The Cochrane library is a global source of independent health evidence for everyone – why is NZ restricting access?

For almost two decades, all New Zealanders had free access to one of the world’s most trusted libraries on medical information.

The Cochrane Library is known as the gold standard in health research.

It is globally respected as a source of independent, peer-reviewed health evidence, providing systematic reviews, rigorous summaries and information about clinical trials that help guide decisions about everything from cancer treatments to mental health therapies.

The reviews are trusted because they are transparent and free from commercial influence. But full access is now under threat as a new licence would limit it to health professionals only from the end of September.

This shift will save some money, but it could have broad consequences. In an age of misinformation, having access to reliable health evidence isn’t a luxury but a necessity.

Restricting access

During the restructure of the health system, the government moved the responsibility to continue funding access to the Cochrane Library from the Ministry of Health to Health New Zealand. Health New Zealand has now decided to downgrade the national license to one that serves only healthcare professionals.

Under the new license, access will be restricted to Health New Zealand staff and primary care providers only. This means national bodies such as the drug-funding agency PHARMAC, the Accident Compensation Corporation and even the Ministry of Health will be excluded, as will all universities.

Most concerning is that everyday New Zealanders will lose access to the very evidence that helps them make informed decisions about their health.

Last year alone, New Zealanders downloaded more than 100,000 Cochrane reviews – that’s 276 every single day. This isn’t a niche resource. Access to this library should be valued as a national asset.

Restricting access takes us back to a time when medical knowledge was held tightly by professionals, with the public expected to simply trust and follow. In today’s world, where transparency and empowerment are key to good health outcomes, this move feels like a step in the wrong direction.

New Zealand falls behind

While New Zealand steps back, other countries are stepping forward. National subscriptions to the Cochrane Library are funded for Australia, Brazil, South Africa, Malaysia, Denmark, Finland, Ireland, Spain, Switzerland, the United Kingdom and for most of Canada.

Even low- and middle-income countries have access through international programmes. New Zealand risks falling behind not only wealthy nations, but those with fewer resources – a sobering reality for a country whose health system once led the way.

The cost of maintaining the national license is relatively modest, especially when compared to other health innovations. Before the introduction of a universal national license, individual institutions, universities, hospitals and government agencies each paid separately for access, placing a greater burden on the public purse.

The national license was adopted in 2006 because it was more cost-effective overall. And as a bonus, it didn’t just consolidate spending, it expanded access. For the first time, all New Zealanders could freely access the same world-class health evidence as clinicians and researchers, all for less than what we were paying before.

New Zealand produces more Cochrane reviews per capita than any other country. Losing national access would be like silencing our own voice in the global conversation.

The decision to downgrade the Cochrane Library license may seem like a small change. But its impact is deeply human. It affects the doctor-patient relationship by no longer ensuring both parties have the same information. It also has an impact on students learning to care for patients, policy makers shaping health strategy and parents trying to understand a diagnosis.

Health evidence should not be locked behind institutional walls. It should be open to all, especially in a country that values fairness, transparency and informed decision making.

I argue that maintaining the national licence would be a low-cost, high-impact decision. This is about more than money. Providing full access fosters equity and trust.