Language and geographical bias limits global health research
BMJ 2026; 392 doi: https://doi.org/10.1136/bmj.s436 (Published 05 March 2026)
https://www.bmj.com/content/392/bmj.s436
Abdourahmane Ndong of Gaston Berger University, Saint Louis, Senegal writes that "Each time I engage with global health research I am reminded of how many studies never reach the global spotlight or appear in indexed databases because of the language they are written in or the journal in which they were published. This persistent exclusion weakens the principles of evidence-based medicine and highlights the need for greater inclusivity in research. For a truly global evidence base, research must urgently expand its linguistic and geographic scope.
"A substantial weakness arises from the dominance of publications in English, with estimates suggesting that as much as 98% of scientific output is published in this language. When research in non-English languages is published, it is often overlooked — even when it’s rigorously conducted and highly relevant. Language restrictions influence which studies are cited, included in clinical guidelines, and used to inform global health policies, especially in biomedical areas with strong regional variations in health systems or disease burden.
"Beyond language, a critical geographic bias also persists. A substantial body of research, particularly from low and middle income countries or specific regions in Africa, is published in local or national journals that are often not indexed in major international databases.10 A study in 2023 showed that of 560 active African biomedical journals, only 96 (17.14%) were included in at least one of four major international databases (Web of Science, Scopus, Embase, MEDLINE). In comparison, an analysis of biomedical journals indexed in Directory of Open Access Journals reported that over 75% of such journals globally were listed in at least one of four major biomedical databases."
R
HIFA profile: Richard Fitton is a retired family doctor - GP. Professional interests: Health literacy, patient partnership of trust and implementation of healthcare with professionals, family and public involvement in the prevention of modern lifestyle diseases, patients using access to professional records to overcome confidentiality barriers to care, patients as part of the policing of the use of their patient data Email address: richardpeterfitton7 AT gmail.com