Houston, We Have a Reviewer Problem

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Science has been under sustained pressure for some time. Some impacts are visible: halted public health initiatives, disrupted clinical trials, declining vaccination rates, and the resurgence of preventable disease. Others are less immediately apparent but no less consequential.

One of these quieter crises is unfolding within scientific publishing.

The traditional publishing model is already under strain. Open access requirements and funder mandates for public availability have reshaped how research is disseminated. At the same time, policy proposals in the United States have raised concerns about restricting transparent communication of federally funded findings to the public. But an even more immediate issue is emerging; one that I grapple with on a daily basis is the growing inability to secure peer reviewers.

In recent months, identifying willing and qualified reviewers has become extraordinarily difficult and at times approaching impossible. This is occurring in a system where careers, funding, and scientific progress depend on the timely publication of research. The causes are multifaceted.

At one end of the spectrum is a philosophical objection. Some scientists, particularly early-career researchers, question a system in which publicly funded research is produced at low academic and governmental salaries (relative to private industry), transformed into scientific publications, and submitted to journals, and then, upon acceptance, the intellectual property rights are transferred to publishers, who then bundle and sell them for profit. From this perspective, providing unpaid peer review to sustain that model feels exploitative. This position is understandable. However, it is rarely followed to its logical conclusion. Very few who hold this view publish exclusively in journals that compensate reviewers or operate gold open access models. As a result, participation in the system often continues as an author, but contributions to peer review decline.

More commonly, however, the issue is not reluctance; it is exhaustion.

Many scientists and practitioner-authors who would otherwise contribute are now disproportionately burdened.

Declining funding success rates have pushed researchers to submit more grants simply to sustain their labs, support trainees, and preserve their careers. At the same time, broader career instability, particularly in fields like public health and biomedical research, has intensified stress and uncertainty.

For decades, many in science, medicine, and public health accepted lower salaries than their private-sector counterparts in exchange for the opportunity to contribute to societal well-being. Yet increasingly, these same professionals find their work questioned, politicized, or misrepresented. Public trust has eroded in some domains, and misinformation has complicated the scientific enterprise. Meanwhile, the structural drivers of population health, such as commercial interests tied to ultra-processed foods, fossil fuels, and environmental exposures, remain powerful and visible. At the same time, the public health workforce itself is shrinking, with significant attrition across federal and state systems.

For journal editors, these pressures converge into a single operational reality: Some potential reviewers decline on principle, and many more decline because they are simply overwhelmed. The result is a bottleneck that threatens the integrity and pace of scientific communication.

Addressing this requires systemic solutions.

Editors and publishers must work to reduce the burden of peer review. Workflows should be streamlined so that expert evaluation can occur efficiently, ideally in minutes rather than hours, where appropriate. Routine and administrative aspects of review should be supported by editorial staff or automated tools, including responsible use of AI. Editorial practices must also evolve. Desk rejection thresholds should be applied more rigorously to prevent unsuitable manuscripts from consuming reviewer time. Reviewer contributions should be recognized more meaningfully, whether through formal credit systems, compensation models, or institutional acknowledgment.

Publishers, in turn, must invest more directly in the peer-review process. Claims of narrow margins are difficult to reconcile with sustained profitability across the industry. If peer review is foundational to product value, it should be treated, and resourced, as such. Most importantly, the scientific community must reconnect with itself. Public health has long recognized that systemic challenges require systemic responses. Just as we cannot place the burden of health solely on individuals without accounting for context, we cannot expect peer review to function without addressing the conditions under which scientists live and work.

This is a moment that calls for collective action. If we can stabilize the professional and personal environments of researchers—reducing strain, restoring trust, and supporting collaboration, we may recover the capacity to contribute to shared scientific goals.

And with that, perhaps more of us will again have the time, energy, and commitment to click “Accept” on the next review request.

About the Author

Justin B. Moore
Justin B. Moore, PhD, MS, FACSM is a Professor and Interim Chair in the Department of Implementation Science in the Division of Public Health Sciences at the Wake Forest University School of Medicine. He holds joint appointments in the departments of Family & Community Medicine and Epidemiology & Prevention. Dr. Moore also serves as the Director of Dissemination, Implementation, and Continuous Quality Improvement within the Clinical and Translational Science Institute at Wake Forest University. He conducts community-engaged research focused on the dissemination and implementation of evidence-based strategies for the promotion of healthy behaviors in underserved populations. He also conducts epidemiological research examining the determinants of health behaviors and related comorbidities across the lifespan. His research portfolio spans chronic diseases such a hypertension, obesity, and diabetes, and interventions to prevent or treat these conditions through physical activity, healthy eating, and related health behaviors. Serving as the Associate Editor of the Journal of Public Health Management and Practice (JPHMP) from 2007-2024, he assumed the role of Editor-in-Chief of JPHMP in January 2025. Previously, he served as Associate Editor-in-Chief for the Translational Journal of the American College of Sports Medicine and previously chaired the editorial board of the American Journal of Public Health. He is a member of the editorial boards of the journals Childhood Obesity, Obesities, Journal of Healthy Eating & Physical Activity, and the International Journal of Behavioral Nutrition and Physical Activity. Dr. Moore is an active member of the American Public Health Association (APHA) and the American College of Sports Medicine (ACSM). He was named a fellow in the ACSM in 2010 and was a founding member of the Physical Activity Section of the APHA. He later served as the chair of the Physical Activity Section and as the Section’s representative on the APHA Governing Council. In 2017, he was named a fellow in the National Cancer Institute supported Mentored Training for Dissemination and Implementation Research in Cancer program. He has served as a visiting scholar at Nanchang University, located in Nanchang, Jiangxi, China, and Wuhan University, in Wuhan, Hubei, China. As a result of his research, he and his colleagues have published more than 200 peer-reviewed articles, and he has received funding as principal investigator for his work from the National Institutes of Health, the US Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, the Duke Endowment, and the de Beaumont Foundation, among others.
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