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Now free for the 100 poorest countries

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The BMJ Publishing Group has for more than a year provided free access to the electronic version of its 23 specialist journals including QSHC to anybody in the 50 poorest countries in the world.1,2Now free access is being extended to over 100 of the world's poorest countries which between them include most of the world's population. Free access is also available to Clinical Evidence, an evidence based compendium of answers to commonly asked clinical questions.3

The BMJ Publishing Group is not alone in providing free access to those in the developing world. This initiative follows the switching on of the World Health Organization initiative which provides institutions in the developing world with free or very low cost access to the publications of many of the big commercial publishers.4 The WHO initiative is being extended to include more publishers, and the Royal College of Psychiatrists has announced that it will be providing free access to its journals for those in the developing world.

Publishers can afford these initiatives because, although journals are expensive to produce, the cost of providing electronic access to one more individual is effectively zero. In contrast, the cost of printing and shipping a paper journal is substantial. Some cynics wonder if providing free electronic access to those in the developing world might be an empty gesture as internet access is limited. Access, however, is skyrocketing in the developing world, particularly with the spread of technology that avoids the necessity for wires in the ground. What's more, there is no point in spending money to get access if you can't then afford to access material. Making material free should fuel a virtuous circle of increasing access.

Healthcare workers in the developing world have for years had the problem of very limited access to the latest information.1,5,6 Ironically, they might quickly have the problem of healthcare workers in the developed world of being overwhelmed with material of low quality and limited relevance. Providing free access to material is only one part of what is needed to improve the use of health information in the developing world. Initiatives are also necessary among those in the developing world to increase their own capacity to distil, package, present, and disseminate not only the material originating from the rich world, but also their own material. Publishers and editors from the rich world should be able to help.

The final aim of these initiatives is not to send a flood of material from the rich to the poor world but for those in the developing world to become equal participants in the global discourse on health. We all stand to gain. We hope you will contribute to the debate via the rapid responses feature on our website (www.qualityhealthcare.com).

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