Transatlantic divide in publication of content relevant to developing countries.

argue that democracy may be the best protection against the harmful effects of globalisation. This view is supported by, for example, the tobacco industry's exploitation of the situation in countries with widespread corruption and a lack of functioning democratic systems, 11 contrasted with the industry's growing record of failure when faced by democratic governments. So does the experience of the former Soviet bloc support the hypothesis that democracy is good for health? Although there have been winners and losers among populations everywhere, regardless of the progress towards democracy that their governments have made, 12 it seems that democracy is good for health. life expectancy in central Europe: is there a single reason? Although 112 countries now receive 2200 medical journals free or at reduced prices, improving access to information on obesity is of little value to physicians treating patients dying of malnutrition. Ninety per cent of the US$70bn (£38bn; €54bn) spent annually on health research is focused on the diseases of 10% of the world's population. 1 Researchers in eight industrialised countries produce almost 85% of the world's leading science; 163 countries, including most of the developing world, account for less than 2.5%. 2 Less than 8% of articles published in the six leading tropical medicine journals in 2000-2 were generated exclusively by scientists from developing countries. 3 Medical journals cannot single handedly right these inequities, but they have an important role to play. The BMJ's ethics committee identified publication of content relating to developing countries as an important ethical issue to examine. Our objectives were to review the relevance of the contents of four leading medical journals to developing countries, compare the journals, and observe trends. Summary points Countries in transition from communism provide valuable information on the effects of democracy on health Health improvements have been greatest in countries that have embraced democracy most enthusiastically Lack of democratic structures in some countries of the former Soviet Union acts as a barrier to the implementation of healthy public policies Content relevant to developing countries of four leading medical journals in January 2002 and January 2003. Values are numbers of articles relevant to developing countries/all published articles in that category (percentages)