121…

The journal article is a form of communication that has stood the test of time, and one that can be modified to all the advantages of the internet age. While the printing press was a great step forward, with the coincidence of that technology and the journal article within the European world with centuries of colonialism, it contributed to the monopoly of knowledge that concentrates the power of knowledge in a very small number of hands relative to the world. The digital is a global technology, or at least it can be.

The task for the South is now not simply to get access to apply to training and knowlege needs, but to transform knowledge, transform the journal article, publish open access and allow knowledge development to flourish South-South-North flow of communication, in a global flow. The North is unable to shoulder the density and magnitutde of contemporary human problems, most of which were created by some blind spot in their colonial or post-colonial consciousness in the first place, there are too few individuals and too few perspectives.

So to face climate change, to face the global burden of infectious disease, to eradicate malaria, to reverse the spread of HIV/AIDS, to provide quality, contextual, free primary education, to direct the shape of curriculi from quaternary to primary, to participate in the global discourse about the form of accreditation of knowledge, it’s relationship to culture and it’s spectrum of universality to plurality, to determine the development agenda locally and extract the global lessons, to realize the right to self-determination, to end the extreme disparity in the world, to correct one’s own biases and blind spots, to throw off cultural baggage and retain traditional strengths, to broadcast African, South American, Asian cultural and intellectual content, and to own the means of media production, to reconcile a global history, to adopt, integrate and hybridize every contribution of the good of any other culture, and to take responsibility for the future, to recognize culture as dynamic while able to transmit wisdom across generations – and to strengthen the majority world, reduce corruption and restore confidence in institutions, to abandon racial and ethnic prejudice and negotiate and manage resources – to equalize the world and make it sustainable – this is not possible unless people have control over and generate knowledge in context, and today that context stretches local to global, today that context is educational, scientific and cultural and problems require communication of all modes of knowing in order to solve them. every society has to be a learning society.

Is this not the task for all? How can all contribute if there are barriers to knowledge? Who should hang their heads in shame are the subscription-based publishers who in the first place accept donations from the research author whose patron is the public, who accept donations of peer-review, and who then turn around and charge exorbitant rates to view public research, and then turn around and pat themselves on the back for making concessions to poor countries. They can change their business model but won’t do it. This is not about charity, this is about enlightened self-interest on the global level, perhaps about survival for which you need all corners of the globe to be active in solving problems instead of suffering them.

Don’t get me wrong, HINARI is good, has to be done. Good for the WHO for arranging this, but I do believe that closed-access publishing is going to evaporate because it is, after all, not a model that intelligent people can accept.

And therein lies the paradox: the so called ‘worse’ can teach the so called ‘best’ many lessons. Perhaps we should look to our colleagues in Malawi and other resource poor environments to help us re-connect with the core values of patient respect, health education, integration of public health with clinical care, and above all pride in caring for patients. Online journals and social networking sites allow us to do this.

Agreed. FWIW it is Barbara’s belief, based on her observation of open access publishing in developing countries, that governments can and should bear those costs.

“Developing nations certainly need this help, but we should not be fooled into thinking that this has anything to do with open access.”

On the one hand it has nothing to do with open access. On the other hand, if our definition of open access can have nothing to do with a project that is revolutionizing access to critical information in the way that HINARI is, then that definition seems a bit narrow.

Open access is often seen as inexpensive in much the same way that open source is seen as inexpensive. This is certainly possible, but not inherent to either open access or open source. There are real costs associated with publishing a journal or developing software. The distribution model may obscure these costs for many people, but they do not go away. Open access and open source are about freedom of information. (In less lofty terms, they protect intellectual property from those who would hold it for ransom.)

Co-mingling economic support for developing countries and open access is part of a strategy of some who oppose open access. By conflating these ideas, they attempt to claim that they are addressing the issues championed by the open access movement when they lower economic barriers. Developing nations certainly need this help, but we should not be fooled into thinking that this has anything to do with open access.

There’s another angle on this. I’ve lived and worked in seven different countries, and variations in medical practices are remarkable. Most dramatically, when we were in Austria my wife was given a cerclage to prevent the premature birth of our second child. While pregnant she returned to Canada, where we were told that had we been in Canada they never would have given her the cerclage. A few hours after the cerclage was removed, her waters broke and our son was born shortly thereafter. Had we not been in Austria earlier in the pregnancy, she almost certainly would have had a miscarriage instead.

Sharing medical practices would be a good idea worldwide. Why is a highly effective and widely used medication in one country, for example, virtually unknown and unavailable in another country? I hope very much that the doctors and medical researchers will begin talking across borders and language barriers and learn from each other.