[MONTEVIDEO, SciDev.Net] Decisions about what gets researched, published, and funded in tropical medicine remain largely in the hands of wealthy countries, driven by deep inequalities in the editorial boards of the main journals in the field, according to a new analysis.
In a review of 24 journals with a total of more than 2,000 board members, two thirds of these were men, while more than half were from high-income countries, and less than three per cent were from low-income countries.
Europe, North America and East Asia account for the majority of board members, while regions more affected by tropical diseases remain heavily underrepresented, namely Latin America (16 per cent), Sub-Saharan Africa (11 per cent), South Asia (10 per cent), and the Middle East and North Africa (3 per cent).
This disparity between rich and poor countries “can skew the lens through which research is assessed”, Manish Barik, researcher at the George Institute for Global Health, in Hyderabad, India, and author of the study, told SciDev.Net.
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“Contextually rich, locally grounded studies might be undervalued. Editorial decisions may lean toward topics or methodologies more aligned with Global North perspectives, possibly sidelining community-led innovations, local expertise or urgent regional issues.”
According to Barik, it is editors based in more affluent countries who decide what gets published — even on diseases that predominantly affect poorer countries — reinforcing long-standing power imbalances in global health.
The study says this risks trivialising tropical diseases as geographically confined issues, despite evidence that climate change, migration, and global inequities have expanded their reach beyond the tropics.
For Marilia Sá Carvalho, co-editor-in-chief of Cadernos de Saúde Pública, a journal published in Brazil, the lack of diversity in editorial boards can lead to the overlooking of important issues for certain regions of the world.
“If a disease is very common in the northeast of Brazil, for example, but it is not on the radar of scientists in the United States or Europe, it may be considered irrelevant and not published,” she told SciDev.Net. “How can we know if a topic is relevant or not if there are no researchers on the editorial board who are familiar with the local reality?”
The study was based on information on editorial board membership from official journal resources or their institutional profiles available in the public domain between October 2024 and December 2024.
The analysis highlights a marked gender disparity with 66 per cent of board members identified as men.
It also highlights a geopolitical divide: 40 per cent of board members come from G7 countries and two-thirds from G20 countries, while the BRICS countries — including Brazil and India, major producers of tropical health research — represent less than a quarter.
Funding inequities
These disparities also affect funding, threatening to misalign resource allocation from global disease burdens.
According to the authors, global funders allocate 75 per cent of direct and 70 per cent of indirect neglected tropical disease funding to leading institutes in non-endemic nations. As a result, infrastructure in these countries is modernised “while perpetuating colonial legacies through sample collection in low-income countries”, according to the authors.
About 85 per cent of the world’s population live in low- and middle-income countries, yet their voices are marginalised when it comes to setting research agendas, the researchers say.
“This imbalance risks creating a ‘Western outlook’, where priorities of high-income countries overshadow diseases of poverty, as seen in historical biases against neglected tropical diseases,” the authors wrote in the paper.
They say diversity in editorial boards is not just symbolic, it is “essential for aligning research priorities with the needs of the populations most affected by tropical diseases”.
Barik added: “It’s a matter of epistemic justice — those closest to the problem should also have a seat at the table in knowledge production and gatekeeping.”
Marco Coral-Almeida, professor at the Universidad de Las Américas in Ecuador and deputy editor of PLOS Neglected Tropical Diseases, told SciDev.Net: “For the first time, they quantify something that in Latin America had only been speculative.”
The underrepresentation of voices from low- and middle-income countries “has major implications, as many of these articles don’t remain solely within academic circles —they also inform public policy, research priorities, and even health interventions”.
“If Latin American voices are not sufficiently represented, the risk is that local realities and needs are underestimated — or worse, misinterpreted,” he added.
However, some publications say they are making progress in this area.
Colombian Alfonso Rodríguez Morales, editor in chief of the journal Emerging Tropical Diseases at Frontiers in Tropical Diseases, said: “In our journal, through various initiatives, we have promoted the participation of the Global South in production, review, and editing.
“As editor in chief of a high-impact journal in this field, I am proud to participate as a Colombian, while also working with associate editors and members of the editorial board who are from the Global South, particularly Latin America and Asia.”
Colonial roots
Soumyadeep Bhaumik, adjunct professor at the Walter Sisulu University, South Africa, and head of the meta-research and evidence synthesis unit at the George Institute for Global Health, Australia, who did not participate in the study, says the field of tropical medicine is rooted in its colonial past.
“While political freedom has been achieved, the knowledge ecosystem in the field remains controlled by global North actors,” he told SciDev.Net.
“There have been calls for decolonising global health and many reforms underway including by funder[s]. However, this is not the case for the field of tropical medicine.”
He says the study’s focus on editorial boards is an important one as “editors are the gatekeepers of the knowledge ecosystem”.
Bhaumik authored a 2019 study on diversity in the editorial boards of global health journals, which also found that journals could improve significantly in terms of gender, geography, and income-level representation.
Alejandro Llanos-Cuentas, a physician and emeritus professor at the Alexander von Humboldt Institute of Tropical Medicine at the Cayetano Heredia University, in Peru, who did not participate in the research, emphasised the relevance of the study but pointed out some limitations.
He says a study on this topic “requires a holistic perspective and analysis over time”.
The authors of the study propose adopting mandatory structural diversity, equity, and inclusion policies to ensure equitable representation in terms of gender, geography, and income level — particularly in high-impact journals.
They also suggest implementing mentorship programmes to support researchers from low- and middle-income countries, with targeted training and inclusive language policies to help overcome entry barriers, and increasing transparency in recruitment processes to prevent bias in the composition of editorial boards.
Barik believes that building partnerships between rich and poor countries would help identify local editorial talent. He says the knowledge held by scientists and health workers in countries where tropical medicine occurs must be given more credibility.
“We need to fund scientists in countries where tropical diseases actually occur, not in distant lands,” he said.
This piece was produced by SciDev.Net’s Global desk.