Scientific publishing faces growing challenges from rapid technological change, artificial intelligence (AI), research integrity concerns, and resource limitations, particularly in low- and middle-income countries. Editors, authors, and peer reviewers must navigate increasingly complex editorial requirements while operating within constrained institutional and financial environments. The emergence of AI-generated content and fabricated citations further threatens scholarly integrity and adds to editorial burdens. The unique challenges confronting regional journals necessitate strengthening editorial capacity, ethical governance, reviewer competency, and requires collaborative effort to sustain scientific publication that is relevant to the region.