Skip to main content

Main menu

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN

User menu

Search

  • Advanced search
CMAJ
  • CMAJ JOURNALS
    • CMAJ Open
    • CJS
    • JAMC
    • JPN
CMAJ

Advanced Search

  • Home
  • Content
    • Current issue
    • Past issues
    • Early releases
    • Collections
    • Sections
    • Blog
    • Infographics & illustrations
    • Podcasts
    • COVID-19 articles
    • Obituary notices
  • Authors & Reviewers
    • Overview for authors
    • Submission guidelines
    • Submit a manuscript
    • Forms
    • Editorial process
    • Editorial policies
    • Peer review process
    • Publication fees
    • Reprint requests
    • Open access
    • Patient engagement
  • Physicians & Subscribers
    • Benefits for Canadian physicians
    • CPD Credits for CMA Members
    • Subscribe to CMAJ Print
    • Subscription prices
    • Obituary notices
  • Alerts
    • Email alerts
    • RSS
  • JAMC
    • À propos
    • Numéro en cours
    • Archives
    • Sections
    • Abonnement
    • Alertes
    • Trousse média 2023
    • Avis de décès
  • Visit CMAJ on Facebook
  • Follow CMAJ on Twitter
  • Follow CMAJ on Pinterest
  • Follow CMAJ on Youtube
  • Follow CMAJ on Instagram
Commentary

Medical journals and global medicine

James Maskalyk
CMAJ January 06, 2004 170 (1) 65;
James Maskalyk
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Responses
  • Metrics
  • PDF
Loading
  • © 2004 Canadian Medical Association or its licensors

Richard Horton, editor of The Lancet, recently described the underrepresentation of poorer countries both on the editorial boards and in the pages of medical journals as a systematic bias against the diseases of poverty.1 One reason for this neglect is that what is true of human nature is true of medical journals and their editors: it is natural to be concerned primarily with one's own affairs. Western medical journals, which often have one eye on the world and the other on their impact factor,2 tend to focus on the sharp point of health progress most familiar to them. However, people do have higher expectations of institutions that are designed to transcend the limitations of individual attention. Arguably, medical journals ought to count themselves among such “institutions.”

One of the commonest questions asked at the weekly editorial meetings at CMAJ is “Is this new?” Rarely do the important ripostes “To whom?” or “To how many?” receive proper consideration. With increased Internet presence throughout the world and improvements in access to scientific literature, the answers to all of these questions are changing. The annual meeting of the Council of Science Editors in May 2003 focused on the theme of “interacting with the digital environment” in scientific publishing. It was no coincidence that there were several sessions on the social responsibility of journal editors, and on movements to improve electronic access to information in low-income countries. Social responsibility notwithstanding, if the world's leading general medical journals have any claim to global legitimacy, that claim rests on their ability to reflect the health of humans everywhere on the planet. Alas, despite their considerable resources, most medical journals have done a distressingly poor job of capturing the world's most important health issues3 and are far from being truly international.

Convincing arguments for greater attention to the oft-cited 10/90 gap — i.e., the fact that only 10% of health research addresses the problems of 90% of the world's population4 — can be made on several levels. Political, moral and economic reasons are familiar to nearly everyone who has taken pause to consider them. From a health perspective, we have known for several years that whatever is contained in the gap between rich and poor makes people sick.5 Proponents of global equity often remark that with a small increase in foreign aid spending, bringing it closer to the agreed target of 0.7% of the gross national product of wealthy countries, significant progress might be made toward addressing disparity in all parts of the world. This target was first proposed in 1969 by the Pearson Commission (led by the former Canadian prime minister). Only 5 countries — Denmark, Luxembourg, the Netherlands, Norway and Sweden — have succeeded in reaching it.6

It has been suggested in several forums1,7 that medical journals should make a similar contribution of their resources (some argue for as much as 15%) to help fill this gap. CMAJ does not receive enough international submissions to devote 15% of its research pages to the diseases of poverty, but we can begin modestly. A few years ago, we made a conscious effort to include global health in our news section, and we will continue to cultivate this emphasis in Synopsis.8 We are also beginning to actively solicit clinical reviews on neglected diseases and to ask for commentaries on topics of international importance. We are expanding our editorial board to include members who can inform our discussions on how CMAJ is responding to important global issues. Certainly, our continued open-access presence on the Web has led us to hear from more international readers and contributors than ever before. We hope that, with time, we will receive and be able to publish more research articles that represent more accurately the interests of our increasingly international readership. While we remain Canada's general medical journal, we intend to train our gaze outward.

That being said, we must acknowledge that, although information flow is an important factor in improving health, it is not a tangible resource like food, shelter or medicine. We hope to provide useful information and insights about international health issues in our pages, but it is clear that more than mere words will be needed to make meaningful progress against global disparities in prosperity and health. The true value, like most things in medicine, will be found in their application.

𝛃 See related articles pages 5, 66

Footnotes

  • Competing interests: None declared.

References

  1. 1.↵
    Horton R. Medical journals: evidence of bias against diseases of poverty. Lancet 2003;361:712-3.
    OpenUrlCrossRefPubMed
  2. 2.↵
    Garfield E. Journal impact factor: a brief review. CMAJ 1999;161(8):979-80.
    OpenUrlFREE Full Text
  3. 3.↵
    Obuaya CC. Reporting of research and health issues relevant to resource-poor countries in high-impact medical journals. Euro Science Edit 2002;28:72-7.
    OpenUrl
  4. 4.↵
    Global Forum for Health Research. The 10/90 report on health research, 2001–2002. Geneva: The Forum; 2002.
  5. 5.↵
    Black D, Morris J, Smith C, Townsend P. Inequalities in health: report of a research working group. London: Department of Health and Social Security; 1980.
  6. 6.↵
    Organisation for Economic Co-operation and Development. OECD DAC countries begin recovery in development aid: 5% increase in 2002. Paris: OECD; 2003 Apr 22. Available: www.oecd.org/document/42/0,2340,en_2649_34447 _2507754 _1_1_1_1,00 .html (accessed 2003 Dec 11).
  7. 7.↵
    Shaywitz DA, Ausiello DA. The 15% solution for majority health problems. Nature 2002;415:575.
    OpenUrlPubMed
  8. 8.↵
    Choi S. Introducing Synopsis: a view onto medicine [editorial]. CMAJ 2004;170(1):70.
    OpenUrlFREE Full Text
PreviousNext
Back to top

In this issue

Canadian Medical Association Journal: 170 (1)
CMAJ
Vol. 170, Issue 1
6 Jan 2004
  • Table of Contents
  • Index by author

Article tools

Respond to this article
Print
Download PDF
Article Alerts
To sign up for email alerts or to access your current email alerts, enter your email address below:
Email Article

Thank you for your interest in spreading the word on CMAJ.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Medical journals and global medicine
(Your Name) has sent you a message from CMAJ
(Your Name) thought you would like to see the CMAJ web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Medical journals and global medicine
James Maskalyk
CMAJ Jan 2004, 170 (1) 65;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
‍ Request Permissions
Share
Medical journals and global medicine
James Maskalyk
CMAJ Jan 2004, 170 (1) 65;
Digg logo Reddit logo Twitter logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like

Jump to section

  • Article
    • Footnotes
    • References
  • Responses
  • Metrics
  • PDF

Related Articles

  • Highlights of this issue
  • Western medical journals and the 10/90 problem
  • Weapons of mass salvation: Canada's role in improving the health of the global poor
  • PubMed
  • Google Scholar

Cited By...

  • Health and economic benefits of an accelerated program of research to combat global infectious diseases
  • Google Scholar

More in this TOC Section

  • Ensuring timely genetic diagnosis in adults
  • The case for improving the detection and treatment of obstructive sleep apnea following stroke
  • Laser devices for vaginal rejuvenation: effectiveness, regulation and marketing
Show more Commentary

Similar Articles

Collections

  • Topics
    • Global health
    • Health economics
    • Journalology & publication ethics

 

View Latest Classified Ads

Content

  • Current issue
  • Past issues
  • Collections
  • Sections
  • Blog
  • Podcasts
  • Alerts
  • RSS
  • Early releases

Information for

  • Advertisers
  • Authors
  • Reviewers
  • CMA Members
  • CPD credits
  • Media
  • Reprint requests
  • Subscribers

About

  • General Information
  • Journal staff
  • Editorial Board
  • Advisory Panels
  • Governance Council
  • Journal Oversight
  • Careers
  • Contact
  • Copyright and Permissions
CMAJ Group

Copyright 2023, CMA Impact Inc. or its licensors. All rights reserved. ISSN 1488-2329 (e) 0820-3946 (p)

All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association or its subsidiaries.

To receive any of these resources in an accessible format, please contact us at CMAJ Group, 500-1410 Blair Towers Place, Ottawa ON, K1J 9B9; p: 1-888-855-2555; e: cmajgroup@cmaj.ca

CMA Civility, Accessibility, Privacy

 

Powered by HighWire