So when I visited a refurbished favourite museum last month I was
disappointed to find that several treasured objects had mysteriously
disappeared. In their place were a couple of video displays and some large
panels of text. The gallery assistant told me there wasn’t enough room to
display many of the objects that had been on show in the past. Going by recent
trips to other museums, this is not an uncommon phenomenon. The change of
emphasis is, of course, driven partly by the technology that has become
available. Computers allow museums and galleries to put on some dazzling
displays, not to mention giving online access to their treasures
(This Week, 10 April, p 17).
Britain’s Museums Week, which runs from 15 to 23 May, sees the
launch of The 24 Hour Museum, a website providing information on nearly
2000 museum collections around the country (www.24hourmuseum.org.uk). It
joins a rapidly increasing number of museums with their own Web pages. As more
children gain access to fast computers at home or in school, they will be able
to see exactly the same graphics as they would if they went to the museum. Will
they ever bother to make the journey?

Electronic displays are clearly in vogue in museums worldwide. Certainly
there are some inspiring initiatives around. In the British Library exhibition
galleries at its expensive new London home, for example, there is a fantastic
computer display which enables the visitor to appear to turn the pages of texts
such as Leonardo da Vinci’s notes and the Lindisfarne Gospels. An exhibit like
this can give you the sort of access that previously would have been impossible,
and complements the physical objects on display. Certainly computers can give
you the option of exploring a single exhibit more thoroughly, and present extra
contextual information about it. But the electronic Lindisfarne Gospels wouldn’t
be nearly so exciting if you had not just seen the originals in all their glory
in the next room.

In smaller museums, computer graphics and videos are increasingly taking over
space where the original objects used to be displayed. Instead of complementing
the material, they effectively remove the opportunity to see the collections
that inspired all this activity in the first place. A few years ago, biology
conservators started to worry that their displays were falling to bits, and they
are still trying to get grants to ensure their survival. I don’t imagine that
removing exhibits from the public eye will help their cause.

In a lecture at the end of last year, Neil Cossons, director of the Science
Museum in London, pointed out that although it was relatively easy to get money
for new projects, museums’ budgets were still failing to keep pace with
inflation—and that this has eroded curatorial expertise in many museums.
The majority of museums’ professional staff—89 per cent according to a
survey by the University of St Andrews—steadfastly believe that scholarly,
collections-based research should be a significant part of a museum’s role.

There is plenty of optimism and creativity in the museum world. What a shame
it would be if enthusiasm for spectacular displays undermined the health of the
collections themselves, and deprived us of the opportunity of seeing the real,
physical objects. Will the next generation have the opportunity to drive their
parents quietly insane as they gaze at the glory of our heritage?

The aim of the report, written by an independent committee of experts, is to
ensure that research is carried out in areas where it will have most impact.
Much of the WHO’s high profile work has focused on battling against infectious
diseases, which kill most people worldwide. But the report predicts that by 2020
mental illness will be the most debilitating affliction in the developing world,
with death and disability resulting from road traffic accidents in second place
(see “Trafficking in death”, p 34). It also warns of an epidemic of
noncommunicable disease, such as tobacco related illnesses, especially in the
developing world.

The committee was set up to look at “best buys” for those who fund research,
after a 1993 World Bank report suggested that relatively small investments could
bring major improvements in public health. Dean Jamison, professor of public
health at the University of California at Los Angeles and chairman of the
committee, hopes the report might persuade agencies to fund research in areas
that have been neglected. “These figures are a wake-up call,” he says. “If we
see serious changes of allocation of funds then we’ll know that our analysis has
made a difference.”

Claude Romer, head of safety promotion and injury control at the WHO, says
that too much attention has been focused on emerging diseases, while major
causes of illness and death have been missed out. “This report is really a
breakthrough in terms of reshaping the priority order of health issues,” he
says.

Some researchers will not be so happy. For example, those looking into less
common but high profile diseases such as Ebola could lose funding. The committee
is also highly critical of the amount spent on what is sees as less urgent
research. This includes attempts to improve on something that already
exists—looking for a better polio vaccine, for instance, at the expense of
more pressing research into a vaccine for, say, pneumonia, which is one of the
world’s biggest killers. It also argues that the case for developing some
vaccines is weak if, as in the case of leprosy, an effective multi-drug
treatment already exists.

There is also likely to be controversy over the committee’s decision to break
with the traditional method of estimating the toll from a particular disease.
Instead of relying on mortality figures, the committee has used a measure called
the DALY, the disability-adjusted life year. This is a measure not just of
deaths but also of loss of health, so it takes greater account of diseases that
disable rather than kill.

“If you don’t use a disability weighting you get into silliness because you
pay no attention to, say, psychiatric illness or half the burden of road traffic
accidents,” says Jamison. “Just using deaths by cause doesn’t take notice of
this.” The new system has catapulted mental illness up the league table; the
figure for mental health was previously based only on the number of deaths by
suicide.

The calculations with the DALY system are likely to cause some embarrassment
at the WHO. The report’s findings indicate, for instance, that for years
researchers have bumped up the mortality rates for their area of interest and
this has led to some huge overestimates of the death toll of certain diseases.
For example, in March the WHO reported that the annual toll from TB was 3
million. The Harvard team that has calculated the DALY figures for the report
has come up with a figure of just over 2 million. “We were just trying to get
people to die once,” explains Chris Murray, the health economist who headed the
Harvard team.

The WHO’s TB programme is trying to come up with a better estimate of how
many people contract the disease and how many die from it. Last weekend saw the
first in a series of meetings to agree a formula for estimating the incidence of
TB. Richard Bumgarner, deputy director of the TB programme, says he is happy
with the Harvard calculations because TB still ranks as a major killer. “What we
need to be doing is concentrating on the top burdens of disease, and stop
fiddling around with those 99th and 100th in the rankings,” he says.