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© 2021 The Authors. Société Internationale d'Urologie Journal, published by the Société Internationale d'Urologie, Canada.

193SIUJ.ORG SIUJ  •  Volume 2, Number 4  •  July 2021

EDITORIAL

The Two Faces of Open Access
Peter C. Black, Editor-in-Chief 

Soc Int Urol J.2021;2(4):193–194

DOI: 10.48083/EROK5654

The two faces of open access remain a point of contention 
in the global world of scientific publishing, and this 
carries over into the microcosm of urologic publishing. 
Many of us are part of the research community and 
all of us are consumers of new research findings. On 
both sides of the research enterprise—as providers 
and consumers—our interests are best met by broad 
dissemination and universal access to all published 
research. These are the underlying objectives of open 
access publishing. There are societal and academic 
advantages to open dissemination of knowledge[1].

“Open access,” however, has almost become a bad 
word in the medical community because of connotations 
of predatory journals and high publication fees. High 
publication fees are not pathognomonic for predatory 
journals—highly reputable journals that publish top 
research after rigorous review processes (not offered 
by predatory journals) can and do charge exorbitant 
publication fees. More importantly, however, open 
access should not be equated with high publication fees. 
Open access can be offered at no cost to authors.

I congratulated a colleague recently on a high impact 
publication that represented several years of carefully 
designed and executed translational research, only 
to discover that publication of that manuscript had 
consumed €5500 of his research budget. The draw of 
the impact factor seems to have justified the cost. If 
this manuscript had been published in the prestigious 
Nature, it would have cost €9500 for open access[2]. 
As researchers and authors, we should be asking 
what happens to those high publication fees. The 
publisher bears the cost of processing the manuscript 
for publication, which does involve professional 
editorial staff. However, the researchers provide the 
content of the published material, their scientific peers 
carry out the review on a voluntary basis, and even 
the scientific editors are generally not remunerated, 
or only at a rate that does not compare on an hourly 
basis to their academic salaries or clinical revenues. 
Lack of compensation for editors and reviewers is not 
necessarily a problem in itself, as it can be considered 
a return of service to the scientific community, but it 
becomes a significant problem when the publishers earn 
large profits from our academic services.

The bottom line is that a large part of those €5500 
publication fees goes back to the publisher as profit. 
Scientific publishing is a lucrative business. Elsevier, 
which is one of the largest publishers of scientific 
research, is owned by the parent company RELX. RELX 
reported US$9.8B profit in 2019, 34% of which was 
derived from Elsevier[3]. This is an extraordinary sum 
of money that is taken out of the research enterprise 
and diverted to investors. In some cases, the €5500 
publication fee may be provided by institutional 
accounts, but more often it is derived from a government 
funder, a charity funder, or perhaps a grateful patient 
donor. Those parties pay for the research to be conducted 
and pay again to read about the results of that research. 
How do we justify taking money from these sources to 
generate profit for publishers for the dissemination of 
research results?

These issues are not new, and initiatives have been 
undertaken to break down some of these financial 
barriers and push for financial transparency. Plan S 
represents an effort by European funding agencies 
demanding open access publication of research funded 
by these agencies (although they do not account for 
publication fees). Academic libraries, most notably the 
libraries of the University of California, have taken a 
stance in negotiating better deals with publishers to 
allow broader access to published literature. Library 
subscription fees represent an important component of 
revenue for the publishers. It takes large institutions or 
conglomerates to challenge the immense influence of the 
publishing companies.

There are two other stakeholders in the publication 
process who cou ld a lso inf luence t he current 
environment if they adopted a coordinated approach to 
work towards lower cost open access: industry partners 
advertising in scientific journals and the researchers 
publishing in scientific journals. Advertising revenue 
remains a large part of journal profits[4]. Those 
advertising dollars would likely cover open access 
publishing costs with no need for publication fees. If 
advertisers took a stand on the high cost of academic 
publishing, this could alter publishing practices. 
However, advertisers want the widest audience from 
the most prestigious journals, just as authors want the 

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194 SIUJ  •  Volume 2, Number 4  •  July 2021 SIUJ.ORG

EDITORIAL

highest impact factor, so it is difficult to break the vicious 
cycle. On the authors’ side there have been initiatives to 
boycott publishers in protest over the cost of publication. 
“The Cost of Knowledge” was one such initiative that was 
started in 2012[5], but it appears to have had little impact 
on publishing practices despite attracting the signatures 
of 18 778 researchers from around the world[6].

Another approach is for medical organizations to 
provide open access journals with no publication fees. 
Several urological organizations have already done 
this, including the Canadian Urological Association, 
the Urological Society of India, the Brazilian Society of 
Urology, and the Chilean Society of Urology. The SIU 
has followed the model of these organizations with the 

launch of the SIU Journal. These journals provide high 
quality editorial processing, peer review, and prompt 
open access publication. The efforts of all involved in 
the process are dedicated to knowledge dissemination 
and not profit, and any profit that is generated feeds 
back into the society that supports the activities of the 
members who are reading and publishing in the journal. 
These journals all provide excellent alternatives to the 
more recognized high-cost journals. The economics of 
urologic publishing relate to supply and demand. We 
have to ask ourselves as physicians and researchers what 
we can do to shift the demand away from the profit-
driven large publishing houses and towards the open 
access free journals. If we shift, the impact factors that 
we all chase will follow.

References

1. Tennant JP, Waldner F, Jacques DC, Masuzzo P, Collister LB, 
Har tgerink CHJ. The academic, economic and societal impacts 
of Open Access: an evidence-based review. F1000Res. 2016 Apr 
11;5:632. doi: 10.12688/f1000research.8460.3. eCollection 2016.

2. Brainard J. For €9500, Nature journals will now make your paper 
free to read. ScienceMag.org.2020. Available at: https://w w w.
sciencemag.org/news/2020/11/9500-nature-journals-will-now-
make-your-paper-free-read. Accessed June 14, 2021. doi:10.1126/
science.abf8491

3. REL X. Annual report and financial statements 2019. Available at: 
https://www.relx.com/~/media/Files/R/REL X-Group/documents/
repor ts/annual-repor ts/2019-annual-repor t.pdf. Accessed June 
14, 2021.

4. Bhat tarcharjee M. Publishers still rely on traditional revenue 
streams, research shows. What’s New in Publishing. Available 
at: ht tps://whatsnewinpublishing.com/publishers-still-rely-on-
traditional-revenue-streams-research-shows/. Accessed June 14, 
2021.

5. https://gowers.files.wordpress.com/2012/02/elsevierstatementfinal.
pdf. Accessed June 14, 2021.

6. http://www.thecostofknowledge.com/. Accessed June 14, 2021.

http://www.siuj.org
https://www.sciencemag.org/news/2020/11/9500-nature-journals-will-now-make-your-paper-free-read
https://www.sciencemag.org/news/2020/11/9500-nature-journals-will-now-make-your-paper-free-read
https://www.sciencemag.org/news/2020/11/9500-nature-journals-will-now-make-your-paper-free-read
https://www.relx.com/~/media/Files/R/RELX-Group/documents/reports/annual-reports/2019-annual-report.pdf
https://www.relx.com/~/media/Files/R/RELX-Group/documents/reports/annual-reports/2019-annual-report.pdf
https://whatsnewinpublishing.com/publishers-still-rely-on-traditional-revenue-streams-research-shows/
https://whatsnewinpublishing.com/publishers-still-rely-on-traditional-revenue-streams-research-shows/
https://gowers.files.wordpress.com/2012/02/elsevierstatementfinal.pdf
https://gowers.files.wordpress.com/2012/02/elsevierstatementfinal.pdf
http://www.thecostofknowledge.com/



