EDITORIAL

Scientific output and impact in Public Health

During the last decades the country has witnessed a noteworthy expansion and consolidation of graduate studies in Public Health. This expansion has been followed by the emergence of new research groups and lines of research, many of which deal fundamentally with the numerous challenges posed by public health at the regional level. Depending on a set of factors (research theme, methodological approaches, institutional context of the research group), it is well-known that given researchers can enjoy greater or lesser ease in publishing their work in what are considered the more prestigious international journals. Due to the delicate balance between "global" and "regional" interests in science, a more in-depth discussion is urgently needed on the evaluation of scientific output in the broader health field and especially that of Public Health. After all, who sets our research agendas?

A study recently published in the Canadian Medical Association Journal by Rochon and colleagues (v. 170, p. 1673, 2004) analyzes articles published in six renowned journals. In addition to the CMAJ itself, the study includes Ann Intern Med,BMJ,JAMA,Lancet, and N Engl J Med. The choice was based on recognition of the influence these publications can bring to bear on setting international research agendas and therefore lines of research funding, among other priorities. Specifically, the study analyzes the relationship between the global burden of disease and injuries or diseases researched in a total of 286 control trials. The authors concluded that many important diseases in the determination of the global burden of disease in numerous developing countries are heavily underrepresented. Only one-third of the studies on HIV/AIDS were conducted in countries outside North America and Europe. Important endemic diseases with a strong presence in the morbidity and mortality profile of numerous countries were the object of very few investigations.

This study does not emerge as an isolated case. It adds to the critical literature which has repeatedly identified the gap between the research agendas predominating in so-called "state-of-the-art science" and daily public health demands around the world, especially in the Third World countries. This orientation is obviously reflected in the editorial policies and lines prevailing in the major medical journals published in the Anglo-Saxon world. In this context, scientific journals published in the developing countries play a strategic role in disseminating the scientific output produced by the latter, in keeping with the research lines and priorities set there. Brazil exerts great influence in this process, not only due to its significant scientific output, but also because it accounts for the largest number of journals in the health field published in Latin America.

It is important that the Brazilian agencies, universities, and research institutions that have sought to implement mechanisms for the evaluation of scientific output recognize and support Brazil's scientific journals. Great care is required in this field. As I recently had the opportunity to highlight, with the purpose of qualifying scientific journals (and by extension, the articles published therein), an indicator has been adopted and rapidly disseminated in Brazil, known as the "impact factor", until recently scarcely known in the country. Even if the "impact factor" is sensitive for evaluating journals in given areas of knowledge, there are many doubts about its suitability for Public Health. The discussion is dense, but it is debatable whether editorial output in this area can be measured by such a simplified bibliometric parameter.

Scientific publishing is an intrinsic part of the process of producing scientific knowledge and innovation. Strengthening of Brazilian national scientific journals is a sine qua non for the ongoing advancement of Brazil's science and technology base. It is indispensable not only to allocate resources, but also to promote creative exercises for evaluating scientific output, beyond the absorption and replication of criteria which, as has been shown, cannot be generalized to all areas of knowledge.

Carlos E. A. Coimbra Jr.

Editor