Health research is essential for global health. But, 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 achieving 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’ll explore health disparities and how research can alleviate them, as long as it’s accessible. Open Access is key for achieving health equity. But first, what do we mean by health disparities and equity?

Defining health disparities and equity

Health disparities are not simply health differences.

A health difference could be something like a higher rate of arm injuries among professional tennis players than the general population. Whilst this doesn’t mean that such health differences are not worth addressing, 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.

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

Basically, 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.

By health research capacity, we are referring 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 are pressed financially 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. 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, we see that research derives its value precisely from its applicability and usefulness. We 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, best ways to care for patients, and best 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” seems very fitting. 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, the USA’s commitment to accessible research, and China’s promotion of open science. And, most importantly, we see that, in low-income and lower-middle-income countries, the use and publication of Open Access research is actually higher than the rest of the world.

So, let’s go over how Open Access helps in achieving health equity and removing disparities.

Achieving health equity with Open Access

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

• Avoiding the duplication of research.
• Generating crucial information about disease trends, risk factors, and the outcomes of interventions in healthcare that are spread globally.
• Allocating research budgets in lower-income countries for producing new research, applying findings, or in educating and training healthcare providers and researchers.
• Pooling expertise from diverse cultural and national standpoints to tackle long-standing issues.
• Generating large amounts of data that can be processed and analysed using artificial intelligence to provide new findings. We previously discussed this in our article AI is Changing Open Access Science.
• Increasing opportunities for collaboration and interdisciplinary research.

These benefits can be applied to targets like those outlined in the SDGs, like 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 we remove the barriers to health research. This ensures that vital information and cutting-edge insights can be applied regardless of financial situations. It’s important to remember what this looks like in practice: saving lives and improving qualities of life.

Opening research

But why stop at health research? Why not make all research open so we can ensure that research benefits the largest amount 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 over 400 journals dedicated to providing the latest findings, including health research. If you’re interested in submitting your work, see our full list of journals here.

If you want to learn more about Why Open Access is Important, we have plenty of articles that may interest you.