Lancet editor and embargo addict Richard Horton calls for openness
There’s a study out in The Lancet today that has good news for maternal health in the developing world, but may raise a lot of concerns about such health in the developed world. As my colleague Maggie Fox reports:
Deaths of women in and around childbirth have gone down by an average of 35 percent globally, according to a study using new methods, but are surprisingly high in the United States, Canada and Norway.
There’s a strong embargo-related paragraph nestled in Lancet editor Richard Horton’s editorial about the data (full disclosure: For about seven years, I wrote an average of two obituaries per month for the journal):
Fourth, there needs to be serious reflection among the global health community about how it responds to new data. Even before the paper by Hogan et al was submitted to us, we were invited to “delay” or “hold” publication. The justification for this concern was several fold: potential political damage to maternal advocacy campaigns; confusion among countries, policymakers, and the media, given the difference between this maternal mortality estimate and the previous UN number; undermining progress on global commitments to maternal health; and the risk of an unproductive academic debate while women continued to die. Although well-intentioned, these requests to slow the pace of scientific discussion for political considerations are likely to be far more damaging than fostering a serious debate about progress in reducing maternal mortality as and when new data appear. Is the global health community unable to accommodate diverse voices and sources of evidence? Is it unable to create constructive ways to bring scientists and policymakers together to reach agreement about the meaning of new research findings?
All excellent questions. Presumably, the “delay” and “hold” was before the embargoed material would have been released to the press, but what are embargoes other than holds and delays?
As far as I’m concerned, the “you’ll just confuse them” argument is always fought best by airing the full data sooner, not later. Why let previous numbers sit out there, if they’re inaccurate? The longer you wait to present new data, the more credence those old numbers accrue. And if you’re afraid of engaging critics and political opponents, ask yourself how strong your data are in the first place.
I think Christopher Murray, director of the Institute for Health Metrics and Evaluation (IHME), which did the study along with a colleague from the University of Queensland, agrees. He wrote, by email:
We all benefit from the normal process of science. Methods and results should be rigorously tested, scrutinized, and subject to serious public debate. Solid and effective health policy and programs need to be based on this kind of science. Identifying what works and what does not in global health can save lives; it is critical that we apply the best science to this challenge and not make decisions based on politics or simple advocacy no matter how well-intentioned.
Richard has been outspoken about embargoes before. As Ed Yong reported last year, this was the scene as Richard — whom Ed said suffers from a 14-year embargo addiction — addressed the World Conference of Science Journalists:
Looking like he was on the verge of spontaneously detonating (and noting with possible accuracy that he was about to get himself fired), he derided journalists for “equating reproduction with communication” and writing material filtered through the lens of biased press releases. “You’re sold your soul to publicity masquerading as science,” he shouted, adding that embargoes hand power over to journals, allowing them to dictate to institutions that have actually done the work.
I’ll have to send him a note about Embargo Watch.
Updated 5:50 p.m. Eastern, April 12, 2010, with Christopher Murray quote.