How Can Biomedical Journals Help to Tackle Global Poverty?

  • The PLoS Medicine Editors
  • Published: August 29, 2006
  • DOI: 10.1371/journal.pmed.0030380

Reader Comments (2)

Post a new comment on this article

HINARI access in Peru: A step backwards?

Posted by plosmedicine on 31 Mar 2009 at 00:09 GMT

Author: Walter H. Curioso
Position: Research professor
Institution: School of Medicine and in the School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru.
Additional Authors: Javier Villafuerte-Gálvez and Oscar Gayoso
Submitted Date: May 10, 2007
Published Date: May 10, 2007
This comment was originally posted as a “Reader Response” on the publication date indicated above. All Reader Responses are now available as comments.

Much has been written about how open access to biomedical journals is vital for researchers in developing countries [1], but so much more needs to be done.

Our experience in Peru with the Health InterNetwork Access to Research Initiative (HINARI), an initiative managed by the World Health Organization that helps promote access to scientific information by providing free (or low cost) online access to major science journals, is not as accessible as hoped for and, in fact, is getting worse. When HINARI launched in 2003, it provided access to more than 2300 major journals in biomedical and related social sciences [2].

In April 2007, we conducted a review of the first 150 highest impact factor science journals on the Science Citation Index available through HINARI [3]. We excluded open-access journals and journals that make online access free to low-income countries (e.g., New England Journal of Medicine, British Medical Journal Publishing Group). We could not access any of the top five journals from major publishers, such as Nature and Elsevier-Science Direct. In other words, from the Nature Publishing Group we had no access to Nature Reviews Cancer, Nature Reviews Immunology, Nature Reviews Molecular Cell Biology, Nature, or Nature Medicine, and from Elsevier-Science Direct we had no access to Cell, Cancer Cell, Current Opinion in Cell Biology, Immunity, or Molecular Cell. In addition, we could not access any of the first-level journals from Blackwell, Oxford Press University, Lippincott Williams and Wilkins, and Wiley and Sons. In 2003, all these journals were available.

Our findings support comments received from users over the last 8-10 months at the main library at Universidad Peruana Cayetano Heredia (Oscar Gayoso, personal communication). Students and faculty could not get access to biomedical journals from Nature, Elsevier-Science Direct, Blackwell, Oxford Press University, Springer Science, Lippincott Williams and Wilkins, and Wiley and Sons through HINARI. The collections of journals from the above-mentioned publishers together represent approximately 57% (2118 of 3741) of journals that were supposed to be accessible through HINARI while the remaining 43% accessible were largely composed of open access journals or journals that make online access free to low-income countries.

Moreover, we have found a significant decrease in the number of users accessing HINARI at our institution. For example, the number of HINARI users has decreased from 12,144 in April 2005 to 5,655 in April 2007, which may reflect the loss of impact of the HINARI initiative at our institution. In contrast, the number of users accessing other databases such as ProQuest and EBSCO has increased over the last few months.

Our findings suggest that we not only have access to a reduced number of biomedical journals on HINARI, but we also have no access to the biomedical journals that have the highest impact factors. The HINARI web site states that it is still incorporating new journal collections. However, we are afraid any addition that will not provide access to major publishers (such as the Nature Publishing Group, Elsevier-Science Direct or Lippincott Williams and Wilkins) could lack real impact according to HINARI’s goals.

Since 2003, Peruvian medical students and health professionals have substantially benefited from access to high-quality scientific information through HINARI. Few medical students and very few researchers in the developing world can pay the usual fee of US$20-45 to download one article. Not even some private universities in Peru can afford the minimum journal subscription rates, even though these subscriptions would help the universities to become less isolated from global medical research. Having to pay US$1000 per year to HINARI has left many public universities in the provinces of Peru without access because they cannot afford it. Even for the Peruvian institutions that are currently paying $1000 per year to HINARI, what is the real benefit of their HINARI subscription now?

We fear that the loss of access to many key journals that are published by the major companies could be a major setback to the education of medical students in Peru and perhaps around the world. Furthermore, it could make medical research in countries like Peru even scarcer while biomedical research in developing countries is a key element to fight poverty.

In conclusion, students and researchers in developing countries such as Peru, working at the frontlines of global health problems, need to access more biomedical journals in order to practice evidence-based health care and conduct high-quality research. The recent loss of access to many key biomedical journals in Peru could be a step backwards. We hope the situation described in this letter might help gain support to the proposal of Godlee et al. who suggested that the World Health Organization and its partners should take the lead to establish an international collaborative group along the lines of the Global Fund for AIDS, TB, and Malaria to achieve the goal of "Universal access to essential health-care information by 2015" or "Health Information for All" [4].

Javier Villafuerte-Gálvez
Walter H. Curioso
Oscar Gayoso


[1] The PLoS Medicine Editors (2006) How Can Biomedical Journals Help to Tackle Global Poverty?. PLoS Med 3(8): e380.
[2] Aronson B (2002) WHO's Health InterNetwork Access to Research Initiative (HINARI). Health Info Libr J 19:164-5
[3] SCI Journal Impact Factor Index, Accessed 4 May 2007
[4] Godlee F, Pakenham-Walsh N, Ncayiyana D, Cohen B, Packer A (2004) Can we achieve health information for all by 2015?. Lancet 364: 295–300

No competing interests declared.