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Bridging the gaps in biomedical research

BMJ 2005; 331 doi: (Published 21 July 2005) Cite this as: BMJ 2005;331:194
  1. Stella Fatovic-Ferencic, professor (stella{at}
  1. 1 Croatian Academy of Arts and Science, Department for the History and Philosophy of Science, Division for the History of Medicine, Zagreb, Croatia

    Soteriades and Falagas1 and Burazeri and colleagues2 explored the distribution of quality research on either side of the Atlantic and in southeastern Europe. The well known North-South and West-East divides re-emerged. The authors emphasise the negative influence that the accession of the new member states will have on the total scientific output of the European Union, as well as the greater productivity of US authors that already exists.

    Science is the environment of different traditions that are unequally distributed among countries and cultures. Historically, its development is deeply rooted in social and cultural processes and often imbued with aspects of power, authority, and control. Totalitarian dictatorships provided us with a variety of examples, but democracies provided some examples as well. Reflecting on how science was transformed through the mediation of unequal power relations is necessary if we are to attempt to rethink strategies for bridging the existing gaps in biomedical research.

    Political and economic experiences are a structural part of modern knowledge. We can hardly discuss knowledge or science without considering the political and economic dimensions of their emergence and use. The West-East and North-South gradients in scientific output are surely related to availability of resources, established research centres, familiarity with today's lingua franca (English), and scientific and individual traditions. Biotechnology requires money, which was and remains scarce in transitional countries.

    The succession of Roman, Byzantine, French, Austro-Hungarian, and Russian cultural traditions in these countries also had negative consequences, particularly on free development and autonomy of education and science. In addition, communism, which combined a scientific view of the world with monolithic coercive power and strict social control, helped create intolerance to scientific creativity. Meanwhile, the dominance of the science-centred West, particularly after the second world war, stimulated cultural change of profound importance. Scientists who emerged in the United States, Canada, and the United Kingdom were regarded as having a public mission and a legitimate claim to political influence.3 They participated in creating “knowledge societies,” in which expert-run systems are incorporated into all parts of social life.

    To address this North-South, West-East divide, I suggest that both sides work hard: teach English to improve scientific communication, explore funding possibilities that the European Union might provide, provide computer technology, encourage young people (who have proved their interest in science) to apply for scholarships and gain experience in the developed world. It worked for Western Europe after the second world war, and it should work for transitional countries today. The role of power in the social structure of science clearly has had an effect on its distribution worldwide. Perhaps the time has come not only to declare obvious research inequalities but to rethink our strategies and use power to bridge the gaps.

    To bridge the gaps in scientific output

    Improve sharing of scientific programmes

    Enhance communication and run multinational projects

    Encourage academic freedom and autonomy of science

    Promote scientific communities worldwide in order to build creative, potent knowledge cultures that will bridge geographical and political boundaries


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