In some countries, publishing is characterized by an unorganized book trade, volatility in publishing patterns, limited press runs, poor quality paper, and inadequate support for scientific research. NLM recognizes that it has a unique role to play in the collection of biomedical and public health literature from countries with limited resources, as few other Western research libraries collect such publications. To ensure the documentation of scientific activity and public health issues from these countries, the Library may select works that might otherwise be excluded (such as works with unique but nominal health content, introductory textbooks, miscellaneous government publications, and ephemera).