[A2k] Barbour, Chinnock, Cohen and Yamey in the WHO Bulletin: The impact of open access upon public health

[Thiru Balasubramaniam]

http://www.who.int/bulletin/volumes/84/5/editorial20506html/en/index.html

The impact of open access upon public health

Virginia Barbour (a), Paul Chinnock (a), Barbara Cohen (a) & Gavin Yamey (a=
)

Arthur Amman, President of Global Strategies for HIV Prevention
(www.globalstrategies.org), tells the following story:

=93I recently met a physician from southern Africa, engaged in perinatal
HIV prevention, whose primary access to information was abstracts posted
on the Internet. Based on a single abstract, they had altered their
perinatal HIV prevention program from an effective therapy to one with
lesser efficacy. Had they read the full text article they would have
undoubtedly realized that the study results were based on short-term
follow-up, a small pivotal group, incomplete data, and were unlikely to
be applicable to their country situation. Their decision to alter
treatment based solely on the abstract=92s conclusions may have resulted
in increased perinatal HIV transmission.=94

Amman=92s story shows the potentially deadly gap between the
information-rich and the information-poor. This gap is not the result of
lack of technology or of money, but of a failure of imagination. We live
in the most information-rich era of history, when the Internet allows
immediate global dissemination of crucial health information, and the
inter-linking of online information creates an integrated, living body
of information =97 the ultimate vision of which is the semantic web.(1)

What is preventing such a living web? For scientific and medical
information, two obstacles are vested interests and traditions. Central
to these traditions is the role of copyright, which was developed when
the dissemination of work was on paper. Initially, applying copyright to
medical articles protected both the intellectual investment of authors
and the commercial investment of publishers. Authors of scientific
articles handed over their copyright to the publishers to prevent
unauthorized print copying. Thus, the prevention of unauthorized copying
helped to disseminate information, by providing a valid business model
for publishers. But the proliferation of subscription-based medical and
scientific journals led to readers having to pay more and more to
publishers in order to keep up with current knowledge, and an increasing
fragmentation of knowledge between different publishers.

Print is no longer the most efficient way to disseminate information.
The Internet provides the means to revolutionize publishing in two
crucial ways. First, it makes it possible to disseminate health
information at no charge to anyone in the world with online access.
Although it costs money to peer review, edit, produce, and host an
online article, this is a one-time, fixed cost. If research funders are
willing to pay this cost, then the published work can be made freely
available to all readers worldwide, and there would be no need for
journal subscriptions. This is one way of financing an open-access model
of publishing. (2)

Second, because the Internet allows not just ease of access but ease of
reuse, an article=92s usefulness is limited only by a user=92s imagination.
To allow this, the traditional role of copyright has to change. Instead
of publishers using copyright to restrict use, authors can retain
copyright and grant the public the right to creatively reuse their work.
Licences such as those developed by the Creative Commons, (3) which
facilitate rather than prohibit reuse, are used by the open-access
publishers Public Library of Science (PLoS) (4) and BioMed Central
(BMC). The result is that: =93=85 copyright can be used for what it is mean=
t
to in science, not to make the articles artificially scarce and in the
process restrict their distribution, but instead, to ensure that their
potential for maximum possible dissemination can be realised.=94 (5)

The potential benefits of such a change are vast. No longer will
physicians have to base their practice on half truths. Instead, everyone
from patients to policy-makers can read for themselves the evidence on
which crucial science and health policy decisions are made. One example
of a paper with potentially profound public health implications is the
first randomized trial of male circumcision to prevent HIV infection;
(6) having this paper and all related discussions freely available has
allowed a lively, informed debate to flourish.

Will poorly funded researchers be excluded from publishing in
open-access journals? This concern is addressed head on by publishers
such as PLoS and BMC who waive fees for authors who cannot pay and who
strictly separate decisions on publication from ability to pay. This is
not a radical departure into subsidies, but an accepted part of
distributing publishing costs across the scientific community.

Increasingly, funders of research also realize the benefit of an
open-access model of publishing. The UK=92s Wellcome Trust (7) mandates
its funded authors to make their work publicly available; the United
States National Institutes of Health are encouraging it, (8) and
increasing numbers of governments and funding bodies are signing up to
declarations on open access. (9)

It may be uncomfortable for those with interest in the status quo, but
by regaining control of copyright the medical and scientific communities
could ensure that publishing is no longer driven by the interests of
publishers, but rather by the needs of society.

Competing interests: The authors are employed by the Public Library of
Science, an open-access publisher. This editorial is being co-published
in PLoS Medicine (www.plosmedicine.org <http://www.plosmedicine.org>).


REFERENCES:

    * W3C The World Wide Web Consortium Available from: http://www.w3.org/
    * Suber P. Open Access Overview. Available from:
      http://www.earlham.edu/~peters/fos/overview.htm
    * Creative Commons. Available from: http://creativecommons.org/
    * Gass A, Doyle H, Kennison R. Whose Copy? Whose Rights? PLoS Biol
      2004;2:e228
    * Velterop J. Guide to Open Access Publishing and Scholarly
      Societies, Open Society Institute, July 2005. Available from:
      http://www.soros.org/openaccess/scholarly_guide.shtml
    * Auvert B, Taljaard D, Lagarde E, Sobngwi-Tambekou J, Sitta R,
      Puren A. Randomized, Controlled Intervention Trial of Male
      Circumcision for Reduction of HIV Infection Risk: The ANRS 1265
      Trial. PLoS Med 2005;2:e298.
    * Wellcome Trust position statement in support of open and
      unrestricted access to published research. February 2006.
      Available from: http://www.wellcome.ac.uk/doc_WTD002766.html
    * Policy on Enhancing Public Access to Archived Publications
      Resulting from NIH-Funded Research. Available from:
      http://publicaccess.nih.gov/
    * Berlin declaration on Open Access. Available from:
      http://www.zim.mpg.de/openaccessberlin/berlindeclaration.html

(a) PLoS Medicine, Public Library of Science, 185 Berry Street, Suite
3100, San Francisco, CA 94107, USA. Correspondence to Virginia Barbour