This issue marks 20 years of publication of The Lancet Infectious Diseases. In the issue, we publish two Reviews that reflect themes from the journal's first year of publication. The first paper published (in the April, 2001, preview issue) was a Review of the history of hand hygiene by Didier Pittet and John M Boyce. In this issue, Pittet and colleagues (with Nasim Lotfinejad as first author) return to this life-saving topic in infection control with a Review of 20 years of progress in promotion of hand hygiene. The terrorist attacks on New York, NY, and Washington, DC, USA, of Sept 11, 2001, and soon after anthrax spores sent through the US mail, were dominant events in the months after the launch of the journal and led to a huge increase in funding for biodefence research. Carrie M Long and Andrea Marzi assess the outcomes of that investment, highlighting the impact on responses to Ebola virus disease outbreaks and the COVID-19 pandemic.
Over two decades, seldom a year has passed without news of an emerging infectious disease outbreak with global ramifications, from SARS in 2003 to influenza A H5N1 from 2004, pandemic influenza A H1N1 in 2009, Ebola virus disease in west Africa in 2013–16, Zika virus disease in the Americas in 2015–16, and now the COVID-19 pandemic. Yet, as the Editorial in our first issue of August, 2001, discussed, the greatest infectious diseases threat of all might be the emergence of organisms resistant to antimicrobial drugs. Indeed, three of the five most highly cited items published by the journal relate to antimicrobial resistance: Yi-Yun Liu and colleagues on the plasmid-mediated colistin resistance mechanism MCR-1, ranking first with 2513 citations at the time of writing; Karthikeyan Kumarasamy and colleagues on the NDM-1 resistance mechanism, fourth with 2042 citations; and the antibiotic resistance Commission by Ramanan Laxminarayan and colleagues, in fifth place with 1964 citations. Although the antimicrobial resistance crisis is now even more pressing than it was 20 years ago, it has at least moved from a fringe concern onto the international political agenda.
Second among the journal's most highly cited items is a letter by Ensheng Dong and colleagues describing how the Johns Hopkins University COVID-19 dashboard was created. Its 2408 citations in just 17 months from publication is a remarkable rate of accumulation. But emergence of the COVID-19 pandemic in 2020 produced the most remarkable year in the journal's 20 year history. We received 6760 submissions, a 3·75-times increase over 2019; website article views or downloads, which had been at about 2 million per year, increased to almost 18 million; indeed, Dong and colleagues’ Correspondence has been downloaded almost 2 million times. In a reflection of an infectious disease being the focus of public consciousness, followers of the journal's Twitter account (@TheLancetInfDis) have almost doubled to more than 53 000 since the end of 2019. We and other journals in The Lancet family have been the subject of intense public scrutiny. Some of the work we have published has been cynically mischaracterised and the motives of editors maligned during the infodemic that emerged with COVID-19. Yet there is clearly a positive public interest in science not seen before in the journal's history, and even when the pandemic is a memory the scientific community must continue to engage with this new audience.
Since its launch, the journal has had readers from more than 200 countries and territories, welcomed advice from peer reviewers from more than 144 countries, and received submissions from 184 countries. Although high-income countries continue to provide the bulk of submissions, there has been considerable diversification, with submission increasing ten-fold from countries such as India, Pakistan, Iran, and Brazil, and a remarkable 100-fold from China. Nevertheless, we welcome additional submissions from authors in low-income and middle-income countries. In another positive recent trend, first, last, or corresponding authors of our published research articles have been close to 50% female, and there is now an equal split between sexes in membership of the journal's international advisory board (IAB). We thank the many readers, authors and other contributors, peer reviewers, IAB members, editors past and present, and Lancet colleagues who have contributed to the success of the first 20 years of The Lancet Infectious Diseases.
Scientific advances over the past 20 years have culminated in a pandemic response that has seen viral spread and evolution tracked in near real time, the development of a suite of vaccines at unprecedented speed, and the execution of platform trials that have allowed rapid insights into disease treatments. The next 20 years will test whether we have the societal will to use these tools to meet the enduring challenges of infectious diseases.
