Collegiality without borders
Authors: Zoë Mullan
Journal: The Lancet Global Health (2014)

I write 2 days after returning from an international conference on publication ethics. The participants were highly knowledgeable and engaged; many were both editors-in-chief and practising consultants. We discussed the perennial issues of authorship and conflicts of interest, as well as newer and more bizarre transgressions such as journal hijacking and reviewer impersonation. Time outside the meeting room was spent networking and socialising with international colleagues over food and drink, and on organised tours of the city and its ample supply of cultural and historical points of interest. Not so unusual, perhaps, except that the city was Shiraz and the country Iran. Strip away the current political tensions over nuclear proliferation, and Iran's rich history of progressive medical and scientific research shines through. In Zoroastrian Persia, before the arrival of Islam in the 7th Century, the practice of medicine—“by the knife, by herbs, and by divine words”—was described in the religious text the Avesta. Later, Persian scholars contributed to the huge advances made in scientific analysis and evidence-based medicine during the Islamic Golden Age. Nowadays, 38% of the 42 500 masters and doctoral students Iran produces every year are studying science or technology—a proportion comparable with Japan. Unlike other Islamic nations in the region, there are as many women as men in higher education. Compound annual growth in scientific publication output exceeds 25%, and more than 300 medical journals are published in the country, nearly all by universities. This long-standing national commitment to the practice and teaching of science and medicine ought to place Iran in the top echelons of international scientific collaboration. But of course it does not. Poor diplomatic relations and sanctions imposed chiefly by the USA and EU make travel difficult (Iranian visas to UK citizens are currently issued by Iran's Embassy in Dublin, Ireland, for example) and the transfer of money (eg, research funding) between Iran and sanction-imposing countries is virtually impossible. The ban on financial transactions also affects subscription payments to US or EU-based journals and article processing charges for open access journals. Additionally, some publishers have instructed their US employees not to handle submissions from authors employed by the Iranian government (most universities are technically government entities). Thus both access to research and the ability to publish are restricted for Iranian researchers. And the damage does not stop at collaborative barriers and publishing embargoes. Although medicines and medical devices are exempt from the US and EU export ban, restrictions on financial transactions render the exemption moot in practice. The result is drug shortages, price increases, and the rise of substandard black-market products. Observers have urged Washington and Brussels to make clear to financial institutions that trade in necessary medical products is legal. Facilitation of a financial channel to support humanitarian trade was in fact one of the concessions agreed in the Joint Plan of Action drawn up between Iran and the so-called P5+1 nations (the USA, UK, France, Russia, China, and Germany) in January 2014. The Plan offers a slight relaxation of sanctions in return for Iran's limiting uranium enrichment and allowing inspectors into nuclear facilities. According to the Arms Control Association, both sides have stuck to their commitments so far, but the deal is only temporary and negotiations on reaching a final agreement have just been extended for the second time until July 2015. At times frustrations ran high in Shiraz, but they did not deflect from the prevailing atmosphere of mutual respect between fellow academics and editors. Economic sanctions are sometimes a necessary evil, but the consequences of blanket policies can be far-reaching and damage aspects of life—health care, access to health information, bioscientific progress—that ought to be unassailable. As researchers and editors, we can have little hope of influencing high-level foreign policy. But what we can do is ensure that we do not slip into the trap of judging our international peers by the actions of their governments. We can extend the hand of fellowship and collegiality because we feel it to be right even if the letter of the law says that it is not.