Catering to the customers

Sometimes, it is important to state the obvious, even if it is not surprising. In our study1 we document that trials published in the leading general medical journals do not reflect the conditions and diseases that are the most important causes of death and disability internationally. Our study points out again the discrepancy between what has priority in North America relative to what is important for most people worldwide.

Even if a problem is obvious, it must sometimes be quantified before the medical community accepts it as a real and pressing issue. Putting numbers to an obvious issue somehow lends it credibility.

We hope our study will have other effects. For example, it may prompt people to think about how they could make a difference. We understand that it is difficult to expect researchers living in developed countries to study what they do not know. As Louis Jacques points out, research on problems of the developing world should be done by those living and working in those countries. Researchers from the developed world could, however, use their research expertise to train investigators working in low-income countries so that they can conduct and publish the studies they think are needed. We also hope our study will serve as a reminder that the human race lives in a global village. Those of us in privileged circumstances must find ways to gain a more global perspective so as to improve health for all.

Paula A. Rochon Jennifer Gold Jocalyn P. Clark Kunin-Lunenfeld Applied Research Unit Baycrest Centre for Geriatric Care Toronto, Ont.