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Ethical regulations have become stricter throughout the world—fortunately so!—but this has not significantly hindered large-scale studies. Also fortunately, legal action does not seem to constitute a major threat to research outside the USA. In particular, epidemiological studies have markedly increased in Latin America and Asia, firstly with important contributions of researchers from North America and Europe, but in the last couple of decades with a steadily growing participation of local scientists. For example, our last national epidemiological conference in Brazil attracted over 4000 participants. Many studies on infectious and nutritional epidemiology are under way in Africa, mainly on AIDS and malaria; although these investigations are still mostly led by expatriates, African scientists are building up their own research centres and networks. I am not sufficiently familiar with the situation in the USA to gauge whether Rothman’s article had a major impact. It received a modest 36 citations in the Web of Science since its publication, and the only letter that appeared in the following issues of the New England Journal of Medicine was from Alvan Feinstein, who challenged the contribution of William Farr to epidemiology because of his backing of the miasma theory. Hardly a topic of current interest! Futurology is a high-risk occupation. Again with the benefit of hindsight, looking at Rothman’s paper after a quarter century shows that ethical guidelines helped improve epidemiology, and that our discipline evolved much beyond the study of proximate exposures and of hospital-based studies. Long live epidemiology!

Commentary: The rise and rise of corporate epidemiology and the narrowing of epidemiology's vision