Access to Medical Journals in Developing Countries
(August 2001)

Modified version of editorial in: Gut 2001; 49:1 (July)  
Michael J G Farthing, Editor  
Alex Williamson, Publishing Director  

For some years, the British Medial Journal has offered free journal subscriptions to applicants from countries in the developing world. In practice, however, this offer has had its difficulties. Many developing countries have either poor or non-existent postal services and granting a print subscription can often be problematic and expensive. 

The gap between the rich and poor countries is widening. While those in the developed world have information overload, the developing countries have bare library shelves. The Internet provides the opportunity to narrow the gap at very little cost. In addition, those in resource-poor countries can access electronic journals at exactly the same time as those in the developed world. Even better, they can access what is relevant rather than what is provided, much of which isn't relevant. Best of all, they can participate in the debate using the rapid response facility on the web site in a way that was almost impossible with the slowness of print distribution. 

The British Medical Association and the British Society of Gastroenterology have made funds available for the installation of 'Digital Island' on all its journal web sites. This clever piece of software recognizes where the user is coming from and will give unrestricted access to the whole web site to users from those developing countries. 

Though there is a lack of access to the Internet and other problems that make access difficult in the developing world, there is every reason to expect that access should increase dramatically. India currently has a million people with Internet access, but this is expected to rise to 40 million within five years. Similarly dramatic increases are expected in Nigeria. Technological developments like access to radio and the proliferation of satellites will render irrelevant the many problems of telephone access in Africa. Rapid progress will also be made because many international organizations such as UNESCO, the British government, the World Bank, and the Bill and Melissa Gates Foundation are increasingly interested in helping improve information access in resource-poor countries. 

The challenge will be sustainability. It is easy for donors to invest money and reap the rewards of short-term success. But enhancing information flow will make no impact on health if projects continue only as long as their funding lasts. Information cannot be separated from the capacity of a healthcare system to work effectively over time. 

For a list of countries with free access, go to: http://www.bmjjournals.com/subscriptions/countries.shtml. 

For a list of the journals currently available over the Internet, go to: http://www.bmjjournals.com/. For access, click on the title of the journal you would like to view.

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