Aspiring to be global

The British can seem strange. Martin Amis, one of Britain's most successful authors, describes how his father, another successful author, was introduced in Nashville: “ ‘We have another gentleman from Britain with us tonight,’[said the chairman], displaying the modest pride of a provincial zoo official who reveals its possession of not one but two Arabian oryxes” (p 319).

Perhaps the BMJ seems similarly strange to our readers in Nashville (if we have any), but we aspire to be as international as air or water. We want to be as useful in Nashville as in Nantwich and as comprehensible in Calcutta as Colchester. We thus feel very good about this week's journal, where all of the five original articles in our papers section come from outside Britain.

Two of the articles deal with diarrhoeal and respiratory disease, which each year kill millions of children in the developing world. Fewer than 40% of infants under 3 months are exclusively breast fed in Latin America, and an ecological study suggests that exclusive breast feeding of all infants under 3 months and partial breast feeding through the rest of infancy would prevent 52 000 deaths a year across the region (p 303). Meanwhile, a randomised controlled trial conducted in the slums of Dhaka, Bangladesh, shows that combining zinc and vitamin A will reduce the prevalence of persistent diarrhoea and dysentery in young children (p 314).

A paper from the World Health Organisation describes how it developed a method for comparing the efficiency of health systems (p 307). League tables are always controversial (particularly for those at the bottom), as Martin McKee discusses in an editorial (p 295), but they are a good way of getting the attention of politicians and the media. Unfavourable comparisons of the British system with various other European systems—particularly the French—seem to have been a major driver of reform in Britain.

Although the BMJ aspires to be more international, we cannot forget that we reach 80% of doctors in Britain. Sometimes it's important for us to be parochial, and we hope that readers from outside Britain will forgive us. You might skip over the pages, or maybe you'll be intrigued by what the oryxes are up to. A good example is a group from Nottingham examining the highly vexed question of whether singlehanded general practitioners offer a poorer service than those in group practices (p 320). They don't.

The one place where the BMJ tends to be irretrievably British is in our obituary columns, but we want to carry more obituaries of those from outside Britain. We are thus honoured (hardly pleased) to carry the obituary of Shibtosh Roy, a paediatrician from Bangladesh, who did internationally important work on water contamination by arsenic (p 345).