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Any worthwhile guideline must be evidence-based, or should it? Evidence for the construction of guidelines often comes from clinical trials that are performed in the West according to the priorities and goals of that population and those of the pharmaceutical industry whose resources are relied upon to perform such trials. This Viewpoint article discusses the development of guidelines using an evidence-based approach and whether this approach is applicable worldwide.

Clinical Guidelines are primarily developed in the affluent West. This Viewpoint article discusses whether these guidelines are really useful and relevant to resource-poor, developing countries, and whether attempts to adhere to such guidelines obscure more fundamental issues such as the provision of basic health care. The authors argue that if guidelines are adapted to local resources and needs, and employ a 'cascade' approach they can work.

Evidence-based guidelines from wealthy countries define optimum goals for resource-constrained countries. This Viewpoint article discusses how health-care policy in developing countries can only be influenced through local involvement in the construction and implementation of guidelines. The authors also discuss the potential yet controversial role of the biomedical industry in facilitating the development and dissemination of global guidelines.

Pathogenic intestinal protozoa are responsible for clinically important infections in both the developed and developing world. Treatments have been available for several decades for giardiasis, isosporiasis and amoebiasis, but until recently there were no effective remedies for the intestinal coccidia—cyptosporidium, microsporidium and cyclospora. In this Review, the author discusses the various pathogenic intestinal protozoa and the treatment options available.