Right to health care for vulnerable migrants.

www.thelancet.com Vol 370 September 8, 2007 827 WHO, and we hope that these can be built on. We also agree that WHO needs to collaborate with others and that there are circumstances under which rapid processes are needed. However, systematic reviews should be used to inform those processes whenever possible, and when systematic reviews are not available, the evidence that was used and the methods that were used to summarise that evidence should be transparent. We fully support Julian Elliott and colleagues’ second recommendation, that WHO should support the development of capacity within countries through initiatives such as EVIPNet and REACH. We are sceptical about their fi rst, more futuristic, recommendation for two reasons. WHO does not have the capacity to do that, and until countries have the capacity to use systematic reviews appropriately to inform recommendations and policy decisions, a map such as they propose would be of limited value. Moreover, it can be argued that international recommendations are important because they reduce unnecessary duplication of eff orts, in addition to providing support to countries with limited capacity. This, of course depends on the guidelines being well informed by the best available evidence, and constructed in a way that they can easily be adapted to specifi c contexts.