Open access and its potential impact on public health - A South African perspective

African primary research publications in plastic surgery: A PRISMA-S-compliant systematic review

BACKGROUND

Plastic surgery (PS) in Africa is a relatively young surgery specialty, and the number of available plastic surgeons on average is one or two surgeons per country in many African low-income countries. This systematic review aims to geographically map the research activities through scientific publications of African PS centres, between February 2012-February 2023.

METHODS

We searched four literature databases (Medline, Embase, Google Scholar and African Journal Online) and did a manual search. We included case reports, randomised controlled trials, and clinical, comparative, observational and multicentre studies conducted in Africa and published in English and French. In the Google Scholar database, we analysed the first 200 references (scientific articles) selected per relevance according to the Boolean terms. In the African Journals Online database, we analysed the references from the first five pages. The selected keywords were: burns, trauma reconstruction, pressure injuries, wound, cleft lip and palate, breast reconstruction, microsurgery, aesthetic surgery, face surgery, head and neck surgery, hand surgery, open fracture surgery, oculoplastic surgery, skin surgery, and soft tissue surgery.

RESULTS

We retrieved a total of 228 articles. Out of the 73 African centres we identified, 27 were in the North, 22 in the West, 8 in the East, 3 in the Centre, and 14 in the South. Most of the retrieved 228 articles involved burns (60, 26.31%), congenital abnormalities (52, 22.80%) and reconstruction (28,12.80%); however, other conditions, such as breast or skin cancer, hand surgery, microsurgery or aesthetics are emerging. The studies were case reports/case series (93, 40.78%), retrospective (78, 34.21%), prospective (36, 15.78%), randomised controlled studies (10, 4.38%), cross-sectional (5, 2,19%) and cohort (2, 0.87%).

CONCLUSIONS

Beyond burns, congenital abnormalities, or reconstructions, other PS indications are emerging, such as skin cancer, breast reconstruction, hand surgery, microsurgery, and aesthetics.

A pathway to strengthening open science: comments on the draft South African Ethics in Health Research Guidelines

The recently released draft South African Ethics in Health Research Guidelines: Principles, Processes and Structures (Draft Guidelines) by the National Health Research Ethics Council recognize open data and provide guiding principles for this in the context of health research in South Africa. While its inclusion is a positive development, there is room for improvement. Although the Draft Guidelines leverage the Draft National Policy on Data and Cloud, it lacks incorporation of other relevant government policies, notably the Draft National Open Science Policy, and fails to sufficiently detail the principles of open science and open access. This limited scope and lack of comprehensive definition and detailed guidance present challenges for researchers in conducting ethical and responsible health research in South Africa. It constrains the Draft Guidelines from fully aligning with national imperatives and from fostering African-centric approaches. To address these issues, it is recommended that the Draft Guidelines integrate broader policies and principles, enhance clarity through comprehensive definitions, provide detailed guidance on open access, and promote African-centric approaches. Implementing these solutions will strengthen the Draft Guidelines, aligning them with national visions of open science, and thereby harnessing the full potential of South Africa's diverse scientific community in advancing health research.

OPEN ACCESS PUBLISHING — “SO NEAR AND YET SO FAR”

Scientific knowledge needs to be widely disseminated across the globe, for it to be critically analyzed or to be built upon for future studies. The conventional publication model has been less accessible due to prohibitive subscription costs and hence the need arose for the open access model where the readers would have free access. The Open Science movement is not only about open-access journals but also includes open source, open data and methodology, open peer review, open-access indexing, and archiving. The prototype open access model is the gold model where researchers (themselves or supported by grants or funding agencies) pay certain article processing charges and the readers have free access to the content without any restrictions. Additionally, there is a need for free-to-use open-access platforms or repositories like PubMed Central to archive the open-access content. Institutional repository is another way for collecting, archiving, and distributing the scholarly contents of an academic institution. Preprint servers allow archiving manuscripts before they are submitted to or undergo review for publication, and they offer an important platform for freely sharing knowledge. While open-access model looks attractive, it has its challenges. Currently, the change to open-access model has meant the transfer of the financial burden, earlier borne by the readers, to the authors in the form of APCs. Irrespective of the model, there is a need to reconsider the high subscription costs and the article processing charges which are often prohibitive for many. Science must be accessible to the researchers and the public at a reasonable cost without delay.