[Air-l] A Fight for Free Access To Medical Research

[Art McGee]

[Internet and Cyberspace Research is next on the hit list
<evil grin goes here>.--Art]

http://www.washingtonpost.com/wp-dyn/articles/A19104-2003Aug4.html

Washington Post

Tuesday, August 5, 2003; Page A01

A Fight for Free Access To Medical Research

Online Plan Challenges Publishers' Dominance

By Rick Weiss, Staff Writer

The family was poor, living on the Great Plains, and the
child had a rare medical condition.

"Here's what we can do," the family doctor told them. But it
didn't work, recalled Michael Keller, who oversees the
libraries at Stanford University. "So the family went to the
Internet."

Soon they were back at the doctor's office with a report of
a new therapy. "They plunked it down and said, 'Hey, can we
try this?' And guess what? It worked."

Such tales are becoming increasingly common, but the happy
endings come at a cost -- literally. That is because the
vast majority of the 50,000 to 60,000 research articles
published each year as a result of federally funded science
ends up in the hands of for-profit publishers -- the largest
of them based overseas -- that charge as much as $50 to view
the results of a single study online. The child's parents,
Keller said, paid for several papers before finding the one
that led them to the cure.

Why is it, a growing number of people are asking, that
anyone can download medical nonsense from the Web for free,
but citizens must pay to see the results of carefully
conducted biomedical research that was financed by their
taxes?

The Public Library of Science aims to change that. The
organization, founded by a Nobel Prize-winning biologist and
two colleagues, is plotting the overthrow of the system by
which scientific results are made known to the world -- a $9
billion publishing juggernaut with subscription charges that
range into thousands of dollars per year.

In its place the organization is constructing a system that
would put scientific findings on the Web -- for free.

Scientists and budget-squeezed librarians have long railed
against publishers' stranglehold on scientific literature,
to little avail. But with surprising political acumen, the
Public Library of Science -- or PLoS -- has begun to make
"open access" scientific publication an issue for everyday
citizens, emphasizing that taxpayers fund the lion's share
of biomedical research and deserve access to the results.

"It is wrong when a breast cancer patient cannot access
federally funded research data paid for by her hard-earned
taxes," Rep. Martin O. Sabo (D-Minn.) said recently as he
introduced legislation that would give PLoS a boost by
loosening copyright restrictions on publicly funded
research. "It is wrong when the family whose child has a
rare disease must pay again for research data their tax
dollars already paid for."

It remains to be seen whether the newly bubbling discontent
among citizens and politicians will boil over into a
full-blown coup, fulfilling scientists' longstanding goal of
democratizing the scientific publication enterprise. But
whether it succeeds or fails, historians of science say, the
effort is a remarkable social experiment in itself. After
all, publication is at the heart of the scientific system of
rank, respect and power. So the movement to dissect and
rewrite the rules of that system is, in effect, a rare
opportunity to watch scientists experiment on themselves.


Research as Moneymaker

Historians peg the birth of scientific publication to 1665,
when England's Royal Society began publishing its
Philosophical Transactions -- the same journal that would
later announce key discoveries by Isaac Newton, Charles
Darwin and other icons of science.

Today the universe of scientific journals includes about
28,000 titles, but they fulfill the same four basic needs:
communicating findings; controlling quality by "peer
review," in which scientists check one another's work;
creating a historical record; and documenting authorship for
personal credit and professional recognition.

In recent decades, however, journals have found that
scientific communication can be not only a service but also
a potent moneymaker. Central to their success is that each
journal publishes original research that appears nowhere
else, so each is necessary for scientists in a given field.

"Scientific journals are monopolies in that there's the
Journal of Artificial Intelligence, for example, and the
Journal of Artificial Intelligence Research, and as long as
they're both good there's no way a library can just say,
'We'll take the one that's most cost-effective.' They have
to have both," said John McCarthy, a Stanford University
professor emeritus of computer science and an authority on
scientific publication. "And when there's a monopoly there's
always the opportunity for extra profit."

Indeed, said Stanford's Keller, "over the course of the
years several of these companies have become giants. And
some of their price increases have been horrendous,
sometimes 25 to 35 percent per year. It's been
unbelievable."

Many commercial publishers -- the biggest include Elsevier
and Wolters Kluwer, both of Amsterdam; Blackwell Publishers
of England, and BertelsmannSpringer of Germany -- charge
between $1,000 and $5,000 for a one-year subscription to
their journals. One prestigious collection of journals
called Brain Research costs subscribers about $20,000 a
year.

Publishers defend their prices largely by pointing to the
extra services they provide. Not only must they pay for
publication and mailing, they say, but they also hire peer
reviewers, editors and contributors to write commentaries
and review articles. Some, including the premier journals
Nature and Science, also have writers who produce news
articles and scientific perspectives.

"We believe we add value to the research," said Jayne Marks,
publishing director for Nature Publishing Group in London, a
closely held company that publishes about 50 journals,
including Nature.

Nature does not reveal financial details, but figures
released by the largest publisher of scientific journals --
Amsterdam-based Elsevier -- help explain why many scientists
and others are frustrated. Its 1,700 journals, which produce
$1.6 billion in revenue, garner a remarkable 30 percent
profit margin.

"I do realize that the 30 percent sticks out," Elsevier Vice
President Pieter Bolman said. "But what we still do feel --
and this is, I think, where the real measure is -- we're
still very much in the top of author satisfaction and reader
satisfaction."

In October, critics say, the real test of that will begin,
as PLoS begins the first of a series of journals dedicated
to the free sharing of results. The aim is to get the
world's best scientists to submit their best work to PLoS --
and force change by starving profit-oriented publishers of
their earnings and prestige.

"Our goal," said PLoS's executive director Vivian Siegel,
"is to transform the landscape completely."


Shift to Open Access

The PLoS plan is simple in concept: Instead of having
readers pay for scientific results through subscriptions or
other charges, costs would be borne by the scientists who
are having their work published -- or, practically speaking,
by the government agencies or other groups that funded the
scientists -- through upfront charges of about $1,500 an
article.

The shift is not as radical as it sounds, the library's
founders argue. That is because government agencies and
other science funders are already paying for a huge share of
the world's journal subscriptions through "indirect cost"
grants to university libraries, which are the biggest
subscribers. The new system would radically increase the
number of people who would have access to published
findings, though, because results would be freely available
on the Internet. By contrast, people today who do not
subscribe to these journals must pay charges, typically $15
to $50, to get a reprint of -- or online access to -- a
single article.

Those charges can add up quickly.

"When my father was diagnosed with multiple myeloma, for
example, I must have glanced through 50-100 articles almost
immediately" while searching for treatment information,
Siegel wrote via e-mail. Physicians, professors, graduate
students and others, including science journalists, face the
same problem daily.

Some journals have already made the leap to open-access
publishing. But for the most part they have not attracted
the best science -- a key to success. Now, with a $9 million
grant from the Gordon and Betty Moore Foundation, the PLoS
hopes to lift open-access publishing into the scientific
stratosphere, in part through the personal gravitas of its
founders and friends.

In terms of scientific stardom, the critical mass is there.
PLoS was founded by three highly respected scientists:
Harold Varmus, who won a Nobel Prize in 1989 for his work
with cancer viruses, headed the National Institutes of
Health from 1993 to 1999 and is now president of Memorial
Sloan-Kettering Cancer Center in New York; Patrick O. Brown,
a renowned genomics expert at Stanford University School of
Medicine and the Howard Hughes Medical Institute; and
Michael Eisen, a computational and evolutionary biologist at
the Lawrence Berkeley National Laboratory and the University
of California at Berkeley.

Having hired a team of hotshot editors and reviewers -- in
some instances wooing them away from prestigious journals --
the group will begin its first monthly open-access journal,
PLoS Biology, in October. It plans to launch PLoS Medicine
in 2004. Others may follow, but the group hopes that the
need to keep creating journals will drop off as existing
journals see how successful the model is and shift to the
open-access system themselves.

For scientists, the benefits would extend well beyond being
able to read scientific papers for free. Unlike their
ink-on-paper counterparts, scientific papers that are
maintained in open electronic databases can have their data
tables downloaded, massaged and interlinked with databases
from other papers, allowing scientists to compare and build
more easily on one another's findings.

"In epidemiology and public health it would be an enormous
leap forward," said Christopher Murray, a World Health
Organization epidemiologist and health economist. "You can't
imagine how much time researchers spend trying to get access
even to old data sets to do new things or make new
connections."

But pressure from consumers, whose taxes provide about $45
billion in federal research funding each year and who are
increasingly asked to take on a larger role in their own
care, may be the force that finally tips the balance.

"They've paid for the research," Eisen said. "And the fact
that the primary results are not available to them is really
crazy and grossly unfair and completely unnecessary."


Publishers Raise Red Flags

The bigger for-profit publishers say advocates of open
access exaggerate the benefits.

"This is, in general, very esoteric material . . . not
written for the public," said Elsevier's Bolman, adding that
he doubts the business model will work. "Everybody is
getting onto the open-access bandwagon. It reminds me of the
enthusiasm and mania of the dot-com explosion, and it will
pop, too."

But what Bolman and other publishers object to most of all
are budding congressional efforts to force publishers to
adopt open-access principles. The latest House
appropriations report instructs the National Library of
Medicine to look into ways to make federally funded research
more available to the public. And Sabo's bill would require
research "substantially funded" by the federal government to
be in the public domain.

That is especially worrisome to the smaller, not-for-profit
publishers -- most of them affiliated with scientific
societies -- that say they are sympathetic to open-access
principles but fear that the system will not work for them,
with their tighter margins.

"Saying you're for free access is like motherhood and apple
pie," said Ira Mellman, chairman of Yale's Department of
Cell Biology and editor in chief of the highly cited but
inexpensive and nonprofit Journal of Cell Biology. "But you
have to recognize that this is an experiment in publishing,
and the legislation seems to be trying to enforce one model
before the conclusion of the experiment."

Several journal editors noted that they have moved in recent
years to widen access. Many have agreed to make their papers
available for free to scientists in developing countries,
for example, and some release results freely to anyone six
to 12 months after publication. But critics say that is not
enough, arguing that even a six-month delay deprives
scientists and others of the latest and best information.

Ironically, several observers said, the fate of open-access
science publication may ultimately depend on something
highly unscientific: the enigmatic quality of prestige. With
scientists' professional standing still intimately linked to
their latest paper in journals such as Science and Nature,
will the best of them step up to the plate and start sending
their hottest papers to open-access journals such as PLoS?

"With scientific journals, competition is not so much on the
reader end but on the author's end," Bolman said. "When you
get the best authors, then other authors tend to follow, and
then you have an exciting journal, which really is your
objective."

PLoS Biology started accepting its first submissions for its
premiere issue last month, and Varmus said he is pleased
with the quality of the work the journal is attracting.

One thing is certain: Among the countless scientists and
others who will read PLoS Biology for free in October will
be Bolman and other publishing executives, who will be
looking for the first hints of an exodus.

Copyright (c) 2003 The Washington Post Company