In a Comment to be published this week in The Lancet, Richard Smith, a former Editor of the BMJ, and Tracey Pérez Koehlmoos, International Centre for Diarrhoeal Disease Research, Bangladesh, argue that medical publishers must "continue to provide free access to all of their journals in all of the 64 low-income countries signed up to the HINARI system". Their call follows the withdrawals of free access by Elsevier (publisher of The Lancet), Lippincott Williams & Wilkins, Springer, and the American Academy for the Advancement of Science (AAAS) and in an Editorial, The Lancet endorses their call and says that "If publishers are genuine about their mission to improve health throughout partnerships with medical and research communities, they need to send a stronger signal of commitment to countries that most need the knowledge they control".
The Health Inter-Network for Access to Research (HINARI) programme was created in 2001 to allow the least developed countries in the world free access to the latest medical research, access that cost would prohibit if these resource-poor nations were charged in the same way as high-income countries. At the beginning of 2011, researchers in Bangladesh, one of the world's poorest countries, received a letter from WHO announcing that several publishers would no longer be allowing free access to their 2500 journals through the HINARI system.
After news of the withdrawals became public, the AAAS (publishers of Science) immediately restored access to its journals through HINARI in Bangladesh. Elsevier has now followed this example.
Elsevier states in its Correspondence that its Research 4 Life programme, that includes the HINARI, Agora and Oare systems, is a "cornerstone" in the company's goal of achieving universal access to scientific, technical and medical research information. But is some developing countries such as Bangladesh, Elsevier says it is moving away from HINARI-style access towards discounted commercial agreements. It aims to give Bangladesh a free trial of regular access platforms throughout 2011 before moving to such a commercial agreement in 2012. Dr Alicia Wise, Director of Universal Access at Elsevier, says: "Unfortunately, there were technical delays in Bangladesh and access under Research4Life was terminated before the free access trial began. This was not well communicated to all R4L users and we are correcting our mistake. Access in Bangladesh under Research4Life is now restored so we can accomplish the transition without disrupting access." The Lancet has welcomed this change in policy, and hopes it will be permanent.
Bangladesh is not the only country affected by this situation. It has emerged that institutions in Kenya and Nigeria are facing similar free access withdrawals. WHO, keen not to publicise the "falling apart" of HINARI, has now revealed access restrictions from major publishers apply in 28 of the 64 countries deemed to have the lowest income in the world. Smith notes that "WHO cannot tell us which publishers have denied access to which countries".
He adds: "In exchange for a few dollars, these publishers risk creating a torrent of ill-will against them from the excluded countries, authors around the world, and quite possibly, their own staff. Pharmaceutical companies have learned the hard way that buccaneering tactics in poor countries do not work and will not be tolerated, and the consequence is the severe damage of their image, brands, and products."
The accompanying Lancet Editorial calls for universal free access to continue in the 42 countries deemed as having low human development by the UN, a list that includes Bangladesh, Kenya and Nigeria.
The Editorial adds: "Low human development means exactly that—high burdens of avoidable morbidity and mortality among the most vulnerable populations. Bangladesh's maternal mortality ratio is 338 per 100,000 livebirths, Kenya's 413, and Nigeria's 608. In the UK it is 8. Free access to critical knowledge is vital if those countries are to address their huge burdens of preventable disease."
Richard Smith, Warwick University, UK, and Patients Know Best, Cambridge, UK. T) +44 (0) 796 880 1963 / +44 (0) 20 7720 5575. E) richardswsmith@yahoo.co.uk
Tracey Pérez Koehlmoos at the International Centre for Diarrhoeal Disease Research, Bangladesh. T) +880 -2- 886-0523 ext. 3101 E) traceylynnk@hotmail.com
Lancet Press Office. T) +44 (0) 20 7424 4949 E) tony.kirby@lancet.com For Dr Alicia Wise, Director of Universal Access at Elsevier, please contact Tom Reller in Communications. T) +1 215 239 3508 E) t.reller@elsevier.com
For full Comment, Correspondence, and Editorial see: http://press.thelancet.com/hinari.pdf
Journal
The Lancet