Open access (95) Q4 How would you design an OA system? (13)

7 November, 2025

Dear Neil and all,

Open access is essential for many reasons, but there are some unfortunate realities that have not been mentioned.

- In many countries, academicians -- and even students in some countries -- are required to publish research to maintain their positions or to graduate. They may not have the resources or time to conduct sufficient research for promotion or graduation, so an industry selling fake papers and authorships on accepted manuscripts has evolved, aka "paper mills."

- AI has made generating fake papers or components of research much faster and cheaper.

- Many journals are receiving many more manuscript submissions to screen and potentially peer review, taxing editorial resources.

- The APC for-profit model means journals are under pressure to publish more articles. Authors submitting fake papers will pay APCs, and in some journals the papers may not receive the scrutiny they otherwise would.

Some journals publish special issues edited by guest editors, but these have led to manipulation of the peer review system to publish articles that otherwise would be rejected.

These issues have helped drive the huge increase in article retractions over the last few years.

For journals with financial resources, publishing organizations like STM have developed tools that editors can use to screen for paper mill papers, AI-generated content, fraudulent images, and a host of other issues. Such screening tools are welcome, but journals must pay for them. Journals from LMICs with smaller or no profit margins, eg, diamond journals, cannot afford such tools. This increases the gap between HIC and LMIC journals created by lack of resources and indexing and English dominance, among other factors. One solution would be to make such tools accessible to LMIC journals. However, the paper mill industry quickly subverts new tools and ongoing investment and updating is required.

Alternatively, the academic incentives could be changed. One approach would be to reward research transparency, including full data access, and deemphasize the number of publications, journal impact factor, and citations as a measure of research importance. Some countries are starting down that path, but many more are needed to change the research culture. If they do not, and LMIC journals don't have tools to meet these new challenges, both they and the research culture they help support, which is so important to contextualize medicine and other fields for local populations around the world, will suffer.

Best wishes,

Margaret

Margaret Winker, MD

eLearning Program Director

Trustee

World Association of Medical Editors

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HIFA profile: Margaret Winker is Trustee and Past President of the World Association of Medical Editors (WAME) and Director of the WAME eLearning Program. She is based in the US. Professional interests: WAME is a global association of editors of peer-reviewed medical journals who seek to foster cooperation and communication among editors, improve editorial standards, promote professionalism in medical editing through education, self-criticism, and self-regulation, and encourage research on the principles and practice of medical editing. margaretwinker AT gmail.com