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Medical journals can reduce global health inequity, conference told

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7335.444/a (Published 23 February 2002) Cite this as: BMJ 2002;324:444
  1. Alex Vass
  1. BMJ

    Doctors from the developing world feel that the world's leading journals are biased against publishing their research and are not playing their role in reducing global heath inequity, an international conference heard last week.

    This was one of several perceived barriers to publication identified during a workshop, hosted by the BMJ, at the conference on the global inequity of health care and development held in Egypt.

    Publishing research from developing countries was seen as an essential step to reduce inequities in health and development across the world. Delegates felt that journals were preventing the dissemination of results that could help to reduce global health inequity.

    Ninety five per cent of the doctors surveyed at the conference, organised by the International Clinical Epidemiology Network (INCLEN), rated publication in a leading journal as “very important.”

    Currently 90% of what is published by international journals is estimated to be relevant to just 10% of the world's population. Doctors said they felt that their research papers did not receive the same treatment as research from the developed world because developing world issues were not seen as “fashionable” by leading journals.

    Data from the BMJ presented at the workshop, however, showed that acceptance rates do not vary as much as delegates perceived. Of 3517 papers submitted from the United Kingdom to the BMJ in 2000, 12% were accepted, compared with an 11% acceptance rate from Africa and 9% rate from Asia. Numbers of submissions, however, vary considerably—just 51 papers were submitted from Africa and 227 from Asia in 2000.

    Conference delegates suggested that journals should give a clear message to the developing world that they are interested in developing world issues and reducing the global inequity of health. They suggested devoting a fixed percentage of journals to issues that relate to the developing world and promoting more authorship of articles by doctors working in developing countries.

    Difficulty writing up research in English was also a major barrier to getting published, they said. If work was rejected on these grounds doctors were less likely to submit their work in the future owing to a fear of repeated rejection. Doctors felt that journals should be more lenient in their judgment of papers and suggested that more editorial help in revising manuscripts should be available. They also proposed that workshops and fellowships on writing scientific papers could be provided by journals.

    Doctors did, however, acknowledge that research from the developing world may be of poor quality. Lack of access to previous research findings because of high subscription costs for journals was cited as one of the reasons for this. They welcomed recent initiatives to increase access but called for wider publicity of them.

    The BMJ's specialist journals are now available free via the internet to more than 100 of the world's poorest and lower middle income countries (16 February, p 380) and an initiative from the World Health Organization will allow nearly 70 of the poorest countries free access to more than 1400 key journals (BMJ 2001;323:65).

    Other problems faced by research doctors were similar to those experienced by researchers from the developed world. Limited research training, lack of time in writing up results, lack of support for research, and lack of funding were most commonly cited.

    More details about INCLEN are available at http://www.inclentrust.org/

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