Open Access: The Only Viable Option for Change

Rebecca RhodesWhy do we publish health research? If the editors of PLoS Medicine are correct that “medical journals have many roles, but, above all, dissemination of medical information is key,” then journals need to be accessible to the most important data consumers—frontline health workers.

While research for its own sake is necessary to advance scientific understanding, this is not enough. At its core health development research should save the lives of people who—without access to basic health care—die from diseases easily cured or preventable childbirth complications.

Impact
If the individuals who could most contribute to and benefit from information on health in the developing world find the resources cost-prohibitive to access, then how much impact can we really expect from research? Considering that many people in a developing area do not have access to a medical or academic library that subscribes to these journals, even a low $10 document viewing fee would be an unreasonable financial burden. For some users, this would be equivalent to a week’s pay.

Research users
As a librarian who collects resources on global health workforce topics for people struggling with real-world problems, I see clearly that Open Access resources (articles, evaluations, videos, tools, etc.) are the only way to scale up innovative thinking and influence decision-making to address health services in low-resource areas.

These library users seek information on issues such as preventing health worker migration from high-need areas or providing HIV treatment in a rural area without the money to offer enticing salaries to retain health workers. Additional funds for journal subscriptions are just not available. No matter how well-written, materials that require payment are not viable options for those most in need of development research.

Free and open
As health system strengthening advocates, we aim to freely and widely distribute information to help address the world's critical health situations. This is the guiding principle around the design of our library, the HRH Global Resource Center, and our two partner libraries, the Global Health Workforce Alliance Knowledge Centre and the HRH Knowledge Hub, all of which provide free access to people working at all levels of the health system.

Almost 45,000 visitors a month from 172 different countries visit the HRH Global Resource Center, so it is clear that there is a thirst for this information. The next steps will be to encourage health workers and researchers, who lack opportunities to publish formal articles, to use informal venues such as Health Information for All 2015 community, as well as other websites and social media outlets to share their knowledge. We must also continue to encourage publishers and authors in the developed world to provide Open Access options. It is only through the open sharing of research that publications can begin to make an impact on the current health workforce crisis.

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Photo by Jennifer Solomon