If you doubt that a librarian can change the world, listen to what Barbara Aronson has to say in this week’s installment of my ITConversations podcast. As the librarian for the World Health Organization, she’s been the driving force behind HINARI, a publisher partnership that’s making thousands of otherwise unaffordable medical journals available to researchers in poor countries — at no cost to the poorest 70 (“band 1”) countries, and at nominal cost to the next-poorest 43 (“band 2”) countries.
I first heard about HINARI from Lee Dirks, Microsoft’s director of scholarly communication, whom I met last month at the EDUCAUSE Seminars on Academic Computing. “She’s doing amazing work,” Lee told me. Wow, is she ever. Her mission to democratize access to medical knowledge challenges our assumptions about the nature of open access, the economics of publishing, and the research priorities of the developed world.
In response to criticism that HINARI isn’t “pure” open access, because of the token fees paid by band 2 countries, she says:
I think that most people who live in wealthy countries have no idea about what incomes are like in poor countries, and how many countries are poor. There are 72 countries whose gross national income per capita is less than a thousand dollars. There are 43 who are in the one- to three-thousand-dollar range. These countries bear the highest burden of disease in the world. These are places where most of the wars in the world are taking place, where they have the highest unemployment, and the most precarious life. Now most of the health research in the world is done on the problems of the richest people, because the money for health research comes from the wealthy countries. So you’ve got these very poor countries with the worst health problems, they’re trying to train doctors and nurses to take care of their populations, they’re trying to train researchers to find out the information that doesn’t exist to solve their problems, and they’re doing all this with no access to scientific and technical information.
Is HINARI open access? Not according to anybody’s strict definition of open access, but those definitions are made in the developed world. The open access argument, or discussion, as it’s going along in the places where it is going along, is too narrow, and it needs to be expanded if we’re going to be truly global about this.
What’s fascinating here, from the perspective of publishing economics, is the way in which publishers seem to be using HINARI to prototype a tiered pricing model that Barbara Aronson suggests may be applicable to their customers in the developed world too:
Maybe if the publishers could find a way to manage tiered pricing, which is a big question, maybe then they’d be able to address issues like: What about poor institutions in rich countries? What about underfunded individuals in rich countries?
But I don’t want to leave the impression that this conversation was all about publishing economics. There’s much more at stake. As she points out, researchers don’t just consume the information that HINARI makes available, they refract it through their own experiences and then contribute important new knowledge.
Two weeks ago I heard from the International Center for Diarrheal Diseases Resarch, in Bangladesh. They’re big users of HINARI. These are the people who pioneered the absolutely brilliant way of treating diarrhea in small children. Diarrheal diseases are one of the two biggest killers of children under five in the world. And this means in the developing world, because in the developed world people don’t die of this. These are the people who developed groundbreaking approaches to dealing with that, and to dealing with acute respiratory infection which is the other big killer. Bangladesh is one of the poorest countries in the world, and yet it has produced world-class research that has helped way beyond its borders.
I tip my hat to Barbara Aronson, to the World Health Organization, and to the hundred-plus publishers who’ve joined the WHO in this inspirational project.