Copyright © 2015 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. Epidemiology •  Volume XX, Number XXX, XXX 2015 www.epidem.com  |  1 LETTERS To the Editor: I have read with great interest your first editorial as the Editor-in-Chief of EPI- DEMIOLOGY entitled: “If You Want to Know the End, Look at the Beginning.” 1 In your editorial, you have posed an important question regarding trachoma: “I cannot fathom how in the year 2015 six million people will go blind because their access to clean water is so insufficient that they cannot wash their face.” Overall there is an extreme shortage of epidemiologic studies of this disease and of other neglected trop- ical diseases in low-income countries. 2 Shortages of epidemiologic stud- ies from low-income countries do not only relate to neglected tropical diseases. Evidence suggests that, at the same time that research from low-income countries contributes only a limited amount to total research production, researchers from the USA, Canada, and Western Europe hold leading positions in the fields of preventive medicine, epidemiology, and public health. 3 It is disappointing that evidence further suggests that some biomedical researchers from low-income coun- tries might believe that a biased attitude of editors from high-income coun- tries against their work might partially explain this trend. 4 Similarly, the serious underrepresentation of editors from low- income countries and its consequences have already been established for a num- ber of health journals. 5–7 This encourages me to look at the composition of EPIDEMIOLOGY’s editorial board. 8 From the point of view of geo- graphic distribution, one out of 29 mem- bers is affiliated with an institution located in China (an upper-middle-income coun- try) and the rest are almost all affiliated with institutions in North America, Can- ada, and Western Europe (high-income countries). Therefore, I think it is time that EPIDEMIOLOGY, as the official journal of the International Society for Environmental Epidemiology (ISEE), take the leading role to diminish this potential/alleged bias. Appointments of an editorial board that is well balanced in terms of home institu- tions from diverse geographical regions across a range of national incomes might have a paramount effect on the advance- ment of our field and of public health. Mohsen Rezaeian Social Medicine Department Occupational Environmental Research Center Rafsanjan Medical School Rafsanjan University of Medical Sciences Rafsanjan, Iran moeygmr2@yahoo.co.uk REFERENCES 1. Lash TL. If you want to know the end, look at the beginning. Epidemiology. 2015;26:6–7. 2. Hotez PJ, Woc-Colburn L, Bottazzi ME. Neglected tropical diseases in Central America and Panama: review of their prevalence, popu- lations at risk and impact on regional develop- ment. Int J Parasitol. 2014;44:597–603. 3. Soteriades ES, Falagas ME. A bibliometric analysis in the fields of preventive medicine, occupational and environmental medicine, epidemiology, and public health. BMC Public Health. 2006;6:301. 4. Rohra DK. Representation of less-developed countries in pharmacology journals: an online survey of corresponding authors. BMC Med Res Methodol. 2011;11:60. 5. Tutarel O. Composition of the editorial boards of leading medical education journals. BMC Med Res Methodol. 2004;4:3. 6. Paton C, Househ M, Malik M. The challenges of publishing on health informatics in developing countries. Appl Clin Inform. 2013;4:428–433. 7. Meena S, Chowdhury B. How international are the leading orthopedic journals: a look at the composition of the editorial board members of the top orthopedic journals. Arch Orthop Trauma Surg. 2014;134:619–622. 8. Editorial board. Available at: http://journals. lww.com/epidem/pages/editorialboard.aspx. Accessed March 3, 2015. Editor's Note: Members of EPIDEMIOLOGY’S Editorial Board are selected from among reviewers who have regularly agreed to re- view submitted manuscripts, returned their reviews on time, and provided thorough and high-quality reviews. Invitations to join the Editorial Board also depend on the topic areas for which reviews are most of- ten required, and topic areas for which spe- cific expertise may be of special value to the journal. Members of the Editorial Board agree to provide up to six reviews per year, and also participate in selection of the an- nual Kenneth Rothman EPIDEMIOLOGY prize. Members of the Editorial Board do not di- rectly participate in decisions related to the journal’s mission, including decisions about manuscripts to accept or reject or topic ar- eas that should receive special attention. The journal welcomes all qualified members of the community to offer their services as peer reviewers. Reviewers can register at http:// www.editorialmanager.com/epid/default. aspx and, while registering, can provide the topic areas in which they can offer peer re- view. Any reviewer interested in eventually joining the Editorial Board can convey that interest by emailing the Editor-in-Chief at timothy.lash@epidemiology-journal.com. Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 1044-3983/15/XXXXX-0000 DOI: 10.1097/EDE.0000000000000344 The author reports no conflicts of interest. Dealing with  the Serious  Underrepresentation  of Editors from  Low-income Countries