AFRO-NETS> Africa's visionary editor

[Dr Rana Jawad Asghar <jawad@alumni.washington.edu>]

Africa's visionary editor
-------------------------
by Gavin Yamey
 
BMJ 2003; 327:832 (11 October)
http://bmj.bmjjournals.com/cgi/content/full/327/7419/832
Download as Adobe PDF file at:
http://bmj.bmjjournals.com/cgi/reprint/327/7419/832
 
 
Professor James Tumwine launched an African medical journal two 
years ago that is already indexed on Medline
 
Professor Tumwine, associate professor of paediatrics at Makere 
University, Kampala, Uganda, was just 14 years old when his eye 
for a good story first caused a stir.
 
He was editor of his school newsletter, and every day his edito-
rial team would post news stories on the school notice board. One 
weekend he went to a village dance. "There was a gramophone play-
ing the cha-cha-cha," he recalls, "and two of our teachers were 
there. It was below their status to go to this type of dance." So 
he was astonished to see them there.
 
He posted this "great news" the next Monday. The headmaster 
called an assembly, condemned James for his outrageous lack of 
discipline, caned him, and suspended him for a month, including 
two weeks of hard labour in which he had to hoe a section of dry 
earth. "It was my first time getting into trouble as an editor."
 
Professor Tumwine, a specialist in paediatric infectious diseases 
and formerly Oxfam UK's health adviser for the Africa region, is 
causing trouble again. Frustrated by the lack of medical journals 
that will publish the work of African researchers, he ignored his 
detractors and in August 2001 launched a new journal for research 
on health and development, African Health Sciences.
 
Eminent professors had said to him, "Who do you think you are 
trying to start a new journal? It's a crazy idea. This is a poor 
country." Though time and money were scarce, he was convinced 
that there was enough local talent to "achieve something for 
Uganda."
 
His own faculty members, he thought, deserved to have a credible 
forum for publishing their research. "We have the brains," he 
said. "We are doing a lot of important research. But journals in 
the `north' aren't interested in our work." He was fed up with 
the "hypocrisy" of journals in developed countries such as the 
BMJ and Lancet telling him and his colleagues that their research 
was "a good piece of work" but they could not publish it.
 
He was also fed up with the fact that, working in Africa, he had 
almost no access to health information published in journals in 
developed countries. For example, when the World Health Organiza-
tion asked him to help investigate a mystery illness in southern 
Sudan called "nodding disease," in which affected children get 
seizures when they eat, he could not gain access to research ar-
ticles on the disease, either in print or online.
 
"At meetings in Geneva, people say that we in Africa should be 
able to get everything online. But we have local internet prob-
lems, many journals aren't easy to access because you need a 
password, and it costs $600 [£360; ?515] a year for the internet. 
How many people can afford this? So I thought, `Let's publish in-
formation ourselves.'"
 
Professor Tumwine's strategy was to create a local editorial 
board made up of people "who wanted to move things forward," to-
gether with some "big names" to give the new journal stature. He 
asked a team of international advisers to help, though he says 
they were sceptical about whether a new African journal would 
succeed.
 
Why not, they suggested, just team up with another regional jour-
nal? "But the regional journals weren't serving us," said Profes-
sor Tumwine. "When we sent them a paper, it took two years to get 
a reply." Or how about reviving the defunct Ugandan Medical Jour-
nal owned by the Ugandan Medical Association? "I refused, because 
the association was conservative and poorly resourced."
 
African Health Sciences is being published not by a medical asso-
ciation but by the faculty of medicine at Makere University, 
which covers the printing costs-about $2000 per issue. The fac-
ulty, he said, allowed him the flexibility he needed. "An editor 
needs leeway. I had a lot of freedom."
 
The journal quickly became talked about. The US National Library 
of Medicine recognised that it was filling a vital niche and in-
dexed it on Medline in April 2003.
 
For the time being paper journals are still the only way for doc-
tors in most of Africa to read research related to health. The 
journal is sent largely to doctors in rural hospitals, and ab-
stracts are freely available online 
(www.inasp.info/ajol/journals/ahs). In the long run, Professor 
Tumwine hopes that the Ministry of Health will buy the journal 
for doctors in Uganda and that other funds will come from sub-
scriptions.
 
He also believes that there could be a renaissance in medical 
journals across Africa if editors start collaborating. This kind 
of networking and sharing of experiences will be made easier by 
the recent creation of the Forum for African Medical Editors, 
which was officially launched last week in Addis Ababa and which 
Professor Tumwine chairs. "We want a credible network of medical 
editors publishing journals relevant to Africa and contributing 
to solving health problems."
 
The forum grew out of a meeting in Geneva in October 2002, organ-
ised by WHO's special programme for research and training in 
tropical diseases, that explored ways to improve the quality and 
dissemination of African medical journals. The forum now has a 
constitution and has published its own guidelines for editors.
 
African journals can learn from journals in developed countries, 
said Professor Tumwine. "We can learn how they make decisions, 
how they ensure quality, what their business model is. The BMJ 
could help train our people." The BMJ has officially twinned with 
African Health Sciences and has supported a training course for 
19 African medical editors in Addis Ababa.
 
"But we're not trying to become the BMJ," he said. "We want to 
become the leading journal in Africa. I'm not interested in be-
coming `BMJ East Africa.' I want my own identity, my own priori-
ties."
 
He seems delighted by the controversy that his journal has al-
ready provoked. A national newspaper, the New Vision, picked up 
one study showing that about half of chloroquine tablets and in-
jections in Uganda are fake or substandard ( African Health Sci-
ences 2003;3: 2-6 [Medline]). A study showing that university stu-
dents know how sexually transmitted diseases are spread, yet do 
not practise safe sex, raised a few eyebrows in this socially 
conservative country ( 2001;1: 16-22).
 
With his lifelong rebellious streak and an editorial vision that 
cannot be clouded, there seems little danger that any journal in 
the developed countries could ever dictate Professor Tumwine's 
agenda.

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