Continuing on from his previous work, which highlighted how most of the world's expenditure on medical research was thrown away, Glasziou outlines how bad the situation is and suggests how it might be improved. Subscription-based academic journals make money by through copyrights assigned by authors to publishers who lock the articles behind paywalls. Open access models, in which journals charge a publication fee and then make research and related content fully and immediately available to all, stand to aid the dissemination of knowledge and to improve its quality.
"The waste sounds bad but the reality is worse," writes Glasziou. "The estimate that '85% of research' is wasted referred only to activities prior to the point of publication." After that, he points out, other barriers create post-publication waste. Despite all the effort and attention put into funding medical research through charitable and government programmes, publishing models that restrict access to research outcomes mean that profit comes at the expense of human health. The systems that encourage poor research and poor communication of research findings may seem like dry subjects but the waste they cause costs lives. Charities and governments should ensure the work they fund and authorise is published in an open access manner, thereby making it far more effective.
"To get full value from research investment," Glasziou concludes, "we need to reduce both the annual $100 billion of pre-publication (research production) waste and the unquantified cost of post-publication (research dissemination) barriers If over a hundred billion dollars of medical research money were being wasted by corruption, the public and political outcry would be overwhelming. That resources of this magnitude are being wasted through incompetence and inattention should be seen as a similar scandal. Badly designed and poorly thought through systems of research and dissemination subtract massively from global human health."