Second re-send - Open access (20) Q4 How would you design an OA system that retains the benefits but fixes the problems of the current OA system? (3)

13 October, 2025

Dear HIFA colleagues, The message from Chris Zielinski just now came through with formatting errors. My re-send also had errors. This is a second re-send - third time lucky. Thanks, Neil

1. As an early supporter of the Budapest Open Access Initiative (BOAI) statement (February 14, 2002 – https://www.budapestopenaccessinitiative.org/), I have long campaigned for OA and watched with initial delight as the uptake of all forms of Open Access have rocketed (https://stm-assoc.org/oa-dashboard/oa-dashboard-2/uptake-of-open-access/).

2. Open Access allows those wishing to read health literature to do so for free, without any paywalls, without paying heavy journal subscription costs. This is obviously very welcome, particularly in resource-poor environments.

3. University libraries can stop paying high subscription costs for journals that have adopted OA, while their parent institutions establish funding mechanisms to pay the article processing charges (APCs) incurred by authors from those universities. Overall, universities should find a net balance between lower library costs and paying for APCs. As a rule, Open Access papers are read, and therefore cited, far more often than papers in non-OA subscription journals. So both the readers and the writers are happy. What could be wrong with such a model? Well, there are a few points of concern.

4. The equilibrium suggested above, of lower subscription costs paying for APCs, has proved to be an illusion. According to Jan Veleterop, a leading OA actor, “The hope that this would result in not only an open research publishing infrastructure, but also a more efficient, less expensive, and less profit-extractive one, was, alas, not fulfilled… The hope that the amount of money siphoned off from the budgets for scholarly research – just to pay for publication – would decrease did not materialise.” Velterop advocates for the adoption of the so-called Plan U (for “Universal OA”) – funders should mandate that research results must always be posted on an openly accessible preprint server before they are submitted to a journal. That way, the communication of science results would not be confused with the scientists' efforts to enhance their reputations through publication in "high-impact" journals."

5. Many of the best and most respected journals in the world are now published using the Open Access model. However, we have also watched the rise of predatory journals using OA purely as a means to make money. Predatory journals use a very simple economic and production model:

a. Think up a resounding journal name (“International”, “Global” etc)

b. Have as many papers as possible submitted

c. Accept them all without excessive peer review

d. Collect a hefty article processing charge for each paper

e. Dump them on your website (=”publish”)

Predatory publishers require little staff, no investment apart from a rudimentary website, and a batch of form letters. Such publishers will publish anything because they don’t care about the quality of what they publish. They have no incentive to care. Consequently, predatory publishers muddy the waters by producing poor, discredited science. Unfortunately, this is something which Open Access enables.

6. Open Access relies on journals being paid an article processing charge (APC) to publish. The APC can be paid by the author, by an academic institution, government or by some other source willing to pay for the author. Journals may also offer waivers of APCs when authors meet certain conditions. There is no rule about the size of an APC – it can range from zero to thousands of dollars. APCs raise a number of questions:

a. Do APCs inhibit science? Well, take the case of individual researchers – researchers not affiliated to an academic institution willing to pay for their publishing, researchers that don’t work on funded projects with publishing budgets. Such researchers are clearly inhibited from publishing. Researchers in resource-poor environments are similarly inhibited. Even though many publishers will waive APCs for such authors, there can be a reluctance to being obliged to turn out your pockets to show you cannot pay. There is no uniformity in the waiver system.

b. Does the inability to pay the APC raise the acceptance barrier? Does your paper have to be considered to be better than run-of-the-mill if you are getting a waiver?

c. Who publishes in the journals with the highest APCs? Is it the best authors or those from the wealthiest universities?

7. Finally, among the possible downsides of Open Access, we should consider what new health literature is suddenly being made available as the cost barrier falls away. Is it mostly Western/Northern/rich-country literature describing actions and interventions requiring expensive equipment and medicines, trained staff and robust institutions, or is it information about locally relevant, appropriate treatments that are applicable in low-resource-settings? My question is deliberately framed in extremes, in order to illustrate the “epistemic injustice” noted in recent literature: the local is being swamped by the global, the traditional healers are being swept away without replacement by the chattering of well-paid allopathic professionals, the inexpensive local cures are being challenged by unaffordable, unattainable medicines that work just as well or badly.

Chris Zielinski

Centre for Global Health, University of Winchester, UK and

President, World Association of Medical Editors (WAME)

Blogs; http://ziggytheblue.wordpress.com and http://ziggytheblue.tumblr.com

Publications: http://www.researchgate.net and https://winchester.academia.edu/ChrisZielinski/

HIFA profile: Chris Zielinski: As a Visiting Fellow and Lecturer at the Centre for Global Health, University of Winchester, Chris leads the Partnerships in Health Information (Phi) programme, which supports knowledge development and brokers healthcare information exchanges of all kinds. He is President of the World Association of Medical Editors. Chris has held senior positions in publishing and knowledge management with WHO in Brazzaville, Geneva, Cairo and New Delhi, with FAO in Rome, ILO in Geneva, and UNIDO in Vienna. He served on WHO's Ethical Review Committee, and was an originator of the African Health Observatory. He also spent three years in London as Chief Executive of the Authors Licensing and Collecting Society. Chris has been a director of the UK Copyright Licensing Agency, Educational Recording Agency, and International Association of Audiovisual Writers and Directors. He has served on the boards of several NGOs and ethics groupings (information and computer ethics and bioethics). chris AT chriszielinski.com. His publications are at https://www.researchgate.net/profile/Chris-Zielinski and https://winchester.academia.edu/ChrisZielinski/ and his blogs are http://ziggytheblue.wordrpress.com and https://www.tumblr.com/blog/ziggytheblue