Magnesium for preventing and treating eclampsia: time for international action

5 years after the report of the Collaborative Eclampsia Trial, the importance of magnesium sulphate was formally acknowledged in a document published by WHO, UNFPA, UNICEF, and the World Bank;9 but unfortunately publication cannot ensure that magnesium sulphate is available to women whose lives may depend on it. As implied by the "bedrock principle" of securing "universal access to quality care"," WHO and other international organisations need to play their part in ensuring that women with pre-eclampsia and eclampsia have access to magnesium sulphate. For its part, WHO could make sure that evidence about the important beneficial effects of the drug is disseminated effectively to ministries of health, and that it is registered and available in all countries. Other organisations-eg, the World Bank and charitable foundations-could fund the provision and distribution of the treatment kits that proved so popular and effective in both of the controlled trials of magnesium sulphate. Still other international organisations-eg, the International Federation of Gynecology and Obstetrics and the International Confederation of Midwives-could help to make sure that front-line clinicians are trained to use the drug. It is time for concerted international action to ensure that women all over the world benefit from the results of the important research on magnesium sulphate.