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Bulletin of the World Health Organization

Print version ISSN 0042-9686

Bull World Health Organ vol.79 n.8 Genebra Jan. 2001 

WHO News

Poor countries get free online access to medical journals

The six publishers of about 1500 of the world's leading medical journals have agreed to provide online access to their journals free or almost free to developing country institutions. At a press conference in London on 9 July, the publishers said the agreement, which was facilitated by WHO with support from the BMJ Publishing Group and the Soros Foundations Network, would take effect from January next year and would benefit at least 600 institutions — universities, medical schools, research institutions, nursing schools — in about 100 developing countries. The six publishers are Blackwell, Elsevier Science, Harcourt Worldwide STM Group, John Wiley, Springer Verlag, and Wolters Kluwer International Health & Science.

Under the agreement, readers in the 60 or so developing countries with a per capita gross national product (GNP) of less than US$ 1000 will have entirely free or, in the case of one publisher, almost free online access to the journals. Readers in the approximately 30 countries with a per capita GNP of between US$ 1000 and US$ 3000 will be offered deeply discounted subscription rates. The agreement will be monitored for an initial three years, at which time decisions will be taken about any changes required to the present arrangement.

The announcement was greeted with almost universal acclaim, verging at times on the awestruck. "Stunning!" was how Ms Helga Patrikios, a librarian at the University of Zimbabwe Medical School in Harare, expressed it. "It really does close the gap [between rich and poor countries]." Dr Richard Smith, editor of the British Medical Journal (BMJ), called the agreement "momentous" and said it "completely transforms their [developing country readers'] environment. It's like a desert turning into a garden". WHO director-general Dr Gro Harlem Brundtland called it "a real breakthrough ... perhaps the biggest step ever taken toward reducing the health information gap between rich and poor countries".

A few critics, however, tinged the euphoria created by the announcement with fears that potential readers in parts of the developing world that lack the logistic and material infrastructure to access these journals electronically will be deprived of the benefits of the arrangement. WHO is tackling this problem through the UN Health InterNetwork project to speed the supply of computers and Internet connections to poor countries and to use the Internet to support public health programmes in these countries.

The Health InterNetwork project was launched last year by UN secretary- general Kofi Annan as a means of bridging the so-called digital divide. It is spearheaded by WHO with support from the United Nations Foundation and the Bill and Melinda Gates Foundation. The project's organizers are planning a global public health portal, through which the publishers participating in the new agreement will provide access to their medical journals. Other material being considered for distribution includes statistical data, clinical guidelines, health policy recommendations, public health software applications, and electronic distance learning packages.

A few journals, notably the BMJ, have already been freely available online for a number of years. Among the 1500 or so newcomers to the list, which will provide electronic access not just to current issues but to all their online material, are Social Science & Medicine, Statistics in Medicine, Health Economics, Medical Education, Parasitology International, Tropical Medicine & International Health, Health Policy, and Brain Research. Annual online subscription rates for these journals can exceed US$ 1500 for a single journal. Mr Derk Haank, chief executive officer of Elsevier Science, said that this project would cost his company "millions". One publisher, Springer-Verlag, will also offer textbooks and reference books online, and others intend to follow suit.

Missing from the list of journals newly available online are major US publications, such as the New England Journal of Medicine, Science, Proceedings of the National Academy of Sciences, and the Journal of the American Medical Association. Nature and its clutch of "sister publications", including Nature Medicine, Nature Biotechnology, and Nature Immunology, are also absent from the list, as are the big university presses on both sides of the Atlantic. WHO and its partners on this project hope to extend the arrangement, in stages, throughout the biomedical publishing community.

John Maurice, Bulletin