The NEJM and the developing world
A recent article highlights how the diseases of resource-poor nations are under-reported in the world's most prestigious medical publication, the New England Journal of Medicine. Bernard Lown and Amitava Banerjee reviewed 416 issues of the NEJM over an eight year period, from January 1997 to December 2004, and found that less than 3% of the articles were relevant to developing countries. Just when people are starting to become familiar with the 90/10 gap -- that 90% of health research expenditures worldwide are devoted to diseases afflicting only 10% of the earth's population -- now we have a 97/3 gap in health research publishing and the NEJM is its unfortunate poster child.
As the authors point out, NEJM is not solely to blame for this. Global socio-economic inequalities inhibit quality research in developing countries by its own citizens, and the NEJM is not the only major medical journal that slants its content towards the interests of its subscription base and advertizers. But the underlying theme of the article seems to be: in an increasingly interconnected world, where health inequalties cannot be ignored, and new journals and centers for global health are springing up like mushrooms, the NEJM has to broaden its scope if it is not to lose its relevance.