One of the millennium development goals of the United Nations is the reduction of child mortality by two thirds by 2015.¹ Academic and research institutions, and professional and scientific associations must contribute their efforts and expertise to child survival and should place their power and credibility behind the child survival agenda.¹ Medical journals have an important role in this effort, but their credibility concerning the problems of the developing world is questionable. Richard Horton, editor of The Lancet, stated that there is widespread systematic bias in medical journals against diseases that dominate the least developed regions of the world,² an argument also brought forward by researchers from these regions.³ As a first step towards examining the objective basis for this claim, researchers from the World Health Organization investigated the composition of the editorial boards of leading psychiatry journals and found an under-representation of individuals from developing world countries.³ General medical and tropical medicine journals followed the same pattern.^2,4

In this study, the composition of the editorial boards of leading general paediatric journals was investigated to evaluate the situation in paediatrics.

METHODS

The leading journals in the field of general paediatrics were defined as all journals that were included in the “Pediatrics” category of the 2003 Journal Citation Report, Science Edition, and that were general paediatric journals; speciality journals such as Pediatric Cardiology were excluded. The geographical composition of the editorial boards of these journals was retrieved from their electronic homepages in February 2005.

The countries in which the board members are currently based were classified according to their Human Development Index (HDI), which combines measures of life expectancy, school enrolment, literacy and income to allow a broader view of a country’s development than does income alone (Human Development Report 2004; http://hdr.undp.org/).

RESULTS

Of the 68 journals from the ‘Pediatrics’ category of the Journal Citation Report, 11 remained for further analysis once the criteria used for the definition of leading general paediatric journals were applied, and in total, 207 editorial board members were found. Of these, 198 (95.7%) were based in countries with a high HDI and 8 (3.9%) in countries with a medium HDI. No board member was based in a country with a low HDI. One member of the International Advisory Board of the journal Pediatrics International is currently based in Taiwan, which is not classified in the Human Development Report 2004 and therefore has no HDI. Results for each journal can be found in table 1 (for more detailed results refer to the supplementary material; available from the Archives of Diseases in Childhood website at http://www.archdischild.com/supplemental).

DISCUSSION

The analysis of the composition of the editorial boards of leading general paediatric journals reveals that 95.7% of their members are based in countries with a high HDI, 3.9% in countries with a medium HDI, and none in a country with a low HDI. These results are in accordance with previously reported figures.^2–4 While Horton found that only 1.8% of editorial board members of leading general medical journals were from countries with a low HDI, and 5.4% from countries with a medium HDI, 92.8% of the members were based in countries with a high HDI.² The figures for leading tropical medicine journals are slightly better, with 70.8%, 24.1%, and 5.1% for countries with high, medium, and low HDI, respectively.⁴ Therefore, the numbers for leading general paediatric journals are the worst.

The theory that a low proportion of editorial advisers from developing countries is evidence of a bias against the work of researchers from this part of the world, remains to be proven.⁵ Keiser et al showed that in tropical medicine journals, the proportion of authors from developing world countries is higher than the proportion of researchers from these countries on the editorial boards of these journals.⁴ In addition, the content of a journal may reflect issues related to poor countries irrespective of the composition of its editorial board. Therefore, a limitation of this study is that the content of the leading general paediatric journals was not evaluated. It must also be kept in mind that editorial boards have a variable part to play in decision making about research papers and editorial policy, with some having little influence.² Their influence on what kind of manuscripts are submitted is probably even smaller.

The importance of editorial boards lies in the fact that they can help to shape the personalities of journals, and that their composition sends a signal to authors and readers about a journal’s interest.² Concerning the composition of editorial boards of leading general paediatric journals, the signal sent out to researchers in the developing world is not encouraging, and indeed, tends to support the theory of an editorial bias against the problems of the developing world.