BMC Medical Ethics
Under-representation of developing countries in the research
literature: ethical issues arising from a survey of five leading medical
Athula Sumathipala*1,4, Sisira Siribaddana2,4 and Vikram Patel3
Address: 1Section of Epidemiology, Institute of Psychiatry, Kings College, London SE5 8AF UK, 2Sri Jayewardenepura Postgraduate Teaching
Hospital, Thalapathpitiya, Nugegoda, 10250, Sri Lanka, 3London School of Hygiene & Tropical Medicine, London, UK and 4Forum for Research
and Development in Sri Lanka
Email: Athula Sumathipala* - email@example.com; Sisira Siribaddana - firstname.lastname@example.org; Vikram Patel - email@example.com
* Corresponding author
Published: 04 October 2004
BMC Medical Ethics 2004, 5:5
Received: 22 April 2004
Accepted: 04 October 2004
This article is available from: http://www.biomedcentral.com/1472-6939/5/5
© 2004 Sumathipala et al; licensee BioMed Central Ltd.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: It is widely acknowledged that there is a global divide on health care and health
research known as the 10/90 divide.
Methods: A retrospective survey of articles published in the BMJ, Lancet, NEJM, Annals of Internal
Medicine & JAMA in a calendar year to examine the contribution of the developing world to
medical literature. We categorized countries into four regions: UK, USA, Other Euro-American
countries (OEAC) and (RoW). OEAC were European countries other than the UK but including
Australia, New Zealand and Canada. RoW comprised all other countries.
Results: The average contribution of the RoW to the research literature in the five journals was