A move to increase general access to scientific journal articles has figured prominently in the news lately, and it is important for all scientists and physicians, including our readership, to educate themselves on this issue. A goal of the open access movement is to provide unfettered, free public access to articles in scientific journals, including journals like Blood that focus on specialized topics in biology and medicine. At present, access to the full content of most biomedical journals requires a subscription paid for by individuals, departments, or institutional libraries. Rising subscription rates can be a source of pressure on subscribers, and a particularly unrelenting one in the case of libraries that try to purchase a limited number of subscriptions from certain large commercial publishing houses and are required to buy an entire set of journals at exceedingly high prices. Leading proponents of the open access movement would shift the burden of publishing costs to authors, who currently already pay variable page fees and often significant charges to subsidize the cost of color figures. One widely publicized open access model, that of the Public Library of Science, asks authors to pay $1500 per article (http://www.plos.org). However, this sum does not begin to pay for the cost of publication. For Blood, which is owned by the American Society of Hematology (http://www.hematology.org), the estimated cost of publishing a paper online and in print is $5100; and if the journal were to publish the article only online, the cost would still be $2700. Under the current Blood model, these costs are borne by a combination of sources, including authors, advertisers, and subscribers. Even if some authors or their granting agencies were able to pay these costs, other authors might not be able to do so. This could create an uneven playing field, a situation that is not in the best interests of science, but a potential unintended consequence of some open access models.

Since rapid, facile, and complete communication of scientific advances benefits everyone, what journal, including Blood, would not want its pages purveyed by as many readers as possible? Given the financial realities, can some of the noble ideas and legitimate concerns of the open access movement be addressed but at the same time be dissociated from a currently unsustainable business model? At Blood, we believe the answer is yes. It is the goal of Blood to provide its content in the most unencumbered way and at the lowest possible cost to its readers and subscribers, without jeopardizing the journal's mandate to provide rigorous editorial review and to publish the most significant advances in hematology. Toward such a goal, Blood adheres to the recently annunciated Washington DC Principles For Free Access to Science: A Statement from Not-for-Profit Publishers (http://www.dcprinciples.org). In addition, ASH has developed its own statement on open access, which can be found at http://www.hematology.org/government/policy/open_access.cfm.

Several recent and forthcoming policies of Blood are also relevant in this context:

  • Blood's back content is free online to anybody in the world as soon as it is 12 months old. Content back to 1990 is now available, with plans to soon go all of the way back to volume 1 in 1946.

  • Abstracts are open to anybody from the time of publication.

  • Readers working in low-income countries are granted immediate free access to the entire online journal through the WHO-sponsored HINARI program. This program serves 99 countries and almost 1000 institutions.

  • Selected articles of interest are free online at the time of publication. These include reviews in the popular Inside Blood section and articles in the How I Treat series. Inside Blood provides readers with expert perspectives on approximately 20% of the original articles in each issue. Free online access to the full content of 5 of these original articles will also be offered.

  • Authors will retain nonexclusive rights to do the following once their article has been published in final version online and in print: reprint their work in print collections of their own writing, present the work orally, reproduce it for use in courses the author is teaching, distribute photocopies to colleagues for noncommercial purposes, reuse the figures and tables, and post a copy of the work on their personal website, provided a hyperlink to the work on the Blood website is included.

Journals operated by learned scientific societies espouse various “degrees” of open access, consistent with their varied goals and business models. They serve readers and benefit the scientific process by providing an editorial filter with the assistance of expert reviewers. They must answer fiscally to interested stakeholders: the scientific societies. However, unlike commercial publishers, society journals do not have to answer to stockholders and bean counters. The future success of Blood will be gauged by a set of criteria that have far more to do with science, quality, and communicating translational breakthroughs than with money. One hard indicator that Blood has been largely meeting the needs of authors and readers is the unrelenting increase in manuscripts submitted: an average of 12% in each of the past five years, leading to a total of 4387 in 2003 alone. If this trend continues, the journal expects to be able to publish only about 25% of submitted manuscripts in 2004, a high bar indeed, but one that reflects both editorial responsibility and fiscal reality. New, viable models for scientific publishing are expected to evolve over the next several years. The editorial team at Blood is committed to evolve with them to maximize access and minimize excess.