Collective voices: the role of medical journals in advocating for global health

When medical journals take action collectively it can be very powerful. Two articles in this issue of the MJA highlight what these actions can look like, and their effects.

An editorial on the role of health professionals in reducing the risks of nuclear war was authored by an international group of editors, including myself as Editor‐in‐Chief of the MJA (doi: 10.5694/mja2.52054). It will be published by over 100 journals worldwide. Its topic could not be more urgent — the effect that the use of nuclear weapons would have on our world and the role of medical professionals in speaking up about this. Although nuclear weapons might seem to be a topic that lives primarily in the realm of international politics, medical professionals have a long and distinguished history of effectively advocating against nuclear weapons. The 1985 Nobel Peace Prize was awarded to the International Physicians for the Prevention of Nuclear War (IPPNW) for their work in educating policy makers and the public about the medical consequences of nuclear war at a time of heightened global tensions during the Cold War. The IPPNW's subsequent campaign — the International Campaign to Abolish Nuclear Weapons — expanded advocacy to include many other groups, leading to the adoption of the Treaty on the Prohibition of Nuclear Weapons in 2017. The Treaty has 92 signatories, including 68 member states; Australia is not a signatory.1 As the editorial notes, we are now again in especially dangerous times with global instability in Ukraine: “Any use of nuclear weapons would be catastrophic for humanity. Even a ‘limited’ nuclear war involving only 250 of the 13 000 nuclear weapons in the world could kill 120 million people outright and cause global climate disruption leading to a nuclear famine, putting 2 billion people at risk.” There could not be a more important public health message for medical journals to disseminate.

More closely related to the day‐to‐day work of medical journals is their role in maintaining the quality and integrity of medical research literature. In 2004, the International Committee of Medical Journal Editors (including the MJA) decided to require the registration of all clinical trials if they were to be published in their journals.2 This step, initially by a small group of journals, was a key part of improving the evidence base in medicine by making it less likely that only positive trials would be published in medical journals. Trial registration is now accepted as the norm, including at the MJA. The perspective by Seidler and colleagues reviews the clinical trial landscape in Australia, which is based on data from the Australian New Zealand Clinical Trials Registry (ANZCTR) and which captures over 95% of registered trials occurring in Australia (doi: 10.5694/mja2.52059). Of particular interest, they note how more early phase trials are being captured through trial registration — which is especially important to minimise waste in early stage clinical research. They also comment on the role of trial registration in supporting open science: “Prospective trial registration is another important cornerstone of the open science movement which the ANZCTR is promoting and facilitating”. The global open science movement has gained momentum in recent years through the UNESCO Recommendation on Open Science,3 and it is now increasingly clear that journals need to be part of this.

Ultimately, these articles highlight the importance of collective voices, including of journals such as the MJA, in advocating on the major global medical challenges of our time.