![]() The Nuffield Council on Bioethics presents an ethical compass that lists three core values that guide researchers at the level of policy-making and on the ground (Wright 2020). The gender gap in Economic Participation and Opportunity will take another 267 years to close, as per the Global Gender Gap Report 2021 (World Economic Forum 2021). Non-binary and transgender individuals are so neglected that statistics on their representation are sparsely available for these organizations. Women are often underrepresented in leadership positions, despite forming 75% of health workers (Zeinali et al. Still, movements such as #LancetWomen, Global Health 50/50 (GH5050), and Women in Global Health have shed light on the unequivocally essential issues pertaining to the ethics of inclusion and gender equity (Zeinali et al. This is further reinforced by the fact that 73% of these global health organizations are headquartered in only three countries in the Global North (Global Health 50/50 2022).įurthermore, ethical issues pertaining to limited gender diversity, in the context of global health, remain under-discussed. The difference represented by this distribution of “ 50 seats and 50% seats” is neither in conformity with the global population nor the global burden of disease. Individuals from the UK and the USA represent more than half of the 2014 board members, while low-income countries (LICs) are represented on only 50 seats. Nationals from high-income countries (HICs) hold 75% of seats across 146 global health governing boards but only comprise 15% of the world population (Global Health 50/50 2022 The World Bank 2021). The “global” in global health appears to have been left unacknowledged, and ethics of inclusion may further be violated when homogeneity in cultural, social, and personal characteristics is perpetuated. A genuinely ethical frame of reference for global health should entail a culture that promotes equitable access to opportunities and care, celebrates individual differences as community strengths, and creates an environment of inclusion irrespective of race, geographic background, socioeconomic status, gender, or belief systems. Thus, it is not uncommon to witness systemic inequities uncovered by phenomena demanding global action, such as the coronavirus 2019 (COVID-19) pandemic. Though health equity is one of the core values of global health ethics, it is seldom prioritized and highlighted. What was intended to be a vision of advocating for health equity is perpetually dominated by those in positions of historical power. ![]() Global health is more than just “ public health beyond borders.” Global health ethics, a relatively newer term, conceptualizes the application of morally acceptable solutions to health issues requiring action at a global level. Thus, we call for swift action regarding the decentralization and redistribution of global and international health journal editorial boards. Despite the continuous evolution of the definition of global health ethics, marginalized individuals, and their perspectives remain underrepresented in this field. Only two journals scored “excellent” on JDI. Among all women editors, more than 70% worked in non-Medline and non-impact factor journals. This disparity in geographic region and socioeconomic level was observed across all five editorial roles. Furthermore, 68.2% of editors were based in high-income countries with 67.3% of the editors belonging to the Global North. Among all the editorial board members, we did not find any information suggesting the representation of non-binary and transgender individuals. Women comprised 44% of the total editors. Out of 43 journals included, 62.7% were published from two high-income countries. Chi-squared test was utilized to study associations between gender and geographic distribution of editors along with the Medline indexing of the journal and its impact factor. Relevant information regarding editorial board members of systematically screened journals was sequentially extracted and job titles were categorized into five editorial roles. We developed Journal Diversity Index (JDI) to measure three parameters of diversity and representation (gender, geographic, socioeconomic status). To play our part, we evaluated diversity and inclusion in the leadership and management of global and international health journals. Journals have been described as “duty bearers” of upholding fundamental ethical principles that are essential for maintaining the ethical integrity of newly generated and disseminated knowledge.
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