GEMA Member Blogs

GEMA member blogs, and microblogs like Twitter, are your destination for global emergency medicine information, teaching tips, insights and observations, networking, and much more. We encourage you to follow the following GEMA member blogs, and if you are a GEMA member and have a blog, Facebook, or Twitter account that you would like to share, please email us

Blog Highlight

January 25, 2017

The altruistic author: making your research visible without breaking the bank or the law

Controversy surrounding access to scientific publications is nothing new.  Back in the seventeenth century, scientists like Sir Isaac Newton (you know, the gravity guy) would commonly publish their work in one of the handful of available journals in anagram format, in order to ensure that only those clever enough, or those who happen to be friendly with Sir Isaac, would have access to the findings. Nowadays readers face another challenge to accessing scientific writing, subscription paywalls. Some 20,000 journals archiving the vast majority of research findings hide publications behind subscription paywalls. While in Sir Isaac’s day it was more about protecting intellectual property from rival scientists, in modern times it is just good business – mainly for publishers.  Unlike other commodities such as drinks, cars and yes Sir Isaac, even apples, end-users do not have a significant amount of choice.  If a poignant paper is published in a specific journal, then the researcher has to access it from that journal, and that journal alone.  Copyright licenses ensure that material can only be replicated through referencing and thus under the banner of protecting intellectual property, publishers report obscene profit margins (around 35%) based on a rigid business model, that builds on mostly public funded research, that is not accessible to the public at large.

The international community, in particular, benefits from openly, accessible research through collaboration.  It is telling that nearly 85% of the world live in either low-income (less than $10 a day) or middle-income settings (less than $20 a day), but over 75% of all global research outputs are produced in high income countries (over $50 a day), mainly directed at high income settings. 

The African Emergency Medicine Perspective

As global health researchers you will know that many high income generated scientific advances have no, or a fairly limited role to play in low- and middle income countries’ emergency care practice.  The financial cost of accessing publications and subscriptions, along with poor local currencies force academic libraries in these countries to abandon subscriptions.  Organisations such as Research4Life provide valuable access to subscription journals for researchers from low- and middle income countries, however, it is not a straight forward process.  Think accessing this blog post on superfast broadband versus accessing an academic paper through your institutional library, via a third , perhaps a fourth party application, on a dial-up internet connection with the prospect of intermittent, unscheduled power outages that will result in you having to start all over again.

As I write this, I am one of only two full-time employed, emergency medicine academics on the continent of Africa.  There are only 13 emergency medicine residency programmes (the first started in 2003), spread between just eight countries (out of 52) on a continent with a population of over a billion people.  In comparison, in the US with a population of just over 300 million people, there are around 190 emergency medicine residency programmes (the first started in 1970).  Want more? African emergency medicine produced just 724 papers over the last five years versus 14,390 papers produced in the US alone.  So it is fair to say that African emergency medicine research is in its infancy and that a sizeable knowledge gap exists. 

Collaboration with high income setting researchers is seen as an important variable in producing research in low- and middle income countries.  Of those 724 African papers, 41% was done through collaborative efforts with non-African researchers, compared to the US collaborating on only 13% of outputs with non-US researchers.  Given the small knowledge economy in a low- to middle income setting such as Africa, collaboration (especially funded collaboration) is a nifty way of working around local funding and resource restrictions.  However, this has no value if all the trouble taken to produce the research, results in the findings being hidden behind subscription paywalls – enriching publishers, courtesy of the US Department of Health and Human Services. 

My own research shows that of those 724 African papers, only 59% are currently available open access.  This may appear high which is not surprising given the philanthropic nature of much of global health research, but it does also mean that 41% is not accessible without subscription.  I do not have data for the rest of the developing world, but I suspect the rate to be fairly similar.  I also suspect the rate for less philanthropic research to be less.  I mention this as although a lot of international emergency care reference standards (i.e. stroke, sepsis, acute coronary syndromes, etc.) are less applicable in the vastly bigger, low- and middle income regions, it is not less relevant.  It is reference standards none the less and as such can be interpreted, translated and adapted with various degrees of effort for local application.  Moreover, it provides a beacon towards where local research should be growing.  Given the lack of choice, rigid publisher business models and cumbersome access pathways discussed, the question isn’t really why an illicit publication repository like Sci-Hub exists, but why it wasn’t established sooner.  I cringe just thinking of the harm that Sci-Hub has caused to the legitimacy of the open access movement.

I know what you are all thinking: open access is expensive.  That it is; on average to publish open access you would need to cough up around $2000-$3000.  However, it is hard to argue that the one-stop access that comes with open access publication provides a significant benefit to not only the reader (especially one from a low- or middle income setting), but also to you, the author, in promoting your research to your core audience.  That said, there are new alternatives such as, which allow for open access publication without exorbitant costs, but one must be willing to tolerate being published on a platform without a tradition “impact factor” rating.  While this may be possible for scholars and scientists who are no longer seeking to climb the ranks of the academic ivory tower, for junior members of our community, this may not be practical.

Self-Archiving as a bridge to open access

So enter open access’ less glamorous cousin: self-archiving.  Unlike Sci-Hub, self-archiving is the process whereby the author stores a legal copy of their paper in a public repository of their choice.  If cleanliness is next to godliness, then indeed, self-archiving must be next to open access (and frankly just as clean).  Millions of researchers self-archive their papers – originally published in subscription journals – into publically accessible repositories, such as your academic library, ResearchGate, Mendeley and others.  Sadly not all journals support self-archiving, and of those that do, various licenses prohibit certain versions of a paper from being self-archived.  An easy way to find out if the journal of your choosing does, is to simply look it up on the Sherpa/ Romeo index.  Go on try it, look up the last journal you published in.

The pre-print, post-print, publisher version

The Sherpa/ Romeo index describes whether a specific journal supports self-archiving and if it does what version of the paper is allowed to be self-archived.  Journal licenses allow self-archiving of one or more of three versions

  1. The publisher version: this is the final published version that you can download from the journal’s website
  2. The post-print version: this is the accepted, post-peer review manuscript before the publisher added all the bells and whistles (such as the fancy fonts, editor summaries and the copyright license)
  3. The pre-print version: this is the version of the manuscript you first submitted to the journal, way back when you expected to be rejected by sundown.

The pre-print is the least helpful version to self-archive and frankly is the equivalent of a lukewarm cup of tea – don’t bother.  The post-print on the other hand is a great alternative to the publisher version as the core text is the same.  Most authors will edit their post-print slightly to appear more respectable and this is acceptable; as long as it is not the final published version, or does not contain any of the additional bells and whistles.  I recommend a clean interface with a simple watermark stating: post-print.  The figure included shows an example of the various versions. 

Abstract for GEMA Member Blog

The publisher version, post-print version and a lukewarm cup of tea

In my view, any respectable global health researcher should be seeking a readership audience in either an open access journal, or a journal that supports at least upon-publication, post-print self-archiving.  This will allow the widest reach for the paper, including the audience that contributed to and will benefit the most from the research.  You’ll find that the majority of top journals do support both open access and self-archiving of the post-print, although there are a few notable bad apples.  To help you get started I have provided a simple algorithm that I use when selecting a journal. 


I would like to acknowledge Teresa Chan (Assistant Professor, Department of Medicine, Division of Emergency Medicine, McMaster University) for her valuable inputs and peer review of this blog.  If you are not yet doing so, you should be following Teresa on twitter handle @TChanMD.

About the author

Stevan Bruijns is a senior lecturer in the Division of Emergency Medicine, University of Cape Town and is also the chief editor for the African journal of Emergency Medicine.  Stevan is passionate supporter of open access.  You can follow Stevan on twitter handle @codingbrown.

The Global Health Researchers Guide

 A global health researcher’s guide to open access publishing and self-archiving  

* I use as it allows filtering by subspecialty and region
** The Directory of Open Access Journals,

A global health researcher’s guide to open access publishing and self-archiving



SAEM17 Reg Open RFF 260x260