1. www.plos.org Is open access publishing for you? May 16 2008 Gavin Yamey MD MA MRCP Senior Editor, PLoS Medicine Consulting Editor, PLoS Neglected Tropical Diseases

2. www.plos.org A depressing story—from Indonesia A group of junior doctors goes online to search the literature Most articles are only available as “pay per view” or via subscription The current medical publishing system bars them from access Ham MF et al. Open-access publishing. Lancet. 2004;364:24-5.

3. www.plos.org Another depressing story—from Africa The WHO asks James Tumwine to investigate an outbreak of “nodding disease” in Sudan Literature review: access denied Yamey G. Africa's visionary editor. BMJ, Oct 2003; 327: 832.

4. www.plos.org Another one—from the UK “Even as an international NGO based in the UK, we don't have enough money in our budget to take subscriptions to all the interesting journals we might wish for”

5. www.plos.org And another—from the US “The ‘unbearable cost’ of accessing journals means that even the world’s richest libraries, such as the Harvard University Libraries, cannot access some of the crucial biomedical literature.” Yamey G, Excluding the Poor from Accessing the Health Literature: A Rights Violation that Impedes Global Health. Health and Human Rights (in press) www.hhrjournal.org

6. www.plos.org Yet another depressing story—UK and Africa The director of the world's largest medical research charity receives notification from one of his funded investigators in Africa reporting exciting progress toward the development of a malaria vaccine The work has just been published, so he goes online: Access Denied

7. www.plos.org Perhaps the most depressing story of all….. “I met a physician from SA, engaged in preventing mother-to-child HIV transmission, whose primary access to information was abstracts online…Based on a single abstract, they had altered their perinatal HIV prevention program from an effective therapy to one with lesser efficacy……… Their decision to alter treatment based solely on the abstract's conclusions may have resulted in increased perinatal HIV transmission.”

8. www.plos.org The problem Biomedical research results—a treasury of medical knowledge—are privately owned and sold only to those who can afford it Publishers make huge profits by restricting access I believe medical research results should be considered a global public good (most is funded by the public) Access to this knowledge: a global public health crisis

9. www.plos.org The solution: make all research results freely available online “It is now possible to share the results of medical research with anyone, anywhere, who could benefit from it. How could we not do it?” Harold Varmus, Nobel Laureate, PLoS Co-founder

10. www.plos.org What I’d like to talk about today The current medical/scientific publishing system Why that system is broken and unsustainable How the system impedes scientific progress and public health Open access publishing: ▪ a healthier alternative ▪ how we fund it at PLoS

11. www.plos.org The private ownership of research results You write the research paper You give your work to publishers, you hand over copyright to them, they then sell it to wealthy readers A high profile drug trial can earn a journal $1m in reprint sales The work is subject to extremely tight copyright restrictions

12. www.plos.org Medical & scientific publishing is big business Worth $5 billion/year Reed Elsevier (market leader): profits of $290m/yr Massachusetts Medical Society: listed $US 88 million in total publishing revenue for yr ending May 31, 2005 Fastest growing sub-sector of the media industry for the past 15 years

13. www.plos.org Copyright is used to protect profits Traditional publishers demand that authors give up ownership of their work Publishers sued copy shops for including copies of research articles in student course-packs without paying royalties to the publisher These articles were being used for educational purposes!

14. www.plos.org Who gets to see the research results? Results of billions of dollars of research funding (NIH: $28bn in 2004) may be seen by only a small fraction of the intended audience, because it is published in journals that few individuals or institutions can afford to subscribe to. Annual subscription to Brain Research costs $21,269

15. www.plos.org The Wellcome Trust’s position The publishing of scientific research does not operate in the interests of scientists and the public, but is instead dominated by a commercial market intent on improving its market position

16. www.plos.org Journal prices CPI/inflation Journals purchased Things are getting worse: the “death spiral” Source: Association of Research Libraries

17. www.plos.org Not for public consumption Restricted access to research funded by NIH Depression severity and drug injection HIV risk behaviors. Am J Psychiatry. 2003;160:1659-62 Taste preferences and body weight changes in an obesity-prone population. Am J Clin Nutr. 2004;79:372-8. Structure of West Nile virus. Science. 2003;302:248.

18. www.plos.org

19. Impeding global health Health professionals worldwide are starved of information; dangerously rely on abstracts Poverty of information hinders health system strengthening Impedes health research (we prevent researchers “standing on the shoulders of giants”) Impedes global scientific conversations Subscription-based journals are forced to ignore the health problems of the poor

20. www.plos.org The logical alternative: open access publishing Subscription fees made sense before Internet Printing, binding, and mailing each additional paper copy cost additional amount But what online publishers do has a one time fixed cost (cost of 2 readers = cost of 2000 readers, so why charge all 2000 readers?) Recover this fixed cost up front Publisher is just a service provider (like a midwife)

21. www.plos.org Research Funder Publisher Reader $ How does open access work at PLoS? Publishing is the final step in a research project

22. www.plos.org Oct 2003 Oct 2004 The Next Generation “Open Access 2.0” 2005: Community Journals

23. www.plos.org What is open access? Free, unrestricted online access Users are licensed to download, print, copy, redistribute, and create derivative works (CC Attribution License) Author retains the copyright (not the publisher), i.e. right to be credited Papers are deposited immediately in a public database that allows sophisticated searches

24. www.plos.org Benefits of open access No longer will physicians and policymakers have to base their work on the half truths of abstracts For authors, reach and impact of work For editors, free of space constraints, can offer greater range of articles For health/science community: post- publication peer review, annotation, interaction, searching & mining

25. www.plos.org Profound benefits to the public Patients and health organizations seeking reliable information Teachers looking for classroom materials Journalists investigating health stories Lawyers, policymakers, activists searching for empirical studies that could inform their work on promoting human rights or protecting the environment

26. www.plos.org Myths about open access MYTH: “Not peer reviewed” MYTH: “Poor impact factors” MYTH: “Excludes poorly funded researchers”

27. www.plos.org Who is propagating these myths?

28. www.plos.org Once knowledge is truly in the public domain, the only limit upon its use is our imagination…

29. www.plos.org Creative Uses of PLoS Materials

30. www.plos.org Creating a derivative work from a PLoS Medicine special issue

31. www.plos.org Article on global epidemic of counterfeit drugs translated into Spanish

32. www.plos.org Neonatal imitation in rhesus macaques Ferrari et al. PLoS Biol 4(9): e302

33. www.plos.org New York Times learning network lesson plan "Monkey See, Monkey Do""Monkey See, Monkey Do" grades 6-8 and 9-12

34. www.plos.org Ultrasonic songs of male mice Holy & Guo. PLoS Biol 3(12): e386

35. www.plos.org Sent: Friday, December 09, 2005 8:27 PM To: PLoS Subject: Thank you Dear Public Library of Science people, I just listened to a mouse song on line… and I wanted to tell you how grateful I am for your journal. I am a middle school science teacher. I do not have the funds to subscribe to the traditional science journals. Tomorrow my students will hear the same mouse song I listened to and I am sure they will be as enchanted and interested as I am. The idea of open access to original research papers is very exciting to someone in my position… I can assure you that the availability of research papers will benefit the future of scientific research by providing motivation and stimulation for millions of fledgling scientists. Sincerely, Science Teacher

36. www.plos.org What is open access? Free, immediate access online Unrestricted use

37. www.plos.org What is open access? Free, immediate access online Unrestricted use

38. www.plos.org What is open access? Free, immediate access online Unrestricted use

39. www.plos.org What is open access? Free, immediate access online Unrestricted use

40. www.plos.org A network of literature Document

41. www.plos.org A network of literature and data Document Database

42. www.plos.org Text mining of full text articles The literature is vast Machines can be used to discover previously unknown information

43. www.plos.org Inclusive Scope all of science and medicine Open Access the right to read, copy, distribute, and share High Capacity no length or volume restrictions Streamlined Production acceptance to publication in 3 weeks Objective peer-review focusing on scientific rigor Post-publication commentary annotations, discussions, journal clubs, rankings

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50. PLoS Hubs “a window onto content in a specific field” PLoS Hubs will collect together OA articles from many journals, and will allow a group of people who are interested in the same subject to share their opinions and knowledge and ultimately to build a dynamic interactive community

51. www.plos.org

53. There are many inequalities in medicine, science, and health care. But access to the latest peer-reviewed research results doesn’t have to be one of them. Gavin Yamey: gyamey@plos.org