BMJ  2005;331 (1 October), doi:10.1136/bmj.331.7519.0-g

Editor's choice

Open your eyes to Africa

Africa is big, complex, and confounding. The ambivalence of looking towards a future full of promise but uncertainty is captured in our cover image—that of a child shielding his eyes in front of a Malian textile containing eyes wide open. Achieving a successful future is by no means a task for Africa alone, and the BMJ is contributing through this week's theme issue.

But can we do justice to a continent as richly diverse as Africa? We will present this theme issue to the 53 African Union health ministers at a meeting in Botswana—a country with the distinction of being one of the continent's richest yet with a staggering HIV prevalence rate (38%) (p 719). We will also launch the issue at a scientific conference in Durban—a setting bearing little resemblance to the atrocities and poverty invoked by the crises in Ethiopia, Rwanda, and Sierra Leone. In fact, we can't capture Africa in its multiplicity. Despite over 300 original research submissions we haven't managed the geographical or linguistic spread we would have liked.

Most of the papers submitted were from researchers in South Africa and Nigeria, and individuals working in Africa with primary affiliations in UK and US public health schools. While we proudly publish articles from such diverse places as Ghana, Guinea-Bissau, Zambia, and Zimbabwe, no articles were received from most African countries.

As our guest editors Jimmy Volmink and Lola Dare assert (p 705), whether this reflects a lack of research capacity or political will the situation is "untenable." For science to contribute to redressing inequalities in health, they argue, all countries must be able to participate in research.

Still, we show an impressive mix of African papers and opinion, representing an eclectic range: the major killers (HIV/AIDS, malaria, tuberculosis), emerging threats (cardiovascular disease, diabetes), and persistent but underappreciated conditions (postpartum haemorrhage, gender inequity). Three randomised trials provide new evidence on interventions that have immediate relevance for African communities, without extra costs. Perhaps most strikingly authors remind us that managing human resources (p 710), meeting the millennium development goals (p 755), and combating corruption (p 784) will come from African leadership and innovation.

We are grateful to the UK Department for International Development, Wellcome Trust, and the Health Foundation, who will help us distribute print copies throughout the continent. Online access to theme issue will be free, forever, for all—not just those in Africa, most of whom already have free access to bmj.com.

We hope this theme issue encourages greater dialogue and collaboration between doctors and researchers in the North and the South. It's a call to see the promise and potential of Africa, not just the struggle and suffering.

(jclark{at}bmj.com)

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Theme issue editorial advisors

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Relevant Articles

Addressing inequalities in research capacity in Africa

Jimmy Volmink and Lola Dare
BMJ 2005 331: 705-706. [Extract] [Full Text] [PDF]

Road safety in Africa

Meleckidzedeck Khayesi and Margie Peden
BMJ 2005 331: 710-711. [Extract] [Full Text] [PDF]

Making up for lost time

Pat Sidley
BMJ 2005 331: 719. [Extract] [Full Text] [PDF]

Confronting Africa's health crisis: more of the same will not be enough

D M Sanders, C Todd, and M Chopra
BMJ 2005 331: 755-758. [Extract] [Full Text] [PDF]

Africa does not need aid, but the opportunity for fair trade

Inwani Malweyi
BMJ 2005 331: 784. [Extract] [Full Text]

Rapid Responses:

Read all Rapid Responses

Whose eyes are being called to open?

Astier M. Almedom
bmj.com, 30 Sep 2005 [Full text]

What did Africa not do that others did; borrow five pillars from “the Asian Tigers”.

Anthony Lwegaba
bmj.com, 9 Oct 2005 [Full text]

Stopping Africa's brain drain

Peter R Mason
bmj.com, 25 Oct 2005 [Full text]