Preventive Medicine: Initium Salutis Renaissance
Chandrakant Lahariya
Abstract
Superior doctors prevent the disease. Mediocre doctors treat the disease before it becomes evident. Inferior doctors treat the full-blown disease. Huangdi Neijing (2,600 BC); A set of writing considered as first Chinese medical text. Sarvesham Mangalam Bhooyat, Sarve Santu Niramayaah. Sarve Bhadraani Pashyantu, Ma Kashchi duhkhabhag Bhavet. “May all be happy, may all be disease-free, may all be witnesses of auspicious events and may no one have to suffer sorrow.” Ancient Indian verse, attributed to multiple scriptures (around 500 AD to 1,000 AD). The concept and idea of preventing diseases and promoting health has been advocated and accepted since ancient times. In fact, till the early part of the last century, the prevention of diseases was far greater priority than the treatment of diseases. However, paraphrasing a recent speech of Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organization about Primary Healthcare,[1] one can well argue that in current times preventive medicine is another ‘one of the most important concepts in “health” and also one of the most misunderstood’. Preventive medicine faces multiple challenges. The term itself is used with limited clarity, by the practitioners. There is a variable understanding amongst policymakers and clinicians on what constitute preventive medicine. This, inspite the power & potential of preventive medicine in keeping the society healthy, is a matter of concern. These – amongst many others – are the reasons and rationale behind starting of this new journal – Preventive Medicine: Research and Reviews (PMRR). PMRR intends to publish scientific research and real-world evidence to promote the practice of preventive medicine as an integral approach to health service delivery and public health policies and interventions. The PMRR aims to serve as an international journal & a multidisciplinary platform for scientific discourses on all aspects of preventive medicine. The journal would function at the intersection of clinical medicine and public health to bring the key stakeholders – academicians, clinicians, public health practitioners, social scientists and many others on the same platform. It has been founded subscribing to the idea that the scientific journals have a bigger role to play in health service delivery.[2] The PMRR would publish high-quality research and review articles on all topics related to – inter alia – preventive medicine, clinical medicine, basic sciences, health policy and public health. We would be happy to publish manuscripts with specific focus on any preventive aspects of specific clinical fields, including but not restricted to preventive cardiology, preventive oncology, preventive hepatology and preventive nephrology and health conditions such as diabetes, obesity, & hypertension. The journal aims to communicate research and evidence better and understood by the policymakers and the public. Therefore, each of the research and review papers published in PMRR would have a special box to explain the ‘relevance to the public health’ and ‘implications for the clinical practice’. The journal would publish the special thematic issues led by guest editors. One such call for paper is in this issue.[3] The editorial team has already planned theme issues on topics such as neglected tropical diseases; Fifty years of Expanded Program on Immunization (2024), vaccination and immunisation agenda 2030; and one health, climate change and AMR. The details of these will be announced in the forthcoming issues. We invite subject experts to submit the proposals for more thematic issues, which will be considered by the editorial board. The journal also aims to have a special section for cross-learning in the field of preventive medicine from low- and middle-income countries. This would require volunteering from leading academic researchers and institutions to submit their work and analytical writing to the journal. The PMRR would have focus on the relevance of scientific findings to the health policy and programme in their settings and authors would be requested to contextualise the evidence with ongoing national and global discourses on primary healthcare and universal health coverage. The journal would publish policy papers and recommendations, & the state of the art commentaries and the perspective articles. The journal would have a few curated sections. For example, the sections named as Asia Health Report and Africa Health Report would cover the key developments in areas of preventive medicine and public health in these two continents.[4,5] The journal would focus on topics related to equity, accessibility and affordability to health services. The research work highlighting the health challenges and needs of the underserved and marginalised groups and tribal populations would be given priority.[6] The PMRR is committed to maintain a high standard of publications process through a rigorous double-blinded peer review, in which every submission will be initially screened by the editorial board and then reviewed by at least two external reviewers, in an expedited review process without compromising on the quality, scientific rigour and the ethical standards. The key features of the journal are summarised in Box 1.Box 1: Special features of the Preventive Medicine: Research and ReviewsTo address the challenge of insufficient common understanding of what constitute preventive medicine, PMRR has commissioned of a collaborative evidence and policy paper to systematically document the concept of preventive medicine and mapping the usage of the term. The history, evolution and linkage with practice of preventive medicine & public health are planned to be documented. PMRR invites academicians, subject experts and researchers worldwide to join hands for this collaborative paper. If you would like to contribute, please write to the editor in chief with your expression of interest. I am happy to share that soon after the opening of the submission portal, the journal received an overwhelming response from different parts of the world. It is a testimony to the trust and confidence posed in this journal. The first issue of PMRR has articles on a range of topics such as gestational diabetes; health concerns of LGBTQ, detection and management of tuberculosis, role of life jackets in drowning prevention, approach to developmental delay; nutrition education, and on primary healthcare service delivery and immunisation and vaccination.[7-15] These articles have been authored by researchers and experts in India, Bangladesh, Ghana, Nigeria, Trinidad and the United States of America. This issue is just a glimpse of what more to come.[16,17] A section of the journal - GP Clinics- would be dedicated to general practitioners (GPs) and family physicians. This section would publish clinical guidelines and practical experience for general practitioners – written by either specialist or the GPs with a long experience in a specific area. Though this section has been named as “GP Clinics’, it would also focus upon the practice of the family medicine as well. This is in recognition of the fact that the world over countries are realising and recognising the importance of family medicine as an approach to low cost and quality healthcare services.[18-19]. The GPs and the practitioners of family medicine, preventive medicine, and community medicine, makes a team to deliver quality primary healthcare services which has a blend of specialist care and public health services. These practitioners also works as right gate - keepers and two way referral system to specialist services. In fact, since the Astana conference on primary health care in 2018, a number of countries are making moves to bring GPs, Primary healthcare networks, team based care and family medicine trainings for GPs.[20-22] The GP Clinics section aims to support and work as CME for physicians working in rural settings and remote areas and smaller towns, who do not get enough opportunity to learn recent advances in the field. Then, the school health service and mental healthcare are two other major public health challenges in most low- and middle-income countries. There is a need for bringing urgent attention of scientific community and policy makers on these topics. PMRR aims to become that platform for by bringing the positive changes in school health services and in provision of mental healthcare services. It is often argued, that, if you know the patho-physiology of a disease or health condition, you know half of (preventive) medicine. The remaining half can be understood by deep dive into socio-economic, political and commercial and environmental determinants. This journal would therefore would publish articles which address patho-physiology of common health conditions. The journal would cover the topics of interest for nursing staff, & nutritionists. We invite authors to contribute lessons from the field and some of the implementation experiences and innovations in this area of preventive medicine. The manuscripts could be country focused, but regional and global perspectives would add value & increase the chances of publications. I take this an opportunity to thank every member of the editorial board, the section editors and members of the international editorial advisory board of the PMRR, who were kind enough to commit their time and services to the journal. This – we hope- would ensure that scientific knowledge is translated into actionable policy interventions. Finally, we invite authors, researchers and subject experts from any field of medicine to contribute to the preventive medicine and for better health of every citizens. Please submit your best work to the journal. Together, we are embarking on a journey which is both promising and exciting. Most importantly, advancing practice of preventive medicine is a right step towards making health systems people-centric. Funding None. Conflicts of Interest The author is the Editor in Chief of Preventive Medicine: Research & Reviews.