'Lancet' back at centre of controversy

Since his appointment 10 years ago as the youngest editor of The Lancet, Richard Horton has turned a once-staid academic journal into a publication at the centre of a string of controversies.

Since taking control of the 182-year-old journal at the age of 33, Dr Horton has been at the centre of a series of highly contentious issues from a report linking the MMR vaccine with autism to the hotly contested estimates of casualties in Iraq. He has also used The Lancet, one of the world's most prestigious journals, to rattle the cages of some of the world's largest academic institutions and has rubbed up members of the medical establishment the wrong way.

In 2004 Dr Horton, who has worked for The Lancet since 1990, courted controversy by publishing the first results of a statistical study putting the death toll of the Iraq war at 100,000.

He is best known for publishing the results of a study by Andrew Wakefield and 12 other doctors in 1998 which suggested that autism might be triggered by the MMR vaccine given to young children to protect them against measles, mumps and rubella.

The research, based on tests on 12 children, sparked a storm in the media and led to a slump in take-up rates of the vaccine. In 2004 Dr Horton said the study should never have been published because of a potential conflict of interest.

Last year Dr Horton incurred the wrath of the Royal Society when an editorial in the journal attacking the society as "shrill and superficial" was condemned as "a shrill editorial that would look more at home on the leader page of a red-top tabloid than in a scholarly journal".

There was further controversy when 30 members of the society criticised the journal for "desperate headline seeking", a claim that was vigorously denied by Dr Horton who defended The Lancet's record. He has also criticised the league table culture in the health service, and was not afraid to attack the journal's owner, the media group Reed Elsevier, for aiding the international weapons trade.

The journal called on the firm to end "all business interests that threaten human, and especially civilian, health and well-being".

In 2003 he called for smoking to be banned.

The journal has been praised for highlighting health issues in the Third World and its scrutiny of the drugs industry.

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