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NLM International Programs

As the world's largest biomedical collection, 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.

In 1865, John Shaw Billings, first director of the library, turned to the international community as he built a world-class compilation of foreign 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-1990's, bi-lateral agreements with International MEDLARS Centers (expanding to include centers in 20 countries) licensed and distributed MEDLINE tapes and also provided online access to MEDLINE and other databases to citizens in selected foreign countries. These quid pro quo arrangements provided NLM with valuable assistance in indexing foreign 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 NLM's databases for free.

NLM's collection retains a strong international character with holdings in over 80 languages.  Fifty-seven percent of MEDLINE journals are published abroad, and almost half of MEDLINE/PubMed users live outside the US. Each day a total of 15 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 17 million bibliographic citations and author abstracts from more than 5,000 biomedical journals published in the United States and 80 other countries dating back to the mid-1950s. PubMed also provides linked access to related genomic and molecular sequence data.  Since the 1980’s 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's 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's free, full-text digital archive of biomedical and life sciences journal literature.  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 NLM's 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 Wellcome Trust in partnership with NLM and the British library.

International Partnerships

NLM's international partnerships strengthen and expand global access to the world's health literature.  Targeting another area of opportunity, NLM played a critical role in the Multilateral Initiative on Malaria, leading the effort to enhance Internet connectivity and access to medical literature for malaria researchers at 19 sites in 13 African countries.


The African Medical Journal Editors Partnership  Project  brings together NLM, FIC, NIEHS, six African journals in Ghana, Uganda, Malawi, Mali, Zambia, and Ethiopia and  six partner journals from the US and UK.  The project’s goal is to strengthen the African journals in order that they are accepted into MEDLINE, making their research available to the world.

The Network of African Librarians and Deans, facilitated by NLM, includes former NLM Associate Fellows from Kenya, Zambia, Mozambique, Mali, Nigeria and collaborating medical librarians from Uganda and Zimbabwe    This group is collaborating in the design, creation, and implementation of an information retrieval course at their universities.  In addition, they provide training and workshops at the biannual AHILA conference.

Central and South America and the Carribean

In partnership with 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, NLM supports the Central American Network for Disaster and Health Information (CANDHI).  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.


NLM Associate Fellows Program now includes an international Associate.  The current focus is on Africa, and five medical librarians have participated in this program from Kenya, Zambia, Mozambique, Mali, and Nigeria.  The Medlars Center at the University of Oslo in Norway is engaged in user training in the Baltic states.

Other international programs include: Library services, such as interlibrary loans to foreign institutions; training of librarians and medical journal editors from developing countries; technical consultations; collaboration with international organizations, governmental and non-governmental; meeting with international visitors; and participation as appropriate in formal U.S. bilateral health agreements.

International MEDLARS Centers

International MEDLARS Centers, originally set up to distribute Medline tapes followed by online access in the 1970s, continue to play major roles in partnership with NLM in traditional services such as translation and indexing as well as embracing the new electronic challenges in archiving and dissemination of medical journal articles.  In some cases, NLM and international partners are taking on new backup roles for one another in disaster preparedness; others are engaged in training end users in under-served areas of the world.

Archiving and Access to Full Text Articles

The British Library, in partnership with Wellcome Trust and NLM, collaborates on co-development of software for UK PubMed Central.  CISTI is also collaborating on development of a Canadian site for PubMed Central.

International Relationships in Translation

BIREME translates MeSH® into Portuguese and Spanish for UMLS®; INSERM into French; DIMDI into German; Central Medical Library of Russia into Russian; Karolinska Institute into Swedish; Institute of Medical Information, Chinese Academy of Medical Sciences into Chinese; Japan Medical Abstracts Society Thesaurus into Japanese; Nederlands Tijdschrift voor Geneeskunde into Dutch; and Central Medical Library Warsaw, Poland into Polish (in progress).  The World Health Organization’s Regional Office for the Eastern Mediterranean makes available MeSH in Arabic.


The British Library indexes UK journals for MEDLINE; Karolinska Institute does the same for Scandinavian journals; Chinese Academy of Medical Sciences for Chinese journals; and BIREME for South American journals.

Disaster Preparedness

In the event of disaster at NLM or at partner libraries in Canada and Germany rendering document delivery service unavailable, backup service would be provided via DOCLINE® for requests which could not be filled by an in-country library network in Canada (via CISTI) and Germany (German National Medical Library)

Document Delivery 

Document delivery is provided by partner libraries 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.

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 (Systematized Nomenclature of Medicine--Clinical Terms).  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's International Programs, please contact:

Chief, Office of International Programs, OHIPD
National Library of Medicine
8600 Rockville Pike
Bethesda, MD 20894