Open access (87) Introducing Q4: How would YOU design an OA system? (5)

5 November, 2025

Re: https://www.hifa.org/dgroups-rss/open-access-58-clinician-investigator-i...

Dear Lacey and all,

Thank you for your comment:

"Given the current less than ideal options, and following the lead of a global Open Access champion (Gates' Ashley Farley), I favor publishing pre-prints and then in an APC-free journal, so as not to financially bolster a broken system."

This refers to the new Gates Open Access Policy which has two main elements:

1. Gates-funded research should be 'shared promptly in the form of a preprint, which is a version of a manuscript hosted on a public server prior to formal peer review'.

https://openaccess.gatesfoundation.org/open-access-policy/

2. 'The Foundation Will Not Pay Article Processing Charges (APs)'

I expressed my reservations about the Gates Policy yesterday: https://www.hifa.org/dgroups-rss/open-access-86-introducing-q4-how-would...

I look forward to understand what others think.

1. 'Pre-prints'. There are pros and cons with pre-prints.

Pros: The main pro is rapid dissemination of results without the delay of journal peer review. This may be important for fields that are rapidly developing, and is perhaps especially useful to promote efficient exchange among researchers. The usefulness for end-users of research is less clear.

Cons: Pre-prints are less reliable than journal papers that have undergone peer review. They are more likely to contain errors or methodological flaws. The authors' interpretation of the findings is more likely to be biased. Pre-prints that have sensational findings are likely to add to dangerous misinformation. For example, pre-prints contributed to misinformatipon about the effectiveness of hydroxychloroquine to treat COVID-19.

It is unclear whether and how frontline healthcare providers and patients use pre-prints to inform their health decisions. And, if they do, whether the benefits outweigh the risks. If I were a frontline healthcare provider, I would almost never use pre-prints. I would rely primarily on the work of others to synthesise and repackage evidence. I look forward to comments on this.

I invite proponents of pre-prints to comment, whether from the perspective of researchers, healthcare professionals or patients.

2. 'APC-free journals'. Open-access journals that are able to deliver quality editorial and peer review are commendable. I invite HIFA members to describe examples of such journals. I understand that many of these are small enterprises, perhaps funded by their academic institution. I think all the major OA journals - those with the highest impact funders - rely on APCs?

I would question whether APC-free is better than APC-affordable, particularly for the larger journals. I would argue that research funders should pay APCs, and that these should reflect the actual cost of processing rather than the current exploitative stance that is currently used by some journals. This can be promoted by capping APCs (and perhaps other approaches?).

3. 'So as not to financially bolster a broken system'. I would agree that the current system can be improved, but I wouldn't say the whole system is broken and that it needs to be swept aside. I would suggest to look at what are the biggest problems with OA publishing, and discuss how to address them. We are currently looking at the problem of inflated APCs, which I think is relatively straightforward to address - what other problems of the current system do we need to look at?

I look forward to further discussion on how we can build an OA system that fixes the problems and retains the benefits of the current system.

Best wishes, Neil

HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org