The New England Journal of Medicine goes to China

Founded in 1881, the New England Journal of Medicine (NEJM) is the world’s oldest continuously published medical publication. Published weekly and peer-reviewed, NEJM recently launched a Chinese language sister publication available for free to registered users via a mobile app and website in China.

SupChina’s Jeremy Goldkorn asked Dr. Jeffrey Drazen, Editor-in-Chief of the New England Journal of Medicine about their decision to launch a Chinese publication and what he saw as the major public health issues facing the People’s Republic.

Jeremy: Why, aside from seeking a growth market, did you decide to launch a site in China?  

Jeffrey: Patient care is undergoing massive change in China as new hospitals and clinics are being built to provide the highest-quality care for the Chinese people. Since medicine is largely knowledge-based, physicians there need to know how to provide the best care.

We wanted to ensure the over one million practitioners in China, many of whom do not easily read or understand English, had access to information that can impact patient care in China, so we collaborated with Jiahui Medical Research and Education to launch NEJM Frontiers in Medicine (NEJM 医学前沿).

Jeremy: Are you planning to run only translations, or will the Chinese NEJM eventually publish original material that is written in China or based on Chinese research?

Jeffrey: Jiahui Medical Research and Education is adding local commentary to some of the articles each week to provide meaningful perspective and we may expand translations to other specialties at some point.

Jeremy: Why will NEJM Frontiers in Medicine focus only on non-communicable diseases?

Jeffrey: The diseases, which are associated with rapid urbanization, lifestyle changes, and an aging population, are emerging as a major threat to public health in China. This content has the greatest relevance for Chinese physicians, because China has faced a growing burden from them.

Jeremy: Are there factors causing non-communicable diseases (NCDs) in China that cannot be attributed to lifestyle factors common countries with a growing middle class–such as diet, lack of exercise, and smoking?

Jeffrey: Generally speaking, genetics and environment are the major determinants of NCDs.  Being overweight and lacking exercise are two well-known environmental factors leading to increased prevalence of NCDs.  There is reason to believe that there are also potential genetic factors.  For example, Han Chinese develop Type 2 diabetes at much lower levels of excess weight and obesity compared to Caucasian populations.  The exact genetic reason for this difference is not known.

Jeremy: What do you see as the biggest health problems facing China today? How do those problems compare with the biggest threats to public health in the United States?

Jeffrey: Stroke is a major problem in China. One out of six people in the world live in China, but estimates are that one out four to five strokes in the world occurs in China.  What environmental and genetic reasons are responsible for this difference needs to be solved.  Although one of the major cancers in China, hepatocellular carcinoma, is due to hepatitis B infection, this infection is being controlled by population vaccination.  However, for many people, this is a lethal cancer that begs for better treatment.

Jeremy: In the last few years, there have been several media reports that see a very bright future for research in China, both because of the financial and human resources that are being thrown at it, and the greater support from the state for certain areas, such as stem cell treatments that are considered controversial in the United States. Does this make sense? Where do you see the most interesting research and development of new treatments in China?

Jeffrey: China has the resources and patients needed to address the problem of stroke, including how to prevent it, how to mitigate it when it occurs, and what to do when patients need rehabilitation.