Abstract Journals publishing open access (OA) articles often require that authors pay article processing charges (APC). Researchers in the Global South often cite APCs as a major financial obstacle to OA publishing, especially in widely recognized or prestigious outlets. Consequently, it has been hypothesized that authors from the Global South will be underrepresented in journals charging APCs. We tested this hypothesis using more than 37,000 articles from Elsevier’s “Mirror journal” system, in which a hybrid “Parent” journal and its Gold OA “Mirror” share editorial boards and standards for acceptance. Most articles were non-OA; 45% of articles had lead authors based in either the United States or China. After correcting for the effect of this dominance and differences in sample size, we found that OA articles published in Parent and Mirror journals had lead authors with similar Geographic Diversity. However, Author Geographic Diversity of OA articles was significantly lower than that of non-OA articles. Most OA articles were written by authors in high-income countries, and there were no articles in Mirror journals by authors in low-income countries. Our results for Elsevier’s Mirror-Parent system are consistent with the hypothesis that APCs are a barrier to OA publication for scientists from the Global South.

11 6 2024 2 1 64 64 12 9 2025 © 2024. The Authors Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License. Abstract Article processing charges (APCs) for open access (OA) journals perpetuate inequities in scientific knowledge. High APCs systematically restrict low- and middle-income country (LMIC) researchers from contributing to research knowledge, preventing the dissemination of high-value, high-quality, and sustainable LMIC-driven solutions. Otolaryngology journals are no exception. The authors propose solutions to rectify the inequities in academic publishing because of APCs, including innovative solutions adopted by several major journals. Addressing these inequities requires medical society and journal editorial board leadership to ensure equitable APC policies. Keywords: global surgery, global otolaryngology, research equity, article processing charges, open access status released display-pdf yes is-olf no is-manuscript no is-preprint no is-journal-matter no is-scanned no is-retracted no Received 2024 Jan 30; Accepted 2024 Apr 16; Collection date 2024. Background Collaboration between high-income countries (HICs) and low- and middle-income countries (LMICs) is crucial for advancements in global otolaryngology-head and neck surgery (OHNS). However, in these collaborations, benefits such as research recognition and career advancement are often skewed in favour of HIC researchers. While the problem of inequity in global health research collaborations is multifaceted, a key barrier to research dissemination for LMIC authors is the article processing charges (APC) model for open access (OA) journals. Open access publishing makes research available without subscription or paywall barriers. While OA improves access to research, components of this system continue to perpetuate inequity. 2 , 3 While initiatives such as the Health Inter Network Access to Research Initiative (HINARI) of the World Health Organization (WHO) were founded to enable LMICs’ access to medical literature at reduced subscription costs, these initiatives target the pay-to-view model, and fail to address the recent shift to the pay-to-publish model. Article processing charges can create barriers for LMIC researchers who aim to contribute to scientific knowledge. While many journals offer LMIC waivers, they are not always effective in increasing publishing access for LMIC authors. 4 Waivers are typically applied only on request, and a study by Burchardt et al. Furthermore, journals with the highest APCs, which are often North American journals with higher impact factors, are less likely to offer waivers to LMIC authors. 7 The OA model is common in otolaryngology journals, and a recent review found that most authors represented in OA otolaryngology journals are based in HICs. 8 Only 33% of OA otolaryngology journals offer APC subsidies for LMIC authors. 2 Article processing charges fluctuate significantly across the five highest impact factor otolaryngology journals, ranging from $1430.00 to $5000.00. Among OA otolaryngology journals, 77% require APCs, with an average cost of $2452.00. Addressing inequity in models for article processing charges Here, we propose solutions to address the inequities in academic publishing related to APCs. Several major scientific journals outside of otolaryngology have recognised the ethical responsibility to ensure equitable APC policies by adopting innovative solutions. For example, journals may offer reduced or no-cost publishing for LMIC authors. Additionally, they may implement a graded APC requirement that accounts for country Gross Domestic Product, Human Development Index, or Institutional Direct Cost rates. Implementation of these policies may vary by journal; for example, some determine the classification based on the academic affiliation of the first or corresponding author. Article processing charge waivers may be granted based on the availability of resources rather than country of affiliation. For example, the Colleges of Medicine of South Africa’s new multidisciplinary OA journal charges zero APCs for authors without institutional or grant support. Otolaryngology journals should strongly consider adopting this equity-centred publishing strategy. In addition, journals should consider offering automatic fee waivers for LMIC authors. In addition, pooling resources to establish a fund to support LMIC authors may be an impactful approach. Furthermore, there is a need for transparency around publishing costs. Research funding organisations are mobilising to support immediate, accessible OA publishing while ensuring cost transparency. 11 Enhanced insight into the costs and profits By reducing the burden of APCs for LMIC researchers, we can expand access to knowledge and ultimately improve healthcare outcomes around the world. Conclusion The APC model poses challenges to both publishing and accessing research findings, depriving the world of valuable insights and diverse perspectives. Low- and middle-income countries have a disproportionate burden of OHNS disease, and high OA publishing fees can prevent the dissemination of LMIC-driven solutions to these disparities. 1 Furthermore, studies have demonstrated that research conducted in LMICs often does not align with national health priorities.

Publish or perish has been the mantra for researchers and scientists. It is an aphorism describing the sheer pressure to publish academic work in order to succeed in an academic career. After all what good one has done if they didn’t even publish an article in a good journal. A good journal is the one with the highest impact factor. The Impact Factor is calculated by dividing the number of citations in the JCR year by the total number of articles published in the two previous years. An Impact Factor of 1.0 means that, on average, the articles published 1 or 2 years ago have been cited one time. While the impact factor metric is very unreliable to judge the quality of the journal or published paper, as numerous unfair and dubious means were frequently adopted to boost the journal impact factors. But still, the race is on with the psychology to publish in higher impact journals as it is often associated with greater academic rewards. What emerged out of this race is that journals and the publishing houses ramped the article processing charges (APC) to an astronomical level, which was unprecedented before. APC for a few BMC, MDPI, SAGE DOVE press journals on an average exceed 2000 USD, equivalent to few months salary of the Principle Investigtor. Journal publishing house often justifies high APC citing reasons for “open access” such that they are freely available for a wider range of readers free of cost or to meet their operational cost. Although apparently sound like a great i The problem with APC and open access: Hurdles in publishing practice | Asian Journal of Medical Sciences The problem with APC and open access: Hurdles in publishing practice Authors Ruby Dhar Scientist, Room No-3020, Department of Biochemistry, All India Institute of Medical Sciences, New Delhi https://orcid.org/0000-0003-3600-6554 Joyeeta Talukdar Research Associate-I, Lab No-3018, Department of Biochemistry, All India Institute of Medical Sciences, New Delhi https://orcid.org/0000-0002-4922-2283 Arun Kumar Professor, Department of Biochemistry, Jagannath Gupta Institute of Medical Sciences and Hospital, Budge Budge, Kolkata, India https://orcid.org/0000-0002-8800-0296 Subhradip Karmakar Additional Professor, Room No-3020, Department of Biochemistry, All India Institute of Medical Sciences, New Delhi https://orcid.org/0000-0002-4757-8729 Keywords: APC, Open access, Hurdles , Publishing practice, Monopoly Abstract Publish or perish has been the mantra for researchers and scientists. While the impact factor metric is very unreliable to judge the quality of the journal or published paper, as numerous unfair and dubious means were frequently adopted to boost the journal impact factors. But still, the race is on with the psychology to publish in higher impact journals as it is often associated with greater academic rewards. What emerged out of this race is that journals and the publishing houses ramped the article processing charges (APC) to an astronomical level, which was unprecedented before. APC for a few BMC, MDPI, SAGE DOVE press journals on an average exceed 2000 USD, equivalent to few months salary of the Principle Investigtor. Journal publishing house often justifies high APC citing reasons for “open access” such that they are freely available for a wider range of readers free of cost or to meet their operational cost. Although apparently sound like a great initiative, a little more investigation reveals an underlying agenda, which is far from true when we find that a majority of this same. Publishing house ferociously opposes Sci-hub like 3d party platforms which genuinely gives free access to all readers worldwide. Recently, three major academic publishers Elsevier, Wiley, and American Chemical Society filed a copyright infringement suit in the Delhi High Court, India against “Sci-Hub” and “Libgen” which provide free access to millions of research papers/books. This clearly indicates that their intentions are misaligned with what they say. High APC is a means to just earn larger profit margins. Publishing house does mention a fee waiver for low-income countries but is exploited and abused instead of this as a helping gesture. Scientific research can hardly proceed in solo. It needs infrastructure, trained manpower, logistic support, and high-level coordination. High APC skew only those rich and affluent labs/groups who may be able to afford them, something getting away even with mediocre articles while genuine data from less affluent labs may never be able to reach these journals. This trend is growing alarmingly high, filtering out publications only from wealthy labs. Though the scientific community is well aware of this, very little is actually done to prevent this as the nexus runs deep benefiting few who can afford it. Unless this chain is broken, future science may just be Abstract 464 PDF 6 Downloads PDF Published 2022-03-01 How to Cite Dhar, R., Talukdar, J. ., Kumar, A. ., & Karmakar, S. . (2022). The problem with APC and open access: Hurdles in publishing practice. Asian Journal of Medical Sciences , 13 (3), 1-2. https://doi.org/10.3126/ajms.v13i3.43090 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver AMA Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 13 No. 3 (2022) Section Editorials License Copyright (c) 2022 Asian Journal of Medical Sciences This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License . Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access ). How to Cite Dhar, R., Talukdar, J. ., Kumar, A. ., & Karmakar, S. . (2022). The problem with APC and open access: Hurdles in publishing practice. Asian Journal of Medical Sciences , 13 (3), 1-2.