Don't Think Open Access Is Important? It Might Have Prevented Much Of The Ebola Outbreak
from the paywalls-kill dept
For years now, we’ve been talking up the importance of open access to scientific research. Big journals like Elsevier have generally fought against this at every point, arguing that its profits are more important that some hippy dippy idea around sharing knowledge. Except, as we’ve been trying to explain, it’s that sharing of knowledge that leads to innovation and big health breakthroughs. Unfortunately, it’s often pretty difficult to come up with a concrete example of what didn’t happen because of locked up knowledge. And yet, it appears we have one new example that’s rather stunning: it looks like the worst of the Ebola outbreak from the past few months might have been avoided if key research had been open access, rather than locked up.
That, at least, appears to be the main takeaway of a recent NY Times article by the team in charge of drafting Liberia’s Ebola recovery plan. What they found was that the original detection of Ebola in Liberia was held up by incorrect “conventional wisdom” that Ebola was not present in that part of Africa:
The conventional wisdom among public health authorities is that the Ebola virus, which killed at least 10,000 people in Liberia, Sierra Leone and Guinea, was a new phenomenon, not seen in West Africa before 2013. (The one exception was an anomalous case in Ivory Coast in 1994, when a Swiss primatologist was infected after performing an autopsy on a chimpanzee.)
But, as the team discovered, that “conventional wisdom” was wrong. In fact, they found a bunch of studies, buried behind research paywalls, that revealed that there was significant evidence of antibodies to the Ebola virus in Liberia and in other nearby nations. There was one from 1982 that noted: “medical personnel in Liberian health centers should be aware of the possibility that they may come across active cases and thus be prepared to avoid nosocomial epidemics.” Then they found some more:
Three other studies published in 1986 documented Ebola antibody prevalence rates of 10.6, 13.4 and 14 percent, respectively, in northwestern Liberia, not far from its borders with Sierra Leone and Guinea. These articles, along with other forgotten reports from the 1980s on antibody prevalence in neighboring Sierra Leone and Guinea, suggest the possibility of what some call ?sanctuary sites,? or persistent, if latent, Ebola infection in humans.
So why did the conventional wisdom continue to insist that Ebola wasn’t likely to be the issue when Liberians started getting sick and dying? Well, a big part of it may have been the fact that the research was locked up:
Part of the problem is that none of these articles were co-written by a Liberian scientist. The investigators collected their samples, returned home and published the startling results in European medical journals. Few Liberians were then trained in laboratory or epidemiological methods. Even today, downloading one of the papers would cost a physician here $45, about half a week?s salary.
Yes, it still would have required the knowledge to be passed along to Liberian doctors and health officials, and one can argue that that might not have happened. But it seems a lot more likely that the information would have been more easily accessible and the knowledge passed around if it didn’t cost half a week’s salary just to download decades old research warning of just such a threat. And, of course, the results were catastrophic. Even once people started dying, doctors had a tremendous amount of difficulty figuring out what the issue was:
…it was months before Ebola was identified as the culprit pathogen. That made it impossible for the region?s few doctors and nurses to deliver effective care.
Open access isn’t just some “free culture” refrain. It really matters and can save lives.