It is estimated that only 28% of scholarly literature is open access, meaning a large amount of research and health information lies behind a paywall. For people without individual or institutional subscriptions, this renders a lot of knowledge inaccessible.

It’s all too easy to spread misinformation while accessing the truth remains expensive. Providing free access to peer-reviewed scientific research could be a great way to address issues of fake news and anti-vaccine conspiracies.

‘A large portion of medical research continues to be published behind paywalls that limit access to research findings. Having open access to medical research is important not only for research scientists, but also for members of the general public.
…Open access can help to broadly distribute research findings that were made possible through the time and efforts of research study participants. Finally, open access to medical research can help members of the public to have more information for making decisions about their health.’

The move to an open access model of health publishing would have vast health benefits, but those who make the decisions within academic publishing are far from eager to let go of the reins.

Benefits to public health

Paywalls make it difficult for members of the general public to engage with research they have taken part in. They may benefit from outcomes the research yields further down the line, but miss out on the opportunity to use the research as insight into their own health.

‘Open access publication enhances transparency and public knowledge, and thus is crucial for fostering patient and public engagement with academic endeavors. Additionally, open access publishing clearly has important implications for public health. Open access allows medical evidence that can impact the policies and practices that shape population health to be widely distributed and freely available to all.’ 

Public access has often come as an accidental byproduct of making things available to academics, but recent work has begun exploring the important benefits of making things available to the public.

A Dutch study found that members of the public were interested in medical treatment research being freely available, particularly when they were faced with a medical problem themselves. In addition, a study of UK medical charities found that ‘staff laypersons extensively made use of open access medical research to assist with tasks such as managing research grants and communicating research findings.’

Researcher accountability

Making research public makes it possible for the general public to hold researchers accountable in terms of the deployment of public funds. This accountability could help direct research towards things that are of wide public benefit and perhaps drive research into previously under researched rare diseases.

‘Medical research is often made possible through public funds, therefore members of the public should be able to access the research results. Open access is also important in order for the public to have enough information to advocate for changes to policies and research funding.’ 

‘Lingering resistance to open access medical research is likely related to the fact that academic publishing is a highly profitable business,’ keeping academic publishing houses in the green. The profit margins of academic journals are reportedly around 40% due to the fact that a large amount of the initial investment into the research itself is footed by taxpayers.

For those publishing the material, there is little business incentive to switch to an open access model. However, high subscription costs to academic publications have even been deemed unsustainable by the likes of Harvard University who have historically encouraged staff to publish in open access journals. If Harvard cannot reasonably afford to shell out for academic journal subscriptions, it is unlikely that individuals will be able to – especially if they wish to read a wide variety of sources.

Public interest

Medical research findings are of significant interest to members of the public because of their roles as funders, advocates, research participants, and patients, yet without open access models many are left unable to access them.

It is possible to purchase access to research papers without being affiliated with an academic institution, but the high costs mean that they are only accessible to those who can afford it. Health inequalities already exist along class lines with those in poorer households more likely to experience poorer health outcomes; making research freely available could help improve public health as a whole. However, health illiteracy remains an issue with a percentage of the population unable to truly understand the health information available to them, so access to the research currently behind paywalls would only be a part of the puzzle in eliminating health inequalities.

Gaining an understanding of the state of health research and the use of public funds extends beyond individual health. For example, many political parties make manifesto promises regarding funding of medical research and health services, so a better understanding of the research being conducted would result in more informed political choices.

Open access also allows publications such as ourselves to access information needed to explore all angles of a narrative and ensure that stories are scientifically accurate. This is an important part of the picture as turning academic papers into something accessible to the wider public makes the knowledge they contain easier to disseminate and share.