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Investigators from Cayetano Heredia University in Peru argue in a letter to PLoS Medicine (26 June) that online access to the latest results in biomedical research through the Health InterNetwork Access to Research Initiative (HINARI) needs to sharpen up if its aim of providing free "health information for all" is to be upheld.

In the experience of Javier Villafuerte-Galvez and colleagues, HINARI is not providing the degree of access it used to when originally set up, and this is growing worse.

When HINARI was launched by the World Health Organization in 2003, it provided free (or low-cost) access to more than 2,300 major journals, they say, but in April 2007 they could not access any of the top five main journals of major publishers such as the Nature Publishing Group or Elsevier Science Direct.

These publishers produce roughly 57 per cent of the journals that are supposed to be accessible through HINARI, so not only are fewer biomedical journals accessible to people in Peru, say the authors, but the journals with the highest impact are no longer available.

Perhaps because of this deterioration in performance, Villafuerte-Galvez and colleagues say that the number of HINARI users in their institution has more than halved over the past two years.

And the worry is, the authors say, that medical students and researchers in low-income countries need free access to the top biomedical journals to practise evidence-based healthcare and to conduct their research at the front line of global health problems.

Link to full article in PLoS Medicine