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A Fight for Free Access To Medical Research
Online Plan Challenges Publishers' Dominance

By Rick Weiss
Washington Post Staff Writer
Tuesday, August 5, 2003; Page A01


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


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.

© 2003 The Washington Post Company

--
For this and many more articles, see Paul Jones' website at
http://www.mult-sclerosis.org/