Editor—Despite research in tropical medicine being undertaken in countries from low human development index, authorship and editorial opinion remain with countries from higher development index. This unfair trend observed by Keiser et al demands to be addressed and overturned.1
Figure 1.

Credit: BETTY PRESS/PANOS
This observed bias may arise because countries of high human development index fund the bulk of research in tropical medicine.2,3 Authors from these countries have prepared the grant applications, taken principal investigator status, and believe that they should take primary or terminal authorship. Researchers from low human development index countries can break this cycle only if they can obtain international funding themselves or are allowed authorship by the principal investigators. It seems this is rarely extended to the collaborators in tropical countries, even though they are the ones practically conducting the study.
If such generosity in authorship and mentorship were provided, this would enable researchers from low human development index countries to become successful principal investigators, obtain funding, and be invited to the editorial board of respected journals. Keiser et al could have examined the funding source of the published research articles against authorship country of origin to see if this was confounding.
We are sure that these publication biases are not just restricted to tropical medicine. Consequently, we strongly advocate this approach be delivered uniformly across all clinical disciplines to support research and researchers in countries of low human development index, who are concurrently tackling substantial healthcare inequalities and unremitting disease,4 and deservedly need greater support.
Competing interests: None declared.
References
- 1.Keiser J, Utzinger J, Tanner T, Singer BH. Representation of authors and editors from countries with different human development indexes in the leading literature on tropical medicine: survey of current evidence. BMJ 2004;328: 1229-32. (22 May.) [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Remme JH, Blas E, Chitsulo L, Desjeux PM, Engers HD, Kanyok TP, et al. Strategic emphases for tropical diseases research: a TDR perspective. Trends Parasitol 2002;18: 421-6. [DOI] [PubMed] [Google Scholar]
- 3.Global Forum for Health Research. 10/90 report on health research 2003-2004. 10 May 2004. www.globalforumhealth.org (accessed 29 Jun 2004).
- 4.Morel CM. Neglected diseases: under-funded research and inadequate health interventions. Can we change this reality? EMBO Rep 2003;4(suppl 1): S35-S38. [DOI] [PMC free article] [PubMed] [Google Scholar]
