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HINARI was created to bridge the “digital divide” in health, ensuring that relevant information—and the technologies to deliver it—are widely available and effectively used by health personnel including professionals, researchers and scientists, and policy makers. Launched by the Secretary General of the United Nations in September 2000 and led by the World Health Organization, HINARI has brought together public and private partners under the principle of ensuring equitable access to health information. HINARI provides access to more than 2,000 scientific publications on public health to institutes within 113 eligible countries.

The Ptolemy Project enables surgeons in several Africa countries access to one of the world’s largest libraries of surgery journals by designating medical researchers and clinicians in these countries as research affiliates of the University of Toronto. The University of Toronto Library is the third largest research library in North America and, as affiliates, participants are provided with full access to the Library’s comprehensive collection of electronic resources.

What is becoming increasingly clear from these initiatives is the very strong need for both technology and training to properly exploit and utilize international information resources.

Of the more familiar open archive initiatives in the North many are either not directly relevant in the developing world (the high-energy physics arXiv) or where they are relevant, lack of awareness means access and use is low.

We must also be aware of evidence, as Richard Horton suggested, that the influx of information from the North to the South is in danger of damaging indigenous initiatives. Authors in the South are looking for recognition and reach as much as authors in the North and they may be tempted to publish in a journal with higher international “standing” than in a locally published journal, however relevant. This practice becomes a self-fulfilling prophecy where the lack of regard for local journals means they struggle with quality and in some cases with publishing at all.

South-to-South information flows are constrained by a lack of funds. High costs hinder awareness, use, and development of information resources. There is also a perception problem that perhaps the most relevant information arena is the North. The Association of African Universities’ DATAD project, which publishes doctoral and master’s theses from African institutes for African institutes, may prove to be an important example working against the trend here.

Can open access bridge any of these gaps? Let us look at the strengths, weaknesses, opportunities, and threats of open access in the context of developing countries. Open access has many strengths. First, it confers visibility. A recent study in Nature suggested that self-archived papers are cited “an average of 336 percent more citations to online articles compared to offline articles published in the same venue.”2 That kind of visibility could improve awareness of and access to resources. In terms of affordability and sustainability open-access software (such as those provided by the Eprints, DSpace, and CERN initiatives) and information are free. The distributed server technology encouraged by the Open Archive Initiative obviates the need for expensive local infrastructure. Another strength of open access is that the software is easy to obtain and straightforward to utilize. If archives are built with Open Archives Initiative compliance, it increases their potential for retrieval and for visibility as well as interoperability.

There are also some weaknesses associated with open access, most of which will likely be solved in the medium to long term. Open access initiatives and open archiving are technology-based concepts. In countries where there is poor ICT infrastructure and a relative lack of open access skills, this is a problem. Another weakness is that archives are presently rather North biased. The vast majority of archives in open access schemes are based in the North. Holding data in the North will potentially perpetuate access and use problems in the South. For example, the Botswana HIV Institution, which partners with Harvard, is concerned that because the data are principally housed in Harvard the Institution lacks control over those data and cannot guarantee their own access in the future. In addition, the content at some open-access sites is not peer reviewed, which presents a potential danger, for example, in medical disciplines. There is also the issue of quality control, involving peer review, the consistency of peer review, and version management.


S. Lawrence. 2001. “Free Online Availability Substantially Increases a Paper’s Impact,” Nature 411 (6837):521.

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