Uncertain Health in an Insecure World – 16

“Open Access, or The Highway?”

The first known scientific journal, Philosophical Transactions of the Royal Society, was published 350 years ago in 1665. As noted on the frontispiece below, its pages gave an “account of the ingenious in the many considerable parts of the world”.

The 15-year old Bill and Melinda Gates Foundation’s current endowment is $43 billion. Their money funds ingenious educational and health care research. Its official blog is called Impatient Optimists because Bill and Melinda, once naïve (by their own admission) to the ways of the world of giving, have come to understand that deep pockets & big ideas alone are insufficient conditions for global game change.

Even geniuses must learn as they go. 

Effective January 2015, the Gates Foundation will require that its funded researchers submit their results to open access online journals, like the OMICS Group and the Public Library of Science PLOS ONE. By 2017, all of the research funded by the Gates Foundation must be initially published in open access journals, without the typical constraints to information sharing associated with big publishing house costs and embargoes.

In addition, the Gates Foundation has stipulated that articles funded by their grants have a Creative Commons Attribution 4.0 Generic License (CC BY 4.0), allowing published content reproduction for both scientific and commercial uses.

So from now on, it’s full, free and immediate information access, or ‘The Highway’, for researchers planning to accept prestigious Gates Foundation money.

These publishing strings are spun from Bill and Melinda’s personal values web. They want health care workers in poor countries and emerging economies to have early access to credible research results, without expensive journal subscriptions & article reproduction fees, or other information dissemination barriers.

Fair enough! After all, it is the Gates’ money, so they can dictate the funding terms as they see fit.

The Gates Foundation’s open access online-in-the-sand looks like a game changer for lucrative multinational scientific publishing conglomerates, like The Elsevier Group. Through its data warehousing subsidiaries like Research Intelligence, Elsevier tracks impact factors for individual scientists and research journals alike, tied to the frequency that their peer reviewed publications are cited by others working in the field.

Ironically, impact factor information is highly influential within the research community for one very important reason - it is grounded in a rigorous peer review process. Impact factors can also parallel and even predict the future commercial value of an idea or patent – so-called intellectual property.

High impact scientific journals like Nature and Science do not support the Gates Foundation’s CC BY 4.0 stipulation, arguing that readily reproduced research materials can be altered or misrepresented for commercial interests, to the detriment of a researcher’s and/or a journal’s reputations.

Neither camp’s position is without merit. 

But what would the Gates say if a less robust piece of research, released without major publishing house expert review into the open access architecture, harmed patients?

And what is The Lancet’s explanation for its failed peer review of the 1998 Dr. Andrew Wakefield MMR vaccination-autism link paper, retracted in disgrace in 2010?

So, “Who is right?”

Can a global medical profession sworn to “Primum Non Nocere” (First, Do No Harm) make the compromises necessary to attain the best of both worlds for the underserved, when neither is perfect?

And if “perfection is the enemy of good” in the developing world, then aren’t pricey developed world publishing house practices simply colonialism under another book’s cover?

For us in The Square, the more germane question to both camps may be “What is wrong?”