In the current issue, Gavin Yamey has an essay on the importance of free and open access of the biomedical literature:
Arthur Ammann, president of the nonprofit organization, Global Strategies for HIV Prevention (http://www.globalstrategies.org), tells the following story:
I 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 unlikely to be applicable to their country situation. Their decision to alter treatment based solely on the abstract’s conclusions may have resulted in increased perinatal HIV transmission.1
The physician in southern Africa could not afford to view the full text article due to its exorbitant cost. The full text version of a research article in a medical journal typically costs US$30 to download, while an annual subscription to a journal usually costs several hundred dollars. Hence the physician was forced to rely on abstracts alone (abstracts of some research articles are made freely available in the online database, PubMed, at www.pubmed.gov). The full text versions of most biomedical studies — an essential treasury of life-saving knowledge — are locked away behind access barriers. These access tolls bring enormous profits to the traditional corporate publishing industry, but at the same time make it impossible for many people worldwide to access the biomedical literature. The imposition of such tolls arguably violates the spirit of the Universal Declaration of Human Rights, which states that everyone has the right “to share in scientific advancement and its benefits” (Article 27, section 1).2
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