Llamamiento a adoptar medidas urgentes para limitar los aumentos de temperatura en el mundo, restablecer la diversidad biológica y proteger la salud / Call for emergency action to limit global temperature increases, restore biodiversity, and protect health

La publicación de este artículo es una iniciativa organizada por la Alianza Global por el Clima y la Salud (GCHA, por sus siglas en inglés) a través de la Alianza de Salud del Reino Unido sobre el Cambio Climático (UKHACC, por sus siglas en inglés) y los miembros del Grupo de Trabajo Latinoamericano sobre Cambio Climático y Salud. La convocatoria tiene un doble objetivo: que los líderes mundiales acuerden los cambios necesarios para mantener el aumento de la temperatura global por debajo de 1,5°C y que los profesionales de la salud adquieran una mayor relevancia en el debate global sobre la crisis climática y la pérdida de la biodiversidad. La convocatoria se desarrolla en el contexto de la próxima celebración de la Asamblea General de Naciones Unidas que se iniciará el 14 de septiembre de 2021, así como también de la celebración de la conferencia climática COP26 que este año se realizará en Glasgow. Este artículo, cuya autoría pertenece principalmente a editores de 18 prestigiosas revistas científicas ampliamente representativas de los continentes y disciplinas de la salud del mundo, ya ha sido publicada simultáneamente en más de 200 revistas científicas internacionales (https://www.bmj.com/content/full-list-authors-and-signatories-climate-emergency-editorial-september-2021). En esta ocasión, la Revista Argentina de Salud Pública se suma a esta iniciativa conjunta a través de la publicación del artículo en español, con el fin de promover su difusión en los países de la Región. El editorial expresa también la necesidad de restablecer la diversidad biológica y proteger la salud, y de que los países de altos ingresos hagan mayores recortes en sus emisiones de carbono y transfieran fondos a los países de ingresos bajos y medianos. Además, exhorta a la intervención de los gobiernos en el rediseño de los sistemas de transporte, las ciudades, la producción y distribución de alimentos, los mercados para las inversiones financieras, los sistemas de salud, entre otros aspectos, lo que redundaría en amplios beneficios para la salud.

Authors' reply.

We thank Dr Rupa V., Dr Nagoba B.S. and their colleagues for their comments on our editorial.1,2 Both the groups generally agree with our propositions, with Rupa and colleagues suggesting some changes. Credit for authorship is a balancing act between giving credit to all those who deserve it versus avoiding the scourge of ‘gift authorship’. Our editorial recommends credit to all the authors in order to encourage interdepartmental research and to prevent junior researchers from being denied their due which Nagoba and colleagues agree with. Any restriction in this context as suggested by Rupa and colleagues has a potential for harm—with credit being limited to the senior authors, who may be in a stronger position to influence their relative position in the authorship list. One wonders whether in India we have carried the ‘one size fits all’ approach too far in the name of ‘being objective’––and whether a subjective decision by a selection committee based on an individual’s actual contribution (e.g. the volume of work reported in a paper, the multidisciplinary nature of the work, and the expertise of a particular author) may be the way forward. We wish to reiterate that our editorial, written on behalf of the Indian Association of Medical Journal Editors, focused mainly on issues related to the publication process, and not on the criteria for faculty promotions, which is an entirely different debate. However, we emphasize that credit based on impact factor, as suggested by Rupa and colleagues, will pose a fresh set of challenges, given that the concept, application and the potential for manipulation of this measure have been the subject of widespread critique and debate in the literature.

Sharing Clinical Trial Data: A Proposal from the International Committee of Medical Journal Editors.

The International Committee of Medical Journal Editors (ICMJE) believes that there is an ethical obligation to responsibly share data generated by interventional clinical trials because participants have put themselves at risk. In a growing consensus, many funders around the world—foundations, government agencies, and industry—now mandate data sharing. Here we outline ICMJE’s proposed requirements to help meet this obligation.We encourage feedback on the proposed requirements. Anyone can provide feedback at www.icmje.org by 18 April 2016. The ICMJE defines a clinical trial as any research project that prospectively assigns people or a group of people to an intervention, with or without concurrent comparison or control groups, to study the cause-and-effect relationship between a health-related intervention and a health outcome.Further details may be found in the Recommendations for the Conduct, Reporting, Editing and Publication of Scholarly Work in Medical Journals at www.icmje.org. As a condition of consideration for publication of a clinical trial report in our member journals, the ICMJE proposes to require authors to share with others the deidentified individual-patient data (IPD) underlying the results presented in the article (including tables, figures, and appendices or supplementary material) no later than 6 months after publication. The data underlying the results are defined as the IPD required to reproduce the article’s findings, including necessary metadata. This requirement will go into effect for clinical trials that begin to enroll participants beginning 1 year after the ICMJE adopts its data-sharing requirements.* Enabling responsible data sharing is a major endeavour that will affect the fabric of how clinical trials are planned and conducted and how their data are used. By changing the requirements of the manuscripts we will consider for publication in our journals, editors can help foster this endeavour. As editors, our direct influence is logically, and practically, limited to those data underpinning the results and analyses we publish in our journals.

The revised guidelines of the Medical Council of India for academic promotions: Need for a rethink.

Measuring academic achievements is never an easy task. This is particularly so when individuals are assessed for promotions in several fields with differing job descriptions. Assessment by peers is time-consuming and may be prone to bias; thus, objective criteria are required to minimize these concerns. The Medical Council of India (MCI) has laid down guidelines for appointments and promotions of teachers in medical institutions in India. Among the criteria used for promotions, publication of research is an essential requirement. Though the need for this requirement has been debated, it is believed that the quality of teaching improves when medical teachers are involved in research. Many countries have made it mandatory for their medical faculty to do research; some other countries incentivize the conduct and publication of research. Reports have also lamented that the physician–scientist might become an endangered species.1,2 Thus, linking publications with promotions might benefit both the individual and society. The flip side is that the time spent on research might take teachers away from teaching or clinical duties, particularly in under-staffed specialty departments. Further, the quality of research is likely to be poor when the resources and training in research are lacking.3 Poor quality may even discredit research as a professional activity. Insistence on a certain amount of published research to maintain teaching credentials may lead to the phenomenon of ‘publish or perish’.4 Finally, it is important to consider that biomedical research may, at times, be relevant to nonbiomedical journals and criteria for awarding credit to such publications should also be devised.