A CEO of a CRO (Contract Research Organization whose main business is conducting drug trials for multinational pharmaceutical companies) is contesting for the post of Chief Editor of Indian Journal of Pharmacology owned by the Indian Pharmacological Society. I wonder whether he would set a record of sorts if he wins the election voted by the members of IPS. Has any biomedical journal, especially a society-run one, been headed by persons with larger commercial interests? The contestant is not just employed, but fully owns the company.
 

My questions are:

1) What are the implications for the journal?

2) What conflicts he would face if he takes over the journal?

R. Raveendran
Chief Editor, IJP
__________________________________________
I think it is a very disturbing and a unhealthy development and should be strongly condemned by the academic community, especially the pharmacologists in India.

I suppose it is time we learns the lessons from the CMAJ episode and put in place a frame-work somewhat along the lines of the Pound Committee recommendations, which, in my opinion, can and should be implementable for all scholarly journals, especially those run by learned societies in India.

K. Satyanarayana
Editor, Indian Journal of Medical Research
__________________________________________
Like Dr Satyanarayana, my first reaction was horror. But then, if you start to think about it, is the would-be editor's position any different from the professor/head of a research department? Both have a vested interest in seeing their research published. Both will often accept money from the pharmaceutical industry. 

Provided he has good written policies on conflict of interest and abides with them, then I see no reason why he should not be a good editor. He also might add value by coming from a slightly unusual background.

Tim Albert
___________________________________________
A person with obvious commercial interests may not necessarily do a bad job of editorship, just as a person with academic interests may not necessarily be immune to mainly personal commercial interests. The key is past and present credentials. Has he research and editorial credentials to go by? Has he done work of this nature before, and how well, or badly, did he manage? What is his standing as a person of integrity?

If the journal is in economic doldrums, a smart businessman-editor may make it economically self-sufficient. If the journal is just managing to break even, he may shore up its revenue base, which may help it depend less on manipulative forces from the health industry. Or Association bosses. But his credentials, and his past record, are critical for any evaluation. Not necessarily the fact that he heads a commercial organisation. A businessman with his heart in the right place can work wonders for biomedicine. Bill and Melinda Gates abroad, (and the earlier Infosys head in India—though not in biomedicine, probably), demonstrate this amply. Even if such people may know little of editorship, I would still not write them off, if they can manage with an efficient editorial team/executive editor, etc.

Moreover, the fact that he heads a commercial organisation may make him acutely aware he should not allow his personal commercial interests to conflict with the journal's interests, research and commercial, since he will be under critical scrutiny of peers all the time. All this provided he is a businessman of integrity. However, it is also possible he may want to grab the plum post of editorship of an association journal by dubious means and carry on with his manipulations in the journal, as he has done in his business (and further his business prospects, with the post getting him much needed respectability). Let us not per se accept that this is indeed the case. Let us judge by past and present actions, and credentials.

Ajai
___________________________________________
At first glance it seems horrible, but let’s consider that the most important point in "conflict of interest" is clarity.

All medical journals that are sponsored by universities or research centers may have positive bias in publishing their research. Some of the heads of these universities and centers are editors of medical journals, but no one has any objection to their position.

I think this nominated editor may act fairly in the future—not to be accused of bias.

Behrooz Astaneh
Deputy Editor, Iranian Journal of Medical Sciences
____________________________________________
I partly agree with Ajai and Tim. There is no one without bias. But equating a head of an academic department with a full time businessman is something I find it difficult to accept. 

It has been already reported that pharmaceutical firms may influence the policy of the journals and the content, too. (A few references were provided on this forum some weeks back by a member.)

The contestant is fully dependent on pharmaceuticals, which form a valuable clientele for him. Our journal, so far, does not hesitate to publish articles criticizing the pharma industry. The next issue of IJP carries an article criticizing the drug companies that misuse the WHO name and its logo to promote their ORS formulations. If one of the companies named in the article is his major client, will he be able to make a decision without bias? If there are occasions where his industry interests and the journal interests will be in direct conflict, where would his loyalty lie? Even if he has written policies, can he anticipate all the problems and conflicting situations in advance? 

I do not say academicians or researchers do not have links with the industry or have bias. But is it correct to equate it with that of someone working in the industry itself? At least in India, those who are in academics or research institutes are not fully dependent on commercial establishments, unlike the company owned by the contestant. There are many departments without any/with very little links to the industry.

If we agree that a person from industry need not necessarily be biased and he/she can head a journal, then is it correct for a journal to avoid inviting those with industry connections to write editorials? If I remember correctly NEJM had/has such a policy (please correct me if this statement is wrong). Why should it blacklist all of them en masse rather than going into individual credibility and choose the suitable ones?

What if there are conflicts between the policies of the society and the contestant's business? For example, the pediatric society of India is dead set against the infant milk formulations (they promote breast feeding). Is it correct (rather safe) for them to allow someone who manufactures and markets milk formulations to become the editor of their journal?

There are implications for the society also. More people from industry may be encouraged to compete for other top posts such as president and general secretary. The whole society could be hijacked if the industry really wants.

If a publishing house wants to appoint a part-time editor for one of its “medical” journals, will it happily accept someone in the industry even if he/she is suitable otherwise? If “no,” why?

I would like to ask a hypothetical question. If we have voting power to elect the WHO chief, how many of us will be willing to vote a drug company person, say for the Chairman of Pfizer or Astra-Zeneca, however good his/her track record is? If the answer is “no,” why?

R. Raveendran

Conflict of interest: I am an academician and one of the contestants. (I did not declare this in my last post as (a) I was not expressing my views, but only stated the facts and invited others to opine and (b) I was/am not sure I should declare my conflicts on this forum.)
___________________________________________
I agree wholeheartedly with Ajai. We should not stereotype, but we should carefully examine each applicant’s credentials and past record. 

This seems to raise another intriguing issue, however. As I understand it, this particular editorship is elected. Is this really the right way to ensure that these important questions are raised and answered—and that suitable people get appointed? Is it appropriate—ethical even?

Should WAME take a view?

Tim Albert
___________________________________________
Tim's issue about electing editors is worth consideration. As an alternative, if editors are not elected, then they may be appointed (not in a transparent way), “self-imposed”, or employed (as a job)—each of which has its own challenges. An elected position may have the legitimacy and possibility of being independent compared to when one is employed. But the other way could also occur. 

Adamson Muula
___________________________________________
Just so everyone is clear, I think Tim is saying that elected is not a good way to go. He should clarify. Maybe he thinks it would be preferable for them to be appointed by the pharmas or by the Medical Associations...or even, heavens to betsy, by the publishers!!!   

Barry Pless
___________________________________________
Thanks for agreeing with what I wrote, Tim.

We ought to be wary of business in general, and Pharma/health care industry in particular, but not paranoid towards them.

Regarding the second issue of election for editorship, it is the common procedure followed for Association journals in India. Along with election for President (Elect), Secretary, Treasurer etc. It makes for democratic functioning (?), although we know how elections are everywhere.

Whether elections for editorship should at all be held, or it should be an appointment for a certain term by an employer, is a separate issue, left to logistic and other procedural considerations, I guess.

Ajai
___________________________________________
I think the key words are integrity and capability. The rest does not matter. 

Uday Khopkar
Chief Editor, Indian Journal of Dermatology, Venereology and Leprology
___________________________________________
This issue of who should be an editor, what should be the relationship with publisher, how to set up a structure to ensure objectivity in the functioning of a journal, minimize interference from the publishers has been debated since the sacking of  the editors of JAMA and NEJM in succession, and more recently February this year—the editor of CMAJ. That office bearers of learned societies in India and elsewhere exploit the society journal for their political interests and of the membership is well known. As I had mentioned in my earlier response, there are guidelines available to ensure best practices in running a journal brought out by AMA, MMS, and now the CMA through the Pound Committee Report. Some of these are also addressed in an editorial in the October issue of the Indian Journal of Medical Research (http://www.icmr.nic.in). But the real question is: Are the Indian or for that matter many journals from abroad interested in setting up such a transparent system? The impending “election” of the editor of IJP is but a manifestation of the serious malady in Indian medical journals published by learned societies. It is time this issue is seriously addressed.

K. Satyanarayana
Editor, IJMR 

P.S. I am the ombudsman of the Indian Journal of Pharmacology edited by Dr Raveendran.
___________________________________________
You rightly ask:

Are the Indian or for that matter many journals from abroad interested in setting up such a transparent system? 

To that, I wish to ask only a simple counter question: How do we ensure journals are quality products if we do not ensure a transparent system in place? Well, people may say, who wants a quality product? Don't we?

If journals are not to remain association rags, and not to remain substandard, or pamphlets of influential mediocrities, how can they not involve a quality system for their own credibility? And ultimate survival?

What is important is to make association bosses realise that their association's face is their journal. And that better not stink. What is equally important is for the association members to want a clean face to project.

For that, conscientious editors who head affairs today must realise the extent of their responsibility, and respond spiritedly to the challenge. They have not only to publish quality work, they have also to direct readers to ask for, and get, uncompromised quality. Edits/articles on ethical considerations in medical care are as important as edits on technical aspects of our respective disciplines.

I only hope that's not asking for too much.

Ethics is not some esoteric concept to be discussed at leisure time. Or lamented over. It is critically connected to our credibility and directly impinges on where biomedicine is to head.

Ajai
_____________________________________________
I have been “listening” to this debate started by Raveendran and was not responding for two reasons—one, I consider Raveendran to be a friend and old acquaintance, and I also regard him highly for lifting the standards of the journal (that is why I thought my views will be biased). Secondly, I am a better listener and a poor talker and was enjoying the debate.

However, I now feel that we must ask the other person to speak and let us see whether he can convince us. (He would need to be really good to be able to do that with most of inclined naturally towards academicians.) 

I think he must speak now—we must listen to him before we pass any verdicts. (After all, in many countries criminals fight for parliament positions.)

Samir Malhotr