By Sandi Doughton

Lancet editor Dr. Richard Horton joked that his lecture at the University of Washington Monday night would be "metrics-free," but the outspoken Brit couldn't help making the case for better data to guide global health and development programs.

Many of the current darlings of philanthropy, such as microcredit, have little solid evidence to back them up, Horton said. One recent study in the Philippines concluded that the small loans did not improve community well-being and actually led to contraction of small businesses.

"These fashions that grip us in waves ... when you actually end up looking at the data can often seem to be very, very thin," he said.

When the book "Dead Aid: Why Aid is Not Working and How There's a Better Way for Africa," argued that $1 trillion in international aid has only increased corruption, war and poverty, the development community had little to offer in rebuttal, Horton told the audience of faculty and students.

"We have badly failed to gather data on what a trillion of aid has done."

UW global health professor Steven Gloyd said he picked Horton to present the Steven Stewart Gloyd endowed lecture partly because of the UK-based Lancet's courage in publishing controversial papers, including one that estimated 650,000 civilians have been killed in the Iraq war, and one by researchers at the UW's Institute for Health Metrics and Evaluation that found many childhood vaccination numbers were inflated.

Horton, who works closely with IHME, is known for poking at the powerful, including the pharmaceutical industry and the medical establishment. His journal recently published a critique of the Bill & Melinda Gates Foundation's accountability and emphasis on technological solutions to global health problems.

But like everyone else in global health, the Lancet has received money from the giant philanthropy: $200,000 to publish a series on maternal and child mortality.

Horton said he'd like to see universities like the UW provide a forum where data on development and global health can be freely available - and critically evaluated.

The UW can also provide a counterbalance to Seattle's global health giant, the Gates Foundation, Horton said.

"I would hate it if Seattle was only seen as the center of technology in global health. The university can provide that added perspective to what comes out of the Northwestern U.S., and that's absolutely critical."