I am 63 years old with the reading age of a slow 4 year old. But I’m not stupid. I can tell that everything around me—the pictograms and ideograms, people’s faces, their clothes, the wonderful decorations on their pottery, the bright pinks, blues and oranges of their houses, the soil they work—is suffused with rich meanings which they read as easily as they breath, unaware of the great intelligence and skill they have in doing so. But I cannot do so. To me it is one vast terra incognito, beyond my ken. I am in Mexico City.

I am here after spending a week in the ancient and mysterious city of Cholula with my colleagues at Centro de Estudios Avanzados de Diseño (CEAD)—www.cead.org.mx—working on guidelines to help Mexican pharmaceutical companies redesign medicine labelling so that Mexicans literate in Spanish can read and use them appropriately.

In truth, I have done very little. I am like the catalyst in a chemical reaction. Along with other members of the Medicine Lablelling Group (www.medicinelabellinggroup.org) I help the process along. But the ingredients that make up the new guidelines, like the ingredients that make up a new substance, are the result of the work of others. In this case Maria Gonzalez de Cosio, Alejandro Lo Celso, their colleagues at CEAD, and the many Mexicans who participated in helping to test new prototype designs that are serving as a examples in these emerging guidelines. Indeed this whole project is a rare example of collaborative design. The project has been funded and steered jointly by the Mexican government regulator and the Mexican over the counter pharmaceutical industry, with a wide variety of interest groups who have converged around the common purpose of making labels easily usable by Mexicans literate in Spanish.

I emphasise ‘literate in Spanish’ because it is so clearly not the only, nor necessarily the most important, form of literacy in this many-layered mixture of highly sophisticated ways of life.

It is all too easy to take a narrow and disrespectful view of other people’s literacy; all too easy to think of an absence of skill in one limited form of literacy as a deficiency that must be remedied by appropriate treatment; all too easy to see resistance to taking up a new and alien form of literacy as a symptom of laziness or, worse, stupidity; and all too easy to say that because of laziness and stupidity, there is no point in even trying. Not far behind this is the view that the ‘illiterate’ poor are both lazy and stupid. Even to this illiterate outsider, with the understanding of a slow 4 year old, those easy ways of thinking seem profoundly wrong. Yet these are some of the persistent political currents of thinking that swirl around this project.

Even as the designers in this project conduct rigorous observations of people using labels, give meticulous attention to typography and wording, and prepare guidelines for others to follow, these and many other currents of thought swirl around the project, pulling the work this way and that.

What is most heartening is that the dominant current influencing everyone working directly on the project, including those funding it, is a simple common desire to help people avoid harming themselves inadvertently and to help them use medicines appropriately to reduce harm. So far nobody has wavered from this central collective purpose.

If successful in Mexico, this project has the capacity to benefit the whole of Latin America. But only if it remains mindful of its place in the scheme of things. To this illiterate, this project looks like a fragile rope bridge across a deep chasm of incomprehension between different forms of life. It would not take much to break it, and all the good work would then be lost, dashed against the uncaring rocks and swept away by the raging silence below. But, with caution and bravery the risky crossing could reduce distress and save lives.