Open access to publicly funded research information seemed idealistic in 2001, when 34 000 scientists signed the open letter to create a public library of science, (1) but it is an idea that is now widely accepted. For example, support for open access is an explicit element within the plan of action produced by the Intergovernmental Working Group on Public Health, Innovation and Intellectual Property (2) and a recommendation of the science academies in the United States of America in their assessment of their country's commitment to global health. (3) Where there is Internet access, individuals are increasingly using research information to inform themselves in making decisions about their health (4) and a survey in the United Kingdom of Great Britain and Northern Ireland showed that many people now consider broadband as essential a utility as water or gas) But free access to more text is just the tip of what could be done with the information iceberg.
The Internet could radically alter the way scientific research is done. (6,7) For that change to happen, more peer-reviewed research papers and the data that support them need to be processed and presented in a high quality digital format to a standard such as the National Library of Medicine's Document Type Definition (DTD) by, for example, ensuring the paper is deposited in a free public repository such as PubMed Central. This allows the text to be automatically tagged to identify keywords, genetic sequences and chemical compounds. Links can then be made, often by computer, between millions of pieces of data in the research literature, databases and compound libraries. (8) The scope for research becomes hugely magnified and interconnected in ways not previously imagined, with greatly improved potential for finding new ways to improve global health. This potential remains unfulfilled while research is kept behind old-fashioned subscription barriers on a multitude of publisher web sites in various formats.
So will open access build a bridge to reduce health inequity? The potential is certainly great but the digital divide remains large, with estimates that only 13% of the developing world use the Internet, often on slow and expensive connections. (9) Therefore, the inequity in accessing information and communication technology infrastructure will need to improve to allow people to get a foot onto the information bridge. But even once they are there, they will still only be able to access information that has been paid for--even when that information was created using taxpayers' money. There is a role for more research funders and donors to support open access as an integral cost of undertaking the research itself to ensure public access. (10)
While the United Nations might be seen as having a "slow bandwidth" approach to this issue, things are moving ahead with the work of the International Telecommunications Union on promoting greater access to information and communication technology worldwide and the newly developed WHO strategy on research for health that states: "[WHO will] . …