Health research production in developping countries/africa

Western europe led the world on infectious diseases and in cardiopulmonary medicine publication, whereas the United States ranked fi rst both in quantity (49.1%) and quality of publication in preventive medicine, public health and epidemiology [1]. Developing countries are not able to contribute to knowledge input as compared to developed countries. Screening of more than 4000 research articles published over 13 years in nine international peer-reviewed journals showed that investigators from high-income economies (developed countries) contributed to almost all the publications, and those from developing countries contributed to (3.9%) of publication. There were no publications at all from around 80% of 154 developing countries, and most publications from developing countries are published by China (15.4%) followed by Turkey and South Africa [2].


Introduction
Researchers share the results of their work through publication in peer-reviewed journals, and participate to the scientifi c progress and advances in health care by providing evidence based policies.
Western europe led the world on infectious diseases and in cardiopulmonary medicine publication, whereas the United States ranked fi rst both in quantity (49.1%) and quality of publication in preventive medicine, public health and epidemiology [1]. Developing countries are not able to contribute to knowledge input as compared to developed countries. Screening of more than 4000 research articles published over 13 years in nine international peer-reviewed journals showed that investigators from high-income economies (developed countries) contributed to almost all the publications, and those from developing countries contributed to (3.9%) of publication. There were no publications at all from around 80% of 154 developing countries, and most publications from developing countries are published by China (15.4%) followed by Turkey and South Africa [2].
Burden of disease in the world falls on developing countries, and chronic non communicable disease such as diabetes and obesity can no longer be considered as diseases of developed world. Impact and burden of these diseases along with tuberculosis, AIDS and Malaria are more common in or limited to developing countries. So it would be reasonable to expect that more researches are needed in these countries . However, a retrospective survey to examine the contribution of the developing world to medical literature in a calendar year, showed that there was non-satisfactory structure and nonobjective based process in research projects with poor outcome.
The survey categorized countries into four regions: UK, USA, Other Euro-American countries (OEAC) and rest of the world (RoW). The study found that average RoW contribution to research in all journals was 6.5%. There was a considerable variation between journals, where more than half (12%) articles from the RoW were published in Lancet. There was an involvement of authorship with developed countries in 68.9% of publication. In 10 % of original papers, the data was from RoW but not authors. There is a marked under-representation of developing countries in high-impact medical journals, where 90% of the world's population lives [3,4].
African countries should assess the status of research within its borders, to be able to become a real contributors to scientifi c advancement on the world. It's time for Africa to acknowledge the importance of research in facing next millennium challenges.
In this article, we would like to discuss current research status, challenges, and needed efforts to promote health research in Africa.
Citation: Nasef   Poverty contributed to malnutrition, pollution,poor hygiene and sanitation, low immunity and increase of communicable and non-communicable diseases as well as psychological and behavioral problems. Poverty and health problems forming a vicious cycle. As reported by world health organization (WHO), 45%of diseases burden is present in poorest countries. Africa would need to be more committed for health status improvement by focusing on health research.
The limited number of citations of articles published by authors from developing countries, resulted in limited input toward the solution of global and national health problems and lack of best evidence published information [6]. This low scholarly output from Africa in many research fi elds attracted a considerable amount of international attention [11][12][13].

Challenge for Africa
In our experience, the current challenges in Africa, that resulted in scanty publication can be attributed to international and local reasons. International causes can be summarized in following factors. Text-Book.1 (International causes): • Uncertainty about journal options.
• High rejection rates and research wrong doing [16].
• Researchers in Africa are poorly paid, so they have to work in unrelated private practice to cover their needs [6] • Brain drain and Immigration to countries which offer enough income (17) .
• Researcheres have no fi nancial support from their institutes or centers to pay publication fees, conference fees or visa and travel dispense.
• Need of descendants from African countries for visa, and refusal of visa issuing even for invited researchers is a problem for researcher from many of these countries.
All these factors have a negative impact and widen knowledge gap and prevent dissemination of information. These factors form a real obstacles for research progress.
A well designed questioner directed to all international and national stakeholders, and bibliometric studies are needed in order to eludicate the underlying factors for the current inconvinent situation of health researches. Africa as all developing country has diffi cult circumstances and challenges at international and national level. A by solidarity and team work, and intervention by comprehensive approaches at all levels are needed in order to contribute to solve Africa specifi c disease and health problems [18] (Figure 2).

Efforts to promote health research
Various global health organizations and alliances have called for both increased access and sharing of research data and primary publications [7]. Scientifi c journals editors tried to contribute by establishment of task force to foster local research capacity in developing countries by launching Author aid who prepare articles to disseminate local knowledge data and practice to set strategy and policy [15].

Another contribution was joining Health Inter Network
Access to Research Initiative through WHO-supported HINARI program (7) . It provides free access to developing countries with a gross national product (GNP) per capita below 1,000 USD. However, Journal editors and publishers have shown a bias against publishing materials on the diseases of poverty from developing countries and failed to provide universal access to the scientifi c and medical literature as solicited [17,18,20].

Future aspiration
It is obvious that the current status of Africa needs an urgent intervention with proper actions. Unless major paradigm shift occurs in the socities such as aimed for "silencing