Significantly expanding Developing World access

Building a viable research culture in developing countries takes more than just access; it calls for training in how to find and use scientific resources, sufficient bandwidth, author workshops and much more.

But access certainly forms a critical foundation on which to build. In mid May, Research4Life announced that the content available through its collaborative public-private partnership has dramatically increased since 2011 to 17,000 peer-reviewed scientific journals, books and databases. Thanks to this rise, more than 6,000 institutions in more than 100 developing countries now have free or low cost access to peer-reviewed online content. The sharp increase is largely a result of Elsevier’s contribution of 7,000 books this past year, in addition to the existing access to Scopus and more than 2,000 journals in the collection.

Research4Life is a unique public-private partnership with four UN agencies, four discipline specific programs (HINARI, AGORA, OARE, ARDI), 150 publishers and technology partners such as Microsoft. And as an avid user of Research4Life, Dr Patrick Kyamanywa, Dean, Faculty of Medicine National University of Rwanda, has particularly welcomed the addition of the ebooks, “A culture of evidence-based practice can no longer be an option but the rule. The publishers involved in the HINARI project should be praised for their commitment to improving access to information to students, researchers and practitioners in some of the poorest countries in the world.  Elsevier appears to be leading the way and our hope is that other publishers will follow suit and help to achieve the target of ‘Health Information For All by 2015’.”

Making a Difference, Stories from the fieldTen years ago, Elsevier was one of the six founding publishers and continues to serve as a driving force behind Research4Life, contributing a quarter of the content and a team of colleagues working to develop the partnership through their technical, communications and industry expertise. There is no room for complacency, however.  Access does not mean active usage or even a thriving research culture. But through programs like the Elsevier Foundation’s Innovative Libraries in Developing Countries, we are able to further support infrastructure building, medical library needs assessments, preservation of unique research and, most critically, training, such as the MLA’s Librarians without Borders program, which has given thousands of researchers, doctors, nurses and librarians training in how to use Research4Life resources.

Research4Life recently celebrated its 10th anniversary by holding a competition for the best stories from the field.  The resulting case study book, Making a Difference, maps the evolution of research cultures in 10 different countries. Below you can read an extract from just one of the inspiring articles it contains. Dr Arun Neopane in Nepal shares how access to Research4Life enabled him to transform his annual hospital publication into a peer-reviewed scientific journal.

CASE STUDY: Research out of reach

In his role as a pediatrician at Kathmandu’s Shree Birendra Hospital, Arun Neopane is a voracious consumer of journal papers. This passion led to his appointment in 2003 as the hospital’s Officer in Charge and Editor of the Journal of Shree Birendra Hospital (JSBH). Over the next few years, Dr Neopane led the conversion of JSBH from an annual publication with news, views and hospital updates to a biannual peer-reviewed scientific journal – with original papers, review articles and case reports – and made it available electronically through Nepal Journals OnLine (NepJOL).

Despite having subscriptions to a small number of international journals, the hospital was desperately short of the up-to-date medical literature that doctors need to maintain and upgrade their skills and knowledge. As is the case in other low-income countries, university libraries and research organizations in Nepal do not have the budgets to pay for important peer-reviewed journals. Critically, Dr Neopane and his team convinced the hospital administration in 2007 to invest in an internet connection. This unblocked the window to the wider world of medical research, but, without access to journals, a key component remained locked. The hospital staff could now read abstracts via the PubMed database, but the complete papers – crucial for the understanding required to incorporate research results into practice – remained out of reach.

It was the new internet connection that led Dr Neopane to Research4Life’s HINARI Program. The institution was granted access to HINARI in February 2008 and it hasn’t looked back since.

“I can remember those days,” says Dr Neopane, “when we had to go to the library and sit in the archives section turning page after page, reading all the abstracts and getting them Xeroxed, and finally coming back to square one, frustrated by the literature search and not finding what one needed. Gone are those days for doctors now, and all because of free access to medical literature through HINARI.”

Better clinical treatment

Waiting for treatment: Research4Life’s HINARI program is helping to improve the standard of medical research and practice for Nepalese people. Photo courtesy WHO/Tom Pietrasik.The most concrete result of the hospital’s access to HINARI is better clinical treatment that has directly improved patient health. For example, research published in Pediatrics (the journal of the American Academy of Pediatrics) showed that zinc is essential in treating diarrheal diseases in children, mitigating illness and even saving lives. Ironically, although some of this work had been performed in Nepal, Nepalese institutions could not afford the subscriptions to the journal and the country’s doctors did not have access to the results. Using HINARI, Nepalese pediatricians discovered the information and changed their treatment of diarrhea, saving many lives and improving the quality of life of many sick children.

Dr Neopane

In gaining access to Research4Life programs, Kathmandu’s Shree Birendra Hospital has not only lifted the standard of medical research in Nepal, but has also improved – and even saved – the lives of many of its patients.

Beyond better clinical practice based on others’ research, HINARI has transformed the way that medical research is performed, not only at Shree Birendra Hospital but also for the Nepalese medical community as a whole. And it was because of HINARI that Dr Neopane was able to advance his own research. In March 2007, he was appointed Editor-in-Chief of the Journal of Nepal Paediatric Society (JNPS), the oldest specialty journal in the country. Launched in 1981 and published annually, JNPS had struggled as a credible scientific publication. With a small editorial team, Dr Neopane has transformed it into a thrice-yearly, internationally recognized, peer-reviewed journal with its own website. HINARI made all this possible by allowing Dr Neopane and his colleagues to learn from leading journals.

Dr Neopane’s achievements were further recognized with his appointment as General Secretary of the recently established Nepal Association of Medical Editors. He describes Nepal’s medical research as still in its infancy, but he is confident that it will progress from the current work, which mostly comprises clinical features and epidemiology, to more complex work based on molecular biology and genetics.

HINARI has fundamentally changed the research landscape in Nepal, with five national journals now indexed in PubMed and many more aspiring to this (including JNPS, which was considered for PubMed in February 2012). Internationally renowned journals such as BMJ, the New England Journal of Medicine andThe Lancet occasionally publish articles by Nepalese researchers. Without HINARI, such achievements would have remained a dream.

Author Biography

Ylann SchemmYlann Schemm
Ylann Schemm manages Elsevier’s corporate responsibility and partnerships program which focuses on research access in the developing world, promoting women in science, popularizing an understanding of peer review and inspiring early career researchers to become ambassadors of sound science. She is the Chair of Research4Life’s Communications and Marketing team which promotes this unique public-private partnership providing free or low cost access to researchers in the developing world. Ylann also runs the Elsevier Foundation’s New Scholars program – which supports projects to expand the participation of women in STEM and create a more family friendly academia – as well as the Innovative Libraries in Developing Countries program with capacity-building projects in science, technology and medicine—through training, education, infrastructure digitization and preservation of information.

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