BIREME Bulletin n° 67

Virtual Health Library completes 24 years

The technical cooperation program of the Latin American and Caribbean Center on Health Sciences Information of the Pan American Health Organization/World Health Organization (BIREME/PAHO/WHO) is characterized by the Virtual Health Library (VHL), which in March 2022 completed 24 years of operation in the countries of the Region.

The VHL is an information management model based on collaborative work and networking, applied to the creation, organization and dissemination of information and scientific and technical evidence in health made available online to users through the 67 portals of active instances of the VHL. Its mission is to provide access to information and scientific evidence in health to users from the health sectors, contributing to narrowing the gap between knowledge and practice in Latin America and Caribbean countries [1].

Conceived in 1998, the VHL was motivated by the advent of the Internet, which enabled the operation through the Web of information sources, as well as its access by users. In this context, at the IV Regional Congress on Health Sciences Information (CRICS4) held in San José, Costa Rica, and approved by the AL&C countries through the Declaration of Costa Rica “Hacia la Biblioteca Virtual en Salud”, the foundation stone of the VHL was laid.

The VHL Network today is made up of 67 national, thematic, and institutional instances, which follow the VHL Model, in constant technological and conceptual evolution, always aligned with collaborative and networked work.

Expansion of the VHL in Brazil

In August 2021, the 20th anniversary of the VHL Ministry of Health of Brazil (BVS MS) was celebrated through an online event that brought together important players in this success story in favor of knowledge management in public health in Brazil [2]. The VHL MS Brazil provides access to the entire collection of the Ministry of Health, including books, health campaigns, journals, scientific papers, and multimedia materials. It also offers access to other national and international scientific databases, including institutional databases with the scientific and technical production of the federal institutions of the Unified Health System (SUS). Throughout these years, the Oswaldo Cruz Foundation and the BIREME have maintained a technical cooperation relationship in the VHL, which has enabled the development of numerous products and services, among which is a collection of VHL instances managed by the Foundation: VHL Fiocruz; VHL Breastfeeding; VHL Infectious and Parasitic Diseases; VHL Bioethics and Diplomacy in Health; VHL Professional Education in Health; VHL Social Determinants of Health; VHL History and Cultural Heritage of Health; VHL Comprehensiveness in Health; VHL Social Thought; VHL Indigenous Peoples’ Health; and VHL Violence and Health.

BIREME provides technical and methodological support for the development of activities related to the VHL instances developed and coordinated by Fiocruz, as well as regular operation of data collection, processing, and publication in the research interface for the instances listed above.

Besides the cooperation with the VHL, BIREME and Fiocruz are in the process of formalizing a technical cooperation agreement formed by five thematic axes: Information Management; Knowledge Translation; Open Educational Courses and Resources; Open Scholarly Communication; and Institutional Communication.

BIREME historically develops projects of technical cooperation with state and municipal instances of health in Brazil. In 2010, the first agreement was signed with the Municipal Health Secretariat of São Paulo, which aimed to develop the VHL SMS – São Paulo, and has been renewed successively. The most recent one, which aims at the maintenance and technological and methodological support of the VHL, was signed in May 2021, and will be in force until May 2025 [3].

There is a history of important developments with State Secretariats, such as with the SES-SP, and is in the process of being formalized with the Secretariats of Rio de Janeiro and Piaui.

The newest cooperation project was established between BIREME/PAHO/WHO and the Special Secretariat of Indigenous Health, in coordination with the General Coordination of Documentation and Information of the Undersecretariat of Administrative Affairs of the Executive Secretariat of the Ministry of Health of Brazil, for the development of the VHL Indigenous Health. It is an innovative initiative for its thematic and that may involve other countries in the Region.

The VHL in Latin American and Caribbean countries

The VHL Model is present in all Latin American and Caribbean (LAC) countries with a higher or lower level of performance of the VHL instances. BIREME monitors the development and updating of all the instances, providing technical and methodological cooperation to the entire Network of Institutions that contribute to the management and updating of VHL information sources and services.

The Health Information Networks are essential to strengthen and extend the work done by BIREME for the VHL and contribute directly to democratizing the access and visibility of scientific knowledge in health in AL&C countries.

These networks aggregate information professionals from cooperating institutions from all AL&C countries, the United States, Spain, Portugal, Mozambique, and other countries, which need coordination, planning, mobilization, and spaces to exchange experiences. In 2022, BIREME promotes a calendar of meetings of the Networks that includes 35 weekly sessions distributed in 3 thematic axes: Coordination of work in the Network; Best Practices of the Editorial Process; and Access and Use of Information.

This coordinated mobilization is already being reflected in the renewal of some VHL instances, such as: VHL Honduras, VHL Nicaragua, VHL Uruguay, and VHL Panama. And in the strengthening of other instances, for example: VHL Colombia, VHL Peru and VHL Argentina.

The VHL in regional instances

In the regional context, there are two thematic instances of the VHL that are particularly expressive and deserve to be highlighted: VHL Nursing and the VHL Traditional, Complementary and Integrative Medicines (VHL TCIM).

The International VHL Nursing aims to contribute to the development of professional and academic nursing, promoting access to qualified scientific and technical information in the area. The VHL Nursing network brings together instances of the VHL from 8 countries – Argentina, Bolivia, Brazil, Colombia, Cuba, Mexico, Portugal, and Uruguay. The entry of Portugal, which occurred in July 2021 [4], marks the presence of the first country outside the Americas to join the Nursing network. This year also saw the establishment of the International Advisory Committee and its first meeting. The VHL TCIM Americas, launched in 2018, is a thematic VHL that involves a Network of Institutions from 17 countries of the Americas. Its objective is to articulate various social actors involved in policy generation, regulation, training, promotion, practice, use and research of these systems and therapeutic methods in the Region of the Americas, to develop a common agenda and promote the integration of TCIM in national health systems and services. The VHL TCIM gains visibility and importance in events such as the II World Summit on Traditional and Complementary Medicine, which counted with the participation of international organizations such as the World Health Organization [5], highlight in an editorial of an international journal [6], presence in national and regional events, and more recently, the development of an exclusive category of the Health Sciences Descriptors [7] on specific terms of TCIM, to improve the indexation and retrieval of articles on this theme.

The most recent Regional VHL initiative is in the planning stage and will integrate the English Caribbean countries of the MEDCARIB Network.  The VHL Caribbean will contribute to the democratization of access and use of scientific and technical health information in the English Caribbean countries, as well as to increase the visibility of their scientific production and support health professionals and managers in their decision-making processes.

Indicators of access to the VHL Regional Portal

The VHL Regional Portal integrates a collection of 50 international, regional, national, and thematic information sources, most of them produced by the VHL Cooperation Network. This large collection brings together more than 33 million references of scientific and technical documents in health, more than half of which have links to the full text. The access to this collection is free and free of charge and is done through the search interface available in Portuguese, English, Spanish, and French. The access indicators to the VHL Regional Portal are measured with the Google Analytics tool and show a growth every year.

In 2021 more than 20 million access sessions of users from all regions of the world were registered, which resulted in 59.5 million pages viewed on the VHL Regional Portal. Compared to the previous year, an increase of more than 6 million pages viewed.

Innovating the VHL Model

An important innovation for the VHL Model was the development and implementation of the instrument of maturity assessment of VHL Instances. The instrument is self-assessment and allows, in addition to monitoring the evolution of VHL Instances, to identify the points of attention and weaknesses in relation to the monitoring of the VHL Model in four dimensions: Governance, Organization and Updating of Contents, Communication and Services to Users, and Systems and Technology. The first results are already available [8], but this is a dynamic process. The coordinators of VHL Instances should regularly apply the instrument to assess the performance of their VHL Instances and draw up action plans aimed at their continuous improvement and the strengthening of their collaboration networks. Learn more about the Instrument in the VHL Network Portal [9].


  1. BIREME/OPAS/OMS, 2020 Guia 2020 para desenvolvimento da Biblioteca Virtual em Saúde/ BIREME OPAS OMS. – 5ª ed., Brasil. Available from: (in Portuguese)
  2. BIREME Bulletin n° 59. Brazil’s Ministry of Health Virtual Health Library celebrates 20 years. Available from:
  3. BIREME Bulletin n° 58: New agreement between BIREME/PAHO/WHO and SMS-São Paulo formalizes phase III. Available from:
  4. BIREME Bulletin n° 58: Launching of the VHL Nursing Portugal marks the first country outside the Americas region to become part of the project. Available from:
  5. BIREME Bulletin n° 59. BIREME marks presence in the II World Summit on Traditional and Complementary Medicine towards an Integrative Medicine. Available from:
  6. Bulletin BIREME n° 42. VHL and TCIM Americas Network are the topic of an editorial in an international journal. Available from:
  7. BIREME Bulletin n° 66. DeCS/MeSH has TCIM as a new thematic category. Available from:
  8. BIREME Bulletin n° 64. 2021 Action Plan strengthens networking within the VHL network. Available from:
  9. VHL Network Portal. VHL Maturity Instrument. Available from:



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