How Open Access Supports Health Equity

Health research is essential for global health. However, if research is locked behind paywalls, this can cause disparities in low-to-middle-income countries that cannot afford to access it. Open Access removes barriers to research and supports health equity.

Considering that 85% of the world’s population live in low-to-middle-income countries, removing financial barriers takes on a vital necessity. Health is a fundamental right that is recognised by the World Health Organization, and health equity straddles two of the United Nations’ Sustainable Development Goals: Goal 3 to ensure healthy lives and promote well-being for all and Goal 4 to ensure inclusive and equitable quality education.

Here, we explore health disparities and how research can alleviate them, as long as it’s accessible.

Defining health disparities and equity

Health disparities are not simply health differences.

An example of a health difference is there being a higher rate of arm injuries among professional tennis players than the general population. Although health differences are important research topics, they are not a disparity.

A health disparity refers to a particular type of health difference that is closely linked with economic, social, and environmental disadvantage.

In response, health equity refers to the commitment to reduce, and ultimately remove, disparities in health. It involves striving for the highest standards of health for everyone and providing special attention to those who need it most.

In short, achieving health equity revolves around reducing health disparities.

What do health disparities look like?

A striking statistic highlights that the gap in life expectancy between the lowest and highest income nations in the world has widened to 30 years. Whilst this reflects a myriad of factors, having a poor health research capacity can mean that lower-income countries cannot participate effectively in national and international health policy development.

Health research capacity refers to the ability to define problems, set objectives and priorities, build sustainable institutions and organisations, and identify solutions to key national health problems.

If cutting-edge information about topics like disease prevention or elderly care are locked behind expensive paywalls, then governments and institutions that have fewer financial resources cannot base their policies on the results and insights provided by such research.

The result of closed access is the fragmentation of valuable insights and experience into national or institutional boundaries. For health research, this means policymakers and healthcare providers are missing out on information that could save lives.

Why is health research so important?

Achieving health equity through research is a vital means for resolving public health challenges. Health research is defined by the World Health Organization as spanning five areas of activity:

  • Measuring the magnitude and distribution of a health problem.
  • Understanding the diverse causes or determinants of a problem.
  • Developing solutions or interventions that will help or mitigate the problem.
  • Implementing or delivering solutions through policies and programmes.
  • Evaluating the impact of these solutions on the level and distribution of the problem.

Importantly, research derives its value precisely from its applicability and usefulness. Researchers generate insights and knowledge from tests, experiments, and experience to learn and solve problems.

Insights that can be generated from such research include finding the best treatments and practices, early warning signs, ways to care for patients, and ways to communicate information, among many other things.

Research is essential in healthcare for improving its quality and effectiveness.

Opening health research

In the context of health research, the Budapest Open Access Initiative’s declaration that Open Access is an “unprecedented public good” is applicable.

Accessing knowledge is clearly a fundamental requirement for tackling health challenges globally. Moreover, producing such knowledge requires sharing information and collaboration, rather than fragmenting research into national or institutional boundaries.

This need for openness is already being recognised by major initiatives like Plan S and widespread support for open science across Africa. And, most importantly, in low-income and lower-middle-income countries, the use and publication of Open Access research is higher than the rest of the world.

Achieving health equity with Open Access

Removing barriers to research, specifically health research, has a range of benefits:

These benefits can be applied to targets such as those outlined in the SDGs, i.e., reducing child mortality and relieving disease burdens, and also to face global challenges like climate change mitigation and aging populations.

Achieving health equity is only possible if the barriers to health research are removed. This would ensure that vital information and cutting-edge insights can be applied regardless of financial situations.

It’s important to remember what this means in practice: saving lives and improving qualities of life.

Opening research

But why stop at health research? Why not make all research open to ensure that research benefits the largest number of people possible?

MDPI makes all its research immediately available worldwide, giving readers free and unlimited access to the full text of all published articles. It has more than 485 journals dedicated to openly sharing the latest findings, including more than 100 journals that published research in Public Health & Healthcare.

If you want to learn more about Open Access, see our article Why Open Access is Important for more.