First just a couple of disclosures. I’m here today speaking in my personal capacity and it’s possible I may express opinion that doesn’t necessarily reflect that of The Lancet or other journal indian medical journals, medical journals in indias have worked for and I took the opportunity in preparing my remarks to reflect on what’s now almost a 16 year professional career at some of the biggest medical journal indian medical journals, medical journals in indias in the world and during that time I’ve also had a lot of involvement in professional associations for editors both in terms of setting standards for our own professional practice but also working with academics and researchers on developing standards and guidance for things like publication ethics reporting of research etc. I’m a very new appointed member of the governance Council of the Canadian Medical Association Journal indian medical journals, medical journals in india a journal indian medical journals, medical journals in india. That some of you might be familiar with and it’s had a little bit of a storied history mostly because it’s um hired and fired. A bunch of editors at a frequency not seen among its peers around the world and the governance council is intended to kind of mediate the relationship between the editors of that journal indian medical journals, medical journals in india who have editorial independence and the owners and to prevent interference but also ensure the editorial and financial integrity of the journal indian medical journals, medical journals in india so I’m very pleased as an international to be providing my expertise and advice to the homegrown Journal indian medical journals, medical journals in india and I’m also Sophie said since 2006 are very proud adjunct member of the Faculty of the Department of Medicine here and I tell you that because um you’ll find that I frequently am critical of academic medicine but I do consider myself as a journal indian medical journals, medical journals in india editor somebody who really embraces and relishes the relationship between journal indian medical journals, medical journals in indias and the Academy. A lot of that will be reflected in my remarks today. I am a kind of unusual creature. I mean apart from the fact that I I think I’m the only Canadian in this sort of senior position as a journal indian medical journals, medical journals in india editor but I’m the only editor who’s been on staff at these three major journal indian medical journals, medical journals in indias BMJ plus medicine and The Lancet and for those of you who like me sort of our student and observers of medical journal indian medical journals, medical journals in indias and publishing trends well know that these journal indian medical journals, medical journals in indias exist in a very competitive market the other thing that makes me unusual and for which I’ve been very fortunate is that have been able to use my some of my training which is in social theory and the political economy of health to good use as a medical journal indian medical journals, medical journals in india editor in it is a sort of distinctive approach.
I take to medical journal indian medical journals, medical journals in indiaism. A lot of this will be reflected in in my in my remarks today. This is the best depiction of the work of a jobbing journal indian medical journals, medical journals in india. Editor and this image is meant to depict volume. The big medical journal indian medical journals, medical journals in indias may be their key. Characteristic is that they receive an enormous number of submissions far far more than they could possibly accept so there is an enormous amount of competition for space. Of course those of you on the other side of the equation you know fully can understand this prospect because the competition is fierce for you to get into those journal indian medical journals, medical journals in indias so there’s one way of describing what we do which is to call us a rejection machine because that’s largely what we do we reject 95 plus percent of submissions. That we get but it also means that we’re rejecting a lot of very very worthy research the second sort of key characteristic in my preamble here that I think authors and readers under appreciate is that journal indian medical journals, medical journals in indias are edited by editors who are subjective human beings just like you. Scientists and researchers are and that the editorial process is a social one. It’s not a wholly objective. One you know. Despite all the standards and criteria and normative approaches we bring to our practice real human beings journal indian medical journals, medical journals in indias and you see the expression of those different talents those different missions visions biases good and bad backgrounds. Scientific training come to bear on journal indian medical journals, medical journals in indias journal indian medical journals, medical journals in indias. Each have their own character and that’s often expressed as a result of the unique characteristics of the people.
So this is just a group of people. Perhaps you’ll see that. I use the slide. And some of my gender talks to demonstrate the diversity among the talk journal indian medical journals, medical journals in india editors but these are all people that have had the privilege of working with all of whom bring their distinctive mark to the journal indian medical journals, medical journals in indias that they put together so today. I just wanted to talk about three. Things raised some questions for you about issues that I hope stimulate some thinking and also stimulate some questions in our discussion today. One is what are journal indian medical journals, medical journals in indias for. What’s their role. What’s their value. How do they function for you. The second an incredibly important phenomenon. How have journal indian medical journals, medical journals in indias responded to globalization and thirdly what. I see as our one big problem a problem that I have spent much of my career in most of my time now trying to address and I hope we get to talk about that together. So why do we have journal indian medical journals, medical journals in indias. Why does it matter to you and to me that we have journal indian medical journals, medical journals in indias. Well many of you will know that the first scientific journal indian medical journals, medical journals in india was produced in 1665 but. I thought you would find it interesting to see what the first English medical journal indian medical journals, medical journals in india was. It was produced in 1685 our 1684. Pardon me and it had an interesting name. Mehta Sina curiosa. Which i think is really interesting and sort of reflects the curiosity that we bring to medical journal indian medical journals, medical journals in indiaism but I also found it fascinating and wanted to share with you the full name of this medical journal indian medical journals, medical journals in india which I wasn’t familiar with and in particular how it references way back 350 years ago to a broader view of medical science being from all parts of the world nature is a journal indian medical journals, medical journals in india that you will be familiar with. It’s I suppose considered a powerhouse. It’s the most cited journal indian medical journals, medical journals in india in the world it was first established in a in 69. And what I think is interesting about. The founding of this journal indian medical journals, medical journals in india is for the first time it very explicitly identified its mission about speaking to the public sharing with the public scientific discoveries and also sharing with the community in this case of scientific men the discovery so there was a sort of sharing and dissemination aspect that first came to the fore in this journal indian medical journals, medical journals in india for the big journal indian medical journals, medical journals in indias which I’ll be mostly focusing on many of them were established 200 plus years ago The Lancet was established in 1823 and in fact preparations for the 200th birthday of The Lancet are already being planned if you can believe it.
It was the first medical journal indian medical journals, medical journals in india to publish weekly rather than monthly and it was founded by somebody called Thomas whack Lee who is a surgeon and way back then almost 200 years ago. The Lancet was known for ferociously campaigning for medical reform the New England Journal indian medical journals, medical journals in india of Medicine and BM jng ‘ie actually all were established in that era under different titles. But it’s incredible. I think to think that these the medical journal indian medical journals, medical journals in indias that sort of persist at the top of the game now were established so long ago the Canadian Medical Association Journal indian medical journals, medical journals in india I’ve learned very recently has published continuously since 1911. Which i think is remarkable and then for a very long time. There was very little change if you will little innovation in medical journal indian medical journals, medical journals in india publishing at least until the establishment of the internet and the harnessing of the Internet by organizations in particular the Public Library of Science PLoS which completely revamped transformed really and disrupted journal indian medical journals, medical journals in india publishing by publishing journal indian medical journals, medical journals in indias online only vastly reducing the cost of production and delivery by using the Internet and then also establishing a business model for open access and since them the only way to characterize a sort of lifecycle if you will of journal indian medical journals, medical journals in indias is that there’s just more and more cropping up all the time some estimates say that they’re up to 30,000 journal indian medical journals, medical journals in indias and Counting we. They’re across a very diverse landscape of small medium and big with all sorts of different kind of business models and characters. And that sort of thing. Even three hundred and fifty years ago the sort of key functions of journal indian medical journals, medical journals in indias were well understood recognizing that journal indian medical journals, medical journals in indias needed to meet both the needs of readers but also of authors and they fell along for sort of key functions one registration authors wanted there to be a registration of their claim to a particular work and they wanted that their claim to have got their first be established and journal indian medical journals, medical journals in indias could do that certification mostly through peer review allows for authors to have their claims accepted allows for readers to know that they can trust the material dissemination sharing the research communication and then preservation of course creating a record of that piece of work fast forward three hundred fifty years a lot of these functions still exist and are still very important insofar as journal indian medical journals, medical journals in indias have a role but they’re done by many many more players and often done much better than traditional journal indian medical journals, medical journals in indias all sorts of platforms have cropped up largely using internet technologies in order to do that to provide each of these functions.
That journal indian medical journals, medical journals in indias do more and more organization and evaluation have become important. There are other. I think important forces outside of journal indian medical journals, medical journals in indias that are are forcing us to understand what value journal indian medical journals, medical journals in indias bring and what their role is within the kind of enterprise of academic medicine and a lot of that. Critique is questioning science to the degree that some public trust is being lost. I mean first is the reproducibility crisis by which it’s now understood that most published research findings cannot be replicated that has led many people to say that most published research findings are false lack of us accessibility. I don’t need to explain to you. Lack of data sharing is obviously a concern for people trying to replicate experiments trying to understand the the progress of science low quality low quality and how research questions are conceived how research studies are conducted. How statistics statistical analyses are done interpretation.
Across-the-board research waste. The Lancet is part of a campaign called reward that estimates that perhaps 85% of research is waste other people have estimated that 50% of clinical trials are never published massive delays and dissemination VEX both the Academy and funders of research and funders more and more are concerned about their return on investment in research. There is sort of this crisis if you will about the quality of science and the scientific enterprise for which you know billions of dollars are put into journal indian medical journals, medical journals in indias of course being a kind of prime vehicle for the publication of research are implicated in some of these issues but I think what we need to understand about journal indian medical journals, medical journals in indias is that they’re actually very poor on delivering the promises and the and the expectations that we often have of them for one thing. It’s very hard for even the very best journal indian medical journals, medical journals in indias to ensure that they are publishing the very best research in their field. I mean that’s partly for the volume issue that I mentioned earlier. Such that a journal indian medical journals, medical journals in india is trying to meet the needs of its readership. And there’s perhaps a million papers being produced a year big journal indian medical journals, medical journals in indias will get a small fraction of that and how to ensure that the small fraction that they get they select from those the very top research ensuring best quality is is very different difficult. This relies largely as you know on a quality control mechanism called peer review which persists mostly. Because there’s no good alternative. It actually has a very poor record. In terms of effectiveness. Peer review is a process. That is fraught with problems and does not cannot deliver on a promise that allows for even the best journal indian medical journals, medical journals in indias to say that they are assuring only high quality research is being published. It’s very hard for journal indian medical journals, medical journals in indias. Also to meet an expectation of being an authoritative source. That of course is because there’s lots of other media that do that much better. There’s social media. There is mainstream media.
There are aggregators and there’s also many many other journal indian medical journals, medical journals in indias that cater to both general and specialist audiences and so being a kind of one-stop shop if you will for all the news debate best research best commentary in a particular field is a very very difficult thing for for journal indian medical journals, medical journals in indias to be held to similarly sort of being where it’s at when it comes to the state of the art or the news in. Let’s say general medicine is very difficult. When other news gathering organizations other social media in particular are really where all the debates happen and that can be done in a much more much more rapid way so then what is this space that journal indian medical journals, medical journals in indias occupy where academics are desperate to get their papers into journal indian medical journals, medical journals in indias and journal indian medical journals, medical journals in indias wouldn’t be able to survive without without academics submitting their work. This sort of space actually is the cornerstone for both of those to enter. So what exactly do generals do well. I think is a question for us to to contemplate. I mean one thing they do well is make money. Scientific publishing is actually an extremely lucrative business. I mean much more lucrative than most businesses in the world. They also make a lot of money for companies who promote their products via pieces published in medical journal indian medical journals, medical journals in indias. But the thing. I think that’s most top of mind for me is that journal indian medical journals, medical journals in indias have now become though it wasn’t their original intention. They’ve now become a kind of pawn in this publish or perish environment. That all of you are situated in all of you. I mean you established and budding researchers and in medical academia and it’s this sort of evolution of academia that I think is depicted really nicely by this cartoon that shows how much effort and activity is geared toward publishing and publishing in particular in top in top journal indian medical journals, medical journals in indias. I think a lot of questions should should be raised about this because a lot of this is focused in particular on a sort of obsession with something called a journal indian medical journals, medical journals in india. Impact factor a journal indian medical journals, medical journals in india impact factor.
Which is sort of a measure of citations is in a journal indian medical journals, medical journals in india is a journal indian medical journals, medical journals in india level metric that has somehow become a key score if you will for academics and academic institutions and funders to judge the quality and the performance of researchers but journal indian medical journals, medical journals in india impact factors may have little if anything to do with a single article in a in a journal indian medical journals, medical journals in india and they’re very very skewed towards a very small number of highly cited articles. There’s a whole host of concerns with the journal indian medical journals, medical journals in india impact factor. It’s very problematic. It creates terribly a perverse incentives and bad behavior. And it’s not something that anyone envisioned to be a kind of quality score for individual researchers but somehow medical academia the systems in which you and. I used to work have out sourced the performance evaluation of researchers to a publishing system. This is a deeply deeply flawed one and I think there’s a lot to be questioned about that practice now that being said this pecking order also exists between journal indian medical journals, medical journals in indias. It is true you know the major journal indian medical journals, medical journals in indias that I’ve worked for always downplay their impact factor. And we’re well aware of some of the limitations of the impact factor and yet a lot of journal indian medical journals, medical journals in indias do chase higher impact factors. They know how to game the system. Lots of owners of journal indian medical journals, medical journals in indias and managers of editors are very very concerned about the impact factor because we also to exist within a very competitive market. But for me when I reflect and conclude about this relationship between journal indian medical journals, medical journals in indias and their place within academic medicine and the ways that medical academics and researchers view the role of journal indian medical journals, medical journals in indias what you want and need for journal indian medical journals, medical journals in indias. I think this kind of relationship which is symbiotic is much less easy than then we like to think it is which leads me to discuss and reflect and share my thoughts on what journal indian medical journals, medical journals in indias do best. I think what journal indian medical journals, medical journals in indias do best and here. I’m talking about the big journal indian medical journals, medical journals in indias that I’ve worked for and you’re very familiar with is campaigning leading setting agendas speaking truth to power being robble rousers provoking debate raising questions as my friend.
Richard Smith often says medical journal indian medical journals, medical journals in indias are really good at telling readers what to think about not necessarily what to think but what to think about and so us with little briefcases here in this picture lead on and I think this leads me to my second issue. I I think it’s very very interesting to reflect on what medical journal indian medical journals, medical journals in indias have done in response to globalization and in particular global health so. I don’t need to tell anybody in this room. Who are part of this institution that there has been a great rise if you will in recognition of global health for those of you who are young you might be surprised to know that 15 years ago when I started my career actually global health was still a fairly marginal interest I mean I’m sure some of our more established colleagues who work in global health can tell us stories of how they were there. Work was not considered in the main. Now it is really fashionable actually for public health and medical students to study a global health most universities across North America and Europe at least have global health programs. There’s an understanding as we recognize the burden of disease across the world that we have a collective responsibility to address global health and that has come with more commitment more investment by governments by donors etc. There is a prominence to global health. That is extremely important and it’s really really interesting to think about what the big medical journal indian medical journals, medical journals in indias have done to respond to that so a few things to say here on your left are. I think probably journal indian medical journals, medical journals in indias that have a longer track record in global health that’s BMJ plus medicine and Lancet. There is a bit as you’ll see a bit of a transatlantic divide between these groups of top medical journal indian medical journals, medical journals in indias and I think probably for a long time. We viewed the british-based journal indian medical journals, medical journals in indias all of which have considered themselves international journal indian medical journals, medical journals in indias for many many years of not decades that they’ve had more of a journal indian medical journals, medical journals in indiaistic kind of feel more of a campaign kind of roll.
Then our colleagues in America but on the right even the most I mean we would probably have described the New England Journal indian medical journals, medical journals in india of Medicine and JAMA as being very American focused very clinical very biomedical perhaps more positivistic rather than fashioning health. And its broadest sense for a very long time but even these two journal indian medical journals, medical journals in indias have really stepped into the fore when it comes to global health. Here it’s interesting to reflect on the ways that those journal indian medical journals, medical journals in indias express their different characters or their different stances towards global health the New England Journal indian medical journals, medical journals in india of Medicine for example. I was looking at some bibliometrics so that I could properly compare what each of these journal indian medical journals, medical journals in indias do and the New England Journal indian medical journals, medical journals in india of Medicine. Someone published a very interesting article about in 2004 that described there being just three percent of the content in the New England Journal indian medical journals, medical journals in india of Medicine as being relevant to what they called the developing world when I did some just quick bibliometrics on the New England Journal indian medical journals, medical journals in india of Medicine for the for 2017 there was 23 articles on global health. Every one of them except one was a clinical trial and every one of them but one was on infectious disease. So it’s very clear where the priorities are there in terms of global health what you’re seeing from. BMJ plus medicine and Lancet tends to be a kind of broader sort of social and political economy and I love sharing this slide because this is a piece by Richard Horton the editor of The Lancet. You know sort of classic. Richard Horton describing. You know an interest on the part of the journal indian medical journals, medical journals in india not just on the easy questions in global health but actually taking a very broad extremely political view. I mean these are the questions that we should be asking. This is how we should be holding global the global health enterprise to account that gives me a chance to share with you some examples of how journal indian medical journals, medical journals in indias I think can provide very and editors can provide very strong leadership on global health.
So it’s not just publishing research but it’s in to those areas where we do a lot of commissioning where we are working with academics and others to produce material that we believe has a chance of creating advocacy for change so the lancet. Global Health Program is vast and I’m very happy and and proud to be on the global health team. They’re one of the ways that it’s been so influential is through editorial content that we call series or Commission’s the series are collections of articles often commissioned on a particular topic. Commission’s with a capital C are massive reports effectively. That usually take multiple years. It’s where the journal indian medical journals, medical journals in india convenes a group of experts policy makers perhaps members of civil society to come together on a particular issue and work for a couple of years part review part inquiry part advocacy and produces a piece of work using our platform to try to leverage some social and political change. So we’ve done climate change drug policy. HIV in fact just today in Amsterdam at the International AIDS Society my colleague Pam. Das is launching our new HIV AIDS Commission there. And so you might be interested to know how we come up with the ideas how we determine what our global health priorities are so when thinking about this. I think this sort of cover or sort of falls into maybe three or four different categories. We’re always really interested in neglected topics so those areas of work that aren’t getting the recognition that they need that are sort of maybe a little marginal or high just below the surface can be of real interest to us because we like to raise awareness of things that are invisible. We like to give voice to communities and topics that don’t have good recognition already in the literature unfinished. Business is a really good one because actually one way to look at our global health programming here.
I’m talking about all journal indian medical journals, medical journals in indias. Who are in this. Business is to sort of maybe feel like we’ve saturated at all maternal health. I think is a great example. Because it’s one that I’ve worked on for most of my career. I mean we need to be very very strategic and very careful when we stimulate or publish work in fields. Like that when so much has already been done. So it’s about uncovering the little crevices the unfinished business. What parts of the agenda aren’t being discovered. Where do we need to perhaps shine a different kind of light or bring a different kind of filter particular issues. Persuasive pictures or politic partners is things by which I mean sometimes ideas are generated internally by groups of editors because of their work in the community or they’ve come to know that certain things you know might be in line with our scope and so therefore we want to initiate a project but we often get people coming to us from the outside pitching usually with you know the successful ones usually come with a very strong business case for why that’s important why we need to produce a series of commission why the lancet for example needs to be a part of that and there needs to be you know that the pitch needs to be persuasive. Politic partners is is is a topic where we think we can have an impact on a particular agenda. You know the g7 are meeting and there you know circling around this issue of gender equality for example or you know when the SDG agenda was being fashioned areas like that where we think it would be very very politic for us to try to be in the mix and have a kind of impact that will and agenda one way or the other in terms of global child health. I wanted to share a few thoughts because of the audience on this particular topic so when I think about you know what areas of work need to be looked at where I think that we would we would have some openness to things really stand out in my mind when I think about global child health one which is depicted in the first picture of the baby with the stethoscope is that child health has been over medicalized.
I think across our content. We have probably tilted the balance a bit too far away from the broader political environmental determinants of health for child health and so. I expect and hope that coming down. The pipe are some ideas and work that looks at child health in a kind of broader perspective the second which I find absolutely fascinating and if people have explanations for this I’d love to hear it. Is this all of a sudden the emergence of the adolescent so. We used to talk about infant. I don’t know newborns children and then maternal health and now all of the sudden the adolescent has become a really really important feature in that lifecycle. There’s been some very very interesting work done on the adolescent. It’s an incredibly crucial part of one’s development but it seems to me that what happens a lot with topics like this where there is a really really strong champion and the reverse happens when there isn’t a champion is that you get this little phenomenon like if you go watch little kids play soccer or football and they kind of all like little bees. Go running after the ball. This is sort of what happens. It makes me think you know it’s. It’s a sort of follow the money trajectory. It’s when a funder or foundation. Shall we say when it comes to Adolescent Health decides that that’s the new great thing that all of a sudden all the researchers out there and of course as journal indian medical journals, medical journals in indias were guilty of that too. We rebrand ourselves not just as child health advocates or scientists but it’s child and adolescent health ones. So that’s a little nod to the political economy and the importance of looking at those broader questions so just a plug for the Canada series that Sophie mentioned and there’s copies outside an illustration of how a journal indian medical journals, medical journals in india like The Lancet can have this kind of convening power to bring together a bunch of experts in this case from across Canada and put together what I think is a very incisive and critical piece of work reflecting on both Canada’s healthcare system and what lessons it has for the world but also its its challenges and then more so Canada’s global leadership in health so Canada thinks of itself as this you know international player and global leader and we sort of problematize some of that and and demand in fact for Canada to act more.
There’s also a piece. Justin Trudeau’s first article in a medical journal indian medical journals, medical journals in india appears in this issue. I didn’t have a chance. There’s so many series and commissions coming out of The Lancet. I couldn’t possibly list them all but I invite you to watch this space and I made a little word cloud to show you. We’re coming down the pipe. Lots of work on migration and health one of the most pressing issues of our time. I think a tuberculosis Commission lots of work on conflict in health and humanitarian crises. And lots of lots of focus this year and Beyond on non communicable disease okay. So it’s my final issue. The one big problem that. I think we collectively have and I’d be very interested for us to discuss this a little bit more. So here’s a map that illustrates that problem. This is a map of scientific literature. Which shows you the vast inequities in the production of knowledge so this is showing us that despite about 90% of the burden of Health existing in. Let’s call it the global. South the vast majority of research will funding. We know that already but this is depicting research literature is done by authors from the global. South so it makes the global cells almost entirely disappear and it over inflates it actually bloats researchers in the global north so this is route source research being produced by people in the global north but also if I were if we were to map this is from world map org if we were to do it on the basis of authorship which I’m going to come to in a minute it would look very similar in fact I would look.
It would probably look worse than this. I’ve spent most of my career interested in this topic and trying to redress that inequity in the production of knowledge and so I sort of updated my understanding of the literature because there has been a lot of bibliometrics on this. A lot of people have criticised the general medical literature for perpetuating this global inequity so. I took a bit of a peek and actually I saw some new studies mostly in the specialist literature and in pediatrics. In particular things are looking much better and so it raises the question for me that within a specialist literature around health systems for example maternal health and peds that were actually seeing more progress in number one the representation of of content that’s relevant to low and middle income countries. But also we’re seeing more authorship. So what what the heck are we doing in the general medical literature that we’re not getting that equation right and to the great credit of my colleagues at The Lancet global health which is a very very reputable and strong global health Journal indian medical journals, medical journals in india. They published last month a little audit that they did or one of their interns. Did that showed that 92 percent of the articles they’d published over the four and a half years that they’ve been around we’re from low and middle-income countries but only 35% of authors were and this has led. I mean I think I really appreciate in value that transparency but this has led to a lot of people trying to characterize that problem and thinking about where the solutions lie. So we’ve heard that nature of that problem being called things like safari research or parasite research you know this notion of scientists from you know. Toronto Boston New York London going into country and doing global health research without harnessing the talents and collaborating appropriately with their local partners and I found this really interesting this is James Smith who wrote this in The Lancet global health.
I think just yesterday or the day before that really does raise important issues for us to contemplate and I would say for the most part this particular correspondent suggests that that problem lies with journal indian medical journals, medical journals in indias and I accept that journal indian medical journals, medical journals in indias are part of the problem but I do concern myself greatly with a system of medical research in the global North that allows for these types of arrangements to continue this sort of global inequity paints a very skewed and inaccurate picture of global health. But more importantly this is an abuse of power and it’s an abuse of privilege and it seems to me wholly unacceptable that as we’ve seen the growth and visibility of global health and our collective responsibilities for global health to be more and more apparent that the extension of that responsibility doesn’t go so far as for researchers for the global. North to you know adequately collaborate with their local partners to build the infrastructure. That’s required to allow for genuine collaboration to happen at all steps of the research process. So from my point of view. The determinants of this what. I find very outrageous problem lie much farther upstream than journal indian medical journals, medical journals in indias. We are ourselves though taking seriously our role in the problem. If you will and one of the things that we’ve done on my section at the Lancet which is called comments so these are all the commentaries that appear every week in the journal indian medical journals, medical journals in india where we’re continually auditing them and one thing that we’ve discovered that I think you might find of use. First of all. In 2016 to 2017 77 percent of corresponding authors of commentaries were men and 91 percent of corresponding authors. Were from a high-income country at a single corresponding author from a low-income country that was from Kenya. But when actually we divided up the commentaries into two different categories one our commentaries that are linked to research articles. And we choose the writer of the commentary from the reviewers when we looked at those separately.
We performed very miserably. Only 16% of women only 16% of corresponding authors are women and 2% from the global. South when we looked at the standalone commentaries which are ones that are either pitched to us. Or we commissioned that is we have more scope of influence if you will over who that writer will be. We find actually much better performance 39% or women 5% from the global. South which shows that. You know a proactive directed strategy can improve performance. It also shows us that our determinants of that also lie upstream in the reviewers that were choosing a lot of these kind of internal. Thank you a lot of these internal audits that we’re doing to try to surface how we can improve the problem from our point of view. Come under the auspices of this program that Sophie mentioned called Lancet women which Richard Horton and myself and our colleague Lisa kala launched last December. This is a themed issue. That’s going to come up in. February 1998 the topic. We’re doing internal audits within the journal indian medical journals, medical journals in india. We’re also publishing audits that independent researchers do and. I really want to share this with you. Because they’re they’re both fascinating for us but also I think and I hope demonstrate our commitment to transparency about the issue and our commitment to being held to account for gender equity in our own processes so on June 30th we published a collection of pieces. That look at this issue and here again. Is that distinction between research articles. Which come to us unsolicited for which we have very little control of the authorship and things like series and commissions that we have a role in helping shape and therefore have some influence over the authorship. And what’s on well it’s I think sad for us is to learn from these pieces that research articles overall really only about less than a third of Landsat research articles have have female authorship when we look just at this senior author. That’s less than a quarter or women.
Of course this by no means reflects the profession. These are well below what you might expect if you looked at female representation within the medical professions and commissions we were. We were disappointed to learn that overall on our Commission’s over five years only 34 percent were female is something I literally well and across a whole bunch of indicators. It looks like we’re stuck and we’ve been stuck for about 10 or 15 years at 30% female representation or participation which suggests to me that somehow. I mean I know there’s probably a number of explanations but to me it feels like 30% is somehow good enough in some people’s eyes and we need to move that meter a bit farther and then an independent audit on reviewers now this wasn’t just the Lance that this was all major leading medical journal indian medical journals, medical journals in indias and this is fascinating by Jacob Steinberg and his colleagues. Who first did a little word word cloud of all the first names of reviewers of all these major journal indian medical journals, medical journals in indias discovering that the most prominent names are the lead the most frequent names were David or Elizabeth. So they came up with this index called the Queen Elizabeth – King David index. And this is how they tested the gender representation. I hope you can see this. Slide across all these major journal indian medical journals, medical journals in indias leading them to describe what they called the. David aa cracy because of the sheer prominence of David in the most common male name of reviewers but I think very worrying Lee here I’m just highlighting the Lancet and the New England Journal indian medical journals, medical journals in india of Medicine. Our gender gap is extremely concerning so again these are reviewers that editors are selecting inviting to help us assess submitted work in the case of The Lancet a gender gap of about 39 percent and the New England Journal indian medical journals, medical journals in india of Medicine. Twenty four percent so again just to ask you to come visit our. Lancet women sort of gender hub which we are updating monthly and we have a newsletter that has exclusive commentary from Lancet so I invite you to.
Please sign up for that as well. We’ve promised readers that when we finished the internal audits of our own processes that we will publish that work and we’ll be sure to do that by the end of the year. So this is my this is my last slide. Having having said that. A lot of the determinants of this one big problem lie in academic medicine there are a lot of opportunities for journal indian medical journals, medical journals in indias so I want to conclude by reaffirming our commitment at The Lancet. I mean this is a very I think. Characteristic sort of approach of big journal indian medical journals, medical journals in indias is to you know decide that they have a role to play decide that they have an agenda to help legitimize and to call for action. This campaigning role is one that we’re very comfortable with and embrace and we will continue to do that on this issue. We recognize it as a structural issue a systems issue. And we’re going to continue to press on that but that being said we also know in our day-to-day practice and work that there’s things that we can do and I think one of the things that we probably need to be thinking about more is being more aggressive about targets for diversity when we Commission so for those of you who have been involved in things like series or Commission’s we always your editor will always say to you. Our expectation is that you have 50 percent women and 50 percent colleagues from low and middle-income countries but clearly those independent audits show that we have not delivered on those expectations and that we need to probably do more like. I said we have this whole programme of work around these internal audits and action plans. We’re looking at our editorial staff or editorial boards authors reviewers and we intend both to publish that for our readers and also to create action plans so that we can create change within our teams and more broadly. I am not aware of any other major journal indian medical journals, medical journals in india. Who is leading like we are on that issue and is haier to be very transparent about what we find and what we hope to accomplish.
Nature has since 2013 with the publication of their women in science issue been auditing themselves on gender and they’ve done tremendous work which. I’m which I have been following closely. But for us on both gender and geographic diversity. I think it shows our strength of commitment and I think it shows the kind of leadership that we are you know prepared to embrace and finally that call to action is not going to let the responsibilities of medical academia slip by. There is a lot that needs to change. It’s for every one of you in this room. Who’s here because you’re interested in global health and publishing to create change and to ask yourself the question of whether you know every advantage that flows to you whether it’s through authorship or participation on projects whether those advantages that flow to you or disadvantaging someone else and be very mindful about how you can be a part of what really really needs to change in terms of the production of knowledge. I’m gonna end there with two plugs one if you haven’t seen this I I’m excited to be the first person to tell you this just last week. The Lancet and our sibling journal indian medical journals, medical journals in india the lancet Child and Adolescent Health called four papers. Because we’re doing a special themed issue in March 2019. So if you have work please can look up this call for papers and kids consider submitting and secondly myself and some colleagues initiated the Canadian women in global health list. Some of you might be familiar with the women in global health movement. We decided it was about time there be a Canadian one that celebrates women’s achievements in Canada in all their diversity. The idea of this list which is kind of going to be a bit of a database is for journal indian medical journals, medical journals in india editors to find female peer reviewers for conference organizers to ensure they don’t have mammals for government to find technical experts if they’re looking to versified their networks and anyone else who would like to think that there’s only senior men available to participate in work.
We are going to deliver you a list of Canadian women in global health so your job is much easier to create that kind of diversity. The deadline for nominations is September 1st so. I encourage you to self nominate if you’d like or to nominate someone else. Thank you wonderful. And thank you for that insightful. And brutally honest look at the world of medical journal indian medical journals, medical journals in indias so we started a little late and we will have 15 minutes for questions. I’d like you to start thinking of your questions so maybe I can kick off Jocelyn while people are thinking of questions so you didn’t say very much about Clary journal indian medical journals, medical journals in indias which you know those of us who receive close to around 8 to 10 invitations every day how are the journal indian medical journals, medical journals in india editors and the groups addressing that because to some extent as you mentioned. I mean it’s a business and to a large extent. The solutions are within the medical publishing world as well well. I’ve written a lot about predatory journal indian medical journals, medical journals in indias but what I’ll say now is yeah I agree I mean I like you all get eight or ten or twenty emails every day. I I think there’s a couple of things. Editor associations have created new guidelines about assessing the quality and integrity of journal indian medical journals, medical journals in indias and one set of guidance in particular. You might find interesting comes from wammy the World Association of medical editors along with the open access scholarly publishers Association and this is intended for people concerned about how to detect a legitimate journal indian medical journals, medical journals in india versus a predatory journal indian medical journals, medical journals in india. There’s guidance there so that’s leadership on the part of editorial associations protecting the kind of attributes of legitimate journal indian medical journals, medical journals in indias and then there is another really interesting piece of work that I was involved in with David Moore the University of Ottawa and colleagues. Who also created a little bit of a checklist. So that people can appropriately identify a predatory journal indian medical journals, medical journals in india and then dismiss it but the broader question of how to get rid of predatory journal indian medical journals, medical journals in indias is a very very difficult one.
Because there’s really no. There’s no stopping them and in the absence of any kind of regulation or legal intervention. It seems unlikely that they’re going to change and there’s an enormous amount of demand for publishing in journal indian medical journals, medical journals in indias. I mean to be honest. It’s you know. Predatory journal indian medical journals, medical journals in indias exists partly because of an manipulation of the open access publishing model but they also are clearly a result of a publisher perish environment where people are under so much pressure to publish. That though you know have created this need for a supply of journal indian medical journals, medical journals in indias thank you. So we’ll start from that side user and then puckish just don’t thank you very much for their superb. Talk and congratulations on all you’ve achieved over the years. It’s a most impressive. I have one comment in one question if I may. My comment relates. That a big problem that you raised and showed that slide. That’s like a just as will show the disparities in health and human rights and and and throughout the world and it seems that the elephant in the room is seldom addressed and then is how the global political economy is purposely structured to maintain that kind of imbalance of which the journal indian medical journals, medical journals in indias and all of us in a sense remain apart but that is not as openly addressed as it could and it would seem to me that that’s a shameful neglect now to deal with those issues because all the addressing of global health is not going to be effective at least the global political economy is critically examined with a view to seeing what could be done and looking at that also about 20% of the world’s population consume 80% of the world’s resources and produce 70% of the global ecological footprint. And that is what’s going to determine the future of global health so that issue would seem to me is a crucial issue. My question relates the fact about ethics. There’s a lot of energy and effort have been diverted to producing ethical requirements for authors in medical journal indian medical journals, medical journals in indias.
What I’d like to ask you is is the set of ethical requirements for editors given the conflicts of interest and the embedding of journal indian medical journals, medical journals in indias within many conflicts of interest not least of which is the the corporate involvement in the financial world with editors is crucial. Would you agree yeah absolutely. I agree with both both your points entirely is the producer kind of useful. Yeah there is a code. I mean most professional editorial associations like Council for science editors world Association of medical editors the Committee on publication ethics which many of us are members of have codes of conduct for editors some individual journal indian medical journals, medical journals in indias also have policies by which editors declare publicly there are conflicts of interest my journal indian medical journals, medical journals in india the journal indian medical journals, medical journals in india. I work for now doesn’t but the previous journal indian medical journals, medical journals in indias I’ve worked for has had conflict of interest statements publicly posted on on the website which is one move toward transparency. Rakesh thank you thank you. Thanks for the great talk. You you you highlighted the issues with the impact factor. Can you from the other side of the world. Can you give an alternative. Yeah there’s a whole bunch of alternate kind of measures of impact if you will that have propped up. I mean some of them that are at the journal indian medical journals, medical journals in india level include things like the eigen factor there. There’s a there’s a whole bunch of them if you’re if you if you really would like to know. I can send you my list but but but the one that I think is most useful for you our article level metrics and. There’s one that is kind of collation of a bunch of article level metrics called alt metrics and many journal indian medical journals, medical journals in indias publish those alongside your article and that combines a number of citations number of wreaths number of downloads number of mentions in the press number of mentions in blogs or social media number of comments so it gives a kind of aggregate score to how well your article was received how it was actually read on top of that. I mean a just a much more basic thing that you can do that.
I encourage you to do when you do. Go up for your promotion and tenure and that sort of thing is simply a count of the number of citations or the count of the number of downloads. All of which these days are readily available either through the altmetrics site or through journal indian medical journals, medical journals in india websites. Themselves please how would you respond to someone who said that. You’re making a big mistake by latching on to a monetized ideologically driven scientific mode which actually undermines the integrity of the actual research being produced or contemplated because things like gender things like north-south that’s ideology that’s politics and if I’m a scientific researcher I will get hard evidence not politics or opinions. How would you respond to that criticism. Because it’s quite interesting that in your own journal indian medical journals, medical journals in india as you’ve intimated today you’ve had editorials or letters to the editor or articles. Even that are trying to deal with you know self-criticism open reflection editorially or but had you that encompass that which. I’ll be looking at later when if Abbott I’m but that to me is very interesting and quite fascinating because an academic journal indian medical journals, medical journals in india which a Lancet is knowing the publisher parish. We all know that but this this ideologically driven agenda. How would you respond to someone saying that. You’re making a big mistake doing that. I don’t I totally understand your question but my response to we’re making a big mistake is simply to disagree. I mean there’s no expectation there’s no expression on the part of this journal indian medical journals, medical journals in india that we are a value free enterprise and there’s no expectation or perception that you said hard science that hard science is value free. I mean everything that we do is political and we are a journal indian medical journals, medical journals in india. That doesn’t just publish scientific work but probably about half of the journal indian medical journals, medical journals in india contains commentary editorial material that raises questions and tries to keep its finger on the pulse of the key debates in health around the world and it would be impossible to do that without it would be impossible to do that thinking that that existed in some kind of social or political vacuum so.
I mean you call it ideology you know I suppose it is but we make no we make no you know there’s no illusion here this is. We are a campaigning. Journal indian medical journals, medical journals in india because health is political Jocelyn if I’m if I may ask you some of the moves in recent years on these open journal indian medical journals, medical journals in indias gates open or way compressed open journal indian medical journals, medical journals in indias is is an effort to perhaps democratize to some extent medical publishing but it does also place an enormous. You know dilemma on the shoulders of young researchers because if you put your papers out for comment and publish them in that it gets virtually zero recognition in terms of either impact most of those have very little to no impact for promotions. And what not what is within the world of medical publishing the balance between those two approaches one is to make everything totally open including data sets and the other to go the traditional route of velocity. New well okay. So you’re you’ve hit on something that I think is highly debatable. So your definition of impact is to publish in. Perhaps what you’re suggesting is in a particular brand name journal indian medical journals, medical journals in india which might be behind a paywall which nobody would read anyways. I think the motive behind things like gates open and welcome open is to meet the needs and the targets around communicating the research in an accessible way so if your target is dissemination and sharing and openness and accessibility then you have had impact by publishing in these more sort of innovative platforms that utilize the Internet. I mean that is one of the central kind of conundrums if you will when you look at this. The more the traditional model of journal indian medical journals, medical journals in india publishing and a traditional model of sharing of your work via the journal indian medical journals, medical journals in india that is an old traditional model. That has persisted outside of medicine that traditional system is has been completely disrupted.
I mean in the BA in biology ecology physics extraordinary so one of the points. I was trying to make that I reflect a lot on. I mean clearly. I’m in a role where and I relish this profession that I’m in where without your papers I wouldn’t have a job and journal indian medical journals, medical journals in indias wouldn’t survive but it doesn’t escape me that the the whole endeavor of science and research communication is completely transformative and in medicine we have just tended to be very very conservative. We haven’t utilized those technologies in the way that we could the fact that people still associate impact with traditional journal indian medical journals, medical journals in indias that take two or three percent of what they get versus getting such stuff out there on the internet. Still you know a lot of those platforms still have peer-review they still have editorial review and there then immediately available without any paywall. So you’re you’re touching on something that is exactly what I’m thinking about. It’s like where where are we in the universe. Why do we continue to thrive and what are the ways that we’re kind of lagging behind when it comes to openness in our scientific communication. I don’t I I mean again. This is a personal view but if I were the department head or if I was the Dean it would matter way more to me that my staff are doing good work and getting their papers published immediately rather than being published in brand-name journal indian medical journals, medical journals in indias great. I mean so. There is probably a way forward which might be a bit of a compromise. Stan last question last question I was actually and continued the question of my question before you answer the last one was that if I could guarantee you’re gonna have a job in 10 or 20 years. Can you give us your crystal ball on where medical publishing publishing is going to be and I’m gonna say 10 years maybe 20 years maybe even 50 years Jocelyn I realize you have a conflict of interest because as you just said you’re dependent on us for your job sending articles. Yeah yeah my sense is that this.
Traditional methodology is changing. Yeah and will change and it’s inevitable. So where is it going to be well. I think it’s gonna be very similar sadly because I think the question you’re asking I was asked. Or you know my predecessors were asked 10 or 20 years ago and we thought things would advance much quicker than they are but. I’ll tell you what I think is what’s most valuable about journal indian medical journals, medical journals in indias and where I think the most value for journal indian medical journals, medical journals in india editors can be and that’s in curation of content. I actually think eventually research is going to go to these alternate and newer platforms exactly the ones that Sophie mentioned and that’s driven a lot by funders so when zalfie mentions gates open. Welcome open those are the gates foundations own publishing platform and the Wellcome Trust own publishing platform. That’s they’re investing an enormous amount of money in that research being funded and they want that research disseminated. So they’re now they want to see the fruits of their investment be born and be widely disseminated and. I think in a lot of respects. They’re saying the traditional journal indian medical journals, medical journals in india publishing model isn’t meeting our needs but journal indian medical journals, medical journals in indias are very very good and where we add the most value is around the editorial content this series the Commission’s the commentaries the policy analyses pieces the editorials where we’re raising questions where we’re trying to legitimate chittim eight certain issues getting them on people’s radars getting them on the world’s agenda and I think we will continue to have that role and that’s I mean that’s a role I relish so I hope in 10 or 20 years even if all research now moves to different types of platforms you know. My publisher is sorry the publisher the journal indian medical journals, medical journals in india that I work for also is experimenting with those platforms so you might even see traditional publishers innovating in their kind of business practices to allow for that but the core work of a journal indian medical journals, medical journals in india. I think will continue to be will kind of be your newspaper or magazine.
The place where you go to learn about you know the most important questions you should be thinking about. We won’t be telling you what to think we’ll be asking you to think about certain things wonderful Jocelyn.
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