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Let’s talk about global health journals

By on February 19, 2015

Seye Abimbola is a PhD candidate at the School of Public Health, University of Sydney, Australia and a research fellow at the National Primary Health care Development Agency, Abuja, Nigeria

In many ways, those of us who are academics live for scholarly journals. The research and commentary published in them are what we are judged by; the measure of an academic’s value, a false and perverse measure no less. Journals set the debate (or have the power to do so), arbitrate which knowledge is legitimate, what the right methods are, what the consensus is, the right way to report research, et cetera. But despite their centrality and power, we don’t talk about them much in global health. I will focus here on three bits of news items in the last couple of weeks relating to journals.

First is a blog post by Griewe Chelwa, titled “Economics has an Africa problem.” The author, a PhD candidate in economics at the University of Cape Town, showed that the most important journals in the field of economic development (e.g. the Journal of Development Economics, the Journal of Economic Growth, and the Journal of African Economies) do not have editorial board members who are based in Africa. The blog is worth reading in full. Things are not as bad in global health, but we definitely can do much better than we do now.

Second is an editorial statement on negative findings made by elite health economics journals, all eight of them based in Europe or the US, pledging to publish studies “regardless of whether empirical findings do or do not reject null hypotheses.” This promise to stop distorting the literature will hopefully lead to better policymaking, and I wish journals in global health and development will make such a commitment. These health economics journals will now welcome studies, as long as they are “well-designed, well-executed empirical studies… compatible with each journal’s distinctive emphasis and scope.” I lingered on that phrase “distinctive emphasis and scope” and wondered who determines the “distinctive emphasis and scope” of a journal.

This leads to the third item. In next month’s editorial in Health Promotion International, the editor Evelyne de Leeuw asked readers (including “activist health promoters”) for ideas on how to establish “a user panel that would advise on urgency, prominence and relevance of the material we should cover.” She gave the example of the BMJ which recently established a patient panel to advise on the “end user relevance” of what the BMJ publishes. Kudos to these two journals. But why did it take these well-established journals so long to seek the input of their end users, and why have others not yet done the same?

Who are the end users of global health journals, and do they have a say in determining the “distinctive emphasis and scope” of the journals? The answer, whatever it is, will say a lot about the balance of power, of knowledge and of influence in global health. The colonial heritage of global health and development makes it such that the balance often tilts in the favour of perpetuating colonial relationships with poor countries. The days of colonial medicine are over; so should colonial practices among journals in global health and development.

One strong argument of the Open Access movement was that journals were denying access to researchers and policymakers in poor countries for which many publications will be most useful. Now is time for a new movement, to push for transparency in the process by which journals determine their “distinctive emphasis and scope,” a movement about Open Agenda Setting. It is not enough to have people from poor countries on editorial boards; many global health journals already do. It is more important to have a commitment to not privilege one kind of evidence, methods, results, audiences or authors over another, but to primarily take into account the kind of knowledge that is useful for policymakers and implementers in poor countries, the supposed end users.

Health Promotion International is trying out some sort of crowd sourcing. They are inviting ideas on how to engage their end users. They also want nominations from the “next generation of scholarly and activist health promoters” to join their editorial board. Please consider contacting the editor, Evelyne de Leeuw (EIC-HPI@vichealth.vic.gov.au) to make your ideas and intentions known. I hope other journals, particularly in global health and development, will follow their example. Bottom line is we need to start shining a light on the policies of global health journals and holding them to account for their practices. The health and development of people in poor countries may be better for it.

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