for decision-makers, who often have to face problems, libraries should look like a solution.

To do this, you need to adapt your arguments, and select or prioritise them. But how to do this?

For our 24th 10-Minute Library Advocate Exercise, think what your audience wants to hear.

You can do this by looking at the issues they care about.

For example, a K-12 education ministry official wants children who are ready for class.

A health official wants people who can learn about how to live healthier lifestyles.

Parents may just want help in keeping children entertained and helping them develop their skills.

So pick someone – or a group of people – you want to talk to and think what they want to hear!

Good luck!


See the introduction and previous posts in our 10-Minute Library Advocate series and join the discussion in social media using the #EveryLibrarianAnAdvocate hashtag!