Editorials

The impact of upon public health Virginia Barbour,a Paul Chinnock,a Barbara Cohen,a & Gavin Yamey a

Arthur Amman, President of Global the proliferation of subscription-based One example of a paper with potentially Strategies for HIV Prevention (www. medical and scientific journals led to profound public health implications is globalstrategies.org), tells the following readers having to pay more and more the first randomized trial of male cir-c story: to publishers in order to keep up with cumcision to prevent HIV infection; w6 “I recently met a physician from current knowledge, and an increasing having this paper and all related discuss- southern Africa, engaged in perinatal fragmentation of knowledge between sions freely available has allowed a lively, HIV prevention, whose primary access different publishers. informed debate to flourish. to information was abstracts posted on Print is no longer the most efficient Will poorly funded researchers be the Internet. Based on a single abstract, way to disseminate information. excluded from publishing in open-access they had altered their perinatal HIV The Internet provides the means to journals? This concern is addressed prevention program from an effective revolutionize publishing in two crucial head on by publishers such as PLoS therapy to one with lesser efficacy. ways. First, it makes it possible to and BMC who waive fees for authors Had they read the full text article they disseminate health information at no who cannot pay and who strictly would have undoubtedly realized that charge to anyone in the world with separate decisions on publication from the study results were based on short- online access. Although it costs money ability to pay. This is not a radical de-p term follow-up, a small pivotal group, to , edit, produce, and host parture into subsidies, but an accepted incomplete data, and were unlikely to an online article, this is a one-time, part of distributing publishing costs be applicable to their country situation. fixed cost. If research funders are will-i across the scientific community. Their decision to alter treatment based ing to pay this cost, then the published Increasingly, funders of research solely on the abstract’s conclusions may work can be made freely available to all also realize the benefit of an open- have resulted in increased perinatal HIV readers worldwide, and there would be access model of publishing. The UK’s transmission.” no need for journal subscriptions. This Wellcome Trust w7 mandates its funded Amman’s story shows the poten-t is one way of financing an open-access authors to make their work publicly tially deadly gap between the informat- model of publishing.2 available; the United States National tion-rich and the information-poor. Second, because the Internet allows Institutes of Health are encouraging w8 This gap is not the result of lack of not just ease of access but ease of reuse, it, and increasing numbers of govern-m technology or of money, but of a failure an article’s usefulness is limited only ments and funding bodies are signing w9 of imagination. We live in the most by a user’s imagination. To allow this, up to declarations on open access. information-rich era of history, when the traditional role of copyright has It may be uncomfortable for those the Internet allows immediate global to change. Instead of publishers using with interest in the status quo, but dissemination of crucial health infor-m copyright to restrict use, authors can by regaining control of copyright the mation, and the inter-linking of online retain copyright and grant the public medical and scientific communities information creates an integrated, living the right to creatively reuse their work. could ensure that publishing is no lon-g body of information — the ultimate Licences such as those developed by the ger driven by the interests of publishers, vision of which is the semantic web.1 Creative Commons,w3 which facilitate but rather by the needs of society. O What is preventing such a living rather than prohibit reuse, are used web? For scientific and medical informa-t by the open-access publishers Public Competing interests: The authors tion, two obstacles are vested interests Library of Science (PLoS) w4 and BioMed are employed by the Public Library of and traditions. Central to these tradi-t Central (BMC). The result is that: “… Science, an open-access publisher. tions is the role of copyright, which copyright can be used for what it is This editorial is being co-published in was developed when the dissemination meant to in science, not to make the ar-t PLoS Medicine (www.plosmedicine.org). of work was on paper. Initially, apply-i ticles artificially scarce and in the process ing copyright to medical articles pro-t restrict their distribution, but instead, to References tected both the intellectual investment ensure that their potential for maximum References prefixed ‘W’ appear in the web of authors and the commercial invest-m possible dissemination can be realised.” w5 version only, available at: http://www.who. ment of publishers. Authors of scientific The potential benefits of such a int/bulletin articles handed over their copyright to change are vast. No longer will physic- the publishers to prevent unauthorized cians have to base their practice on half 1. W3C The World Wide Web Consortium Available print copying. Thus, the prevention of truths. Instead, everyone from patients from: http://www.w3.org/ unauthorized copying helped to dis-s to policy-makers can read for themselves 2. Suber P. Open Access Overview. Available seminate information, by providing a the evidence on which crucial science from: http://www.earlham.edu/~peters/fos/ valid business model for publishers. But and health policy decisions are made. overview.htm

a PLoS Medicine, Public Library of Science, 185 Berry Street, Suite 3100, San Francisco, CA 94107, USA. Correspondence to Virginia Barbour (email: medicine_editors@.org). Ref. No. 06-032409

Bulletin of the World Health Organization | May 2006, 84 (5) 339 Editorials

3. Creative Commons. Available from: http:// creativecommons.org/ 4. Gass A, Doyle H, Kennison R. Whose Copy? Whose Rights? PLoS Biol 2004;2:e228 5. 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 6. 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. 7. 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 8. Policy on Enhancing Public Access to Archived Publications Resulting from NIH-Funded Research. Available from: http://publicaccess. nih.gov/ 9. Berlin declaration on Open Access. Available from: http://www.zim.mpg.de/openaccess- berlin/berlindeclaration.html

Bulletin of the World Health Organization | May 2006, 84 (5)