In the 1990s, the Global Forum for Health Research famously coined the phrase "the 10/90 gap" to explain the systemic inequality underpinning global health research.

The 10/90 gap generally refers to the estimate (Commission on Health Research for Development 1990) that 90% of health research benefits only 10% of the world's disease burden, while the remaining 10% of research and resources is spread across 90% of the world's disease burden. Thus, health issues that affect low- and middle-income countries (LMICs) - whose citizens form the majority of the human population - receive the minority of attention.

In various hands, the 10/90 gap has been applied to the allocation of spending, the availability of goods, the selection of research topics, the distribution of researchers, and even the amount of media coverage dedicated to health problems in LMICs.

But the 10/90 gap may also apply to the accessibility of health information.

HIFA recently completed a discussion series to explore forward looking questions on how to improve the accessibility of research produced in LMICs. The highlights of the discussion can be read here.

Not surprisingly, failure to publish research was highlighted as a key reason for inaccessibility. The participants - many of whom are researchers in LMICs - cited the failure to publish research and inaccessibly high publishing charges as roadblocks.

"Most of our young researchers do not know where to publish their paper," said online participant Eben Afari-Kumah of Ghana.

"A key reason why health research is not accessible is because it is never actually published," Dr Neil Pakenham-Walsh, HIFA coordinator, said in one of these discussions.

He added that a large percentage of research may not reach its full potential in terms of impact if published in subscription-only journals, where it may be inaccessible to those who need it most.

Ironically, participants suggested that researchers in their countries might be prejudiced against open-access journals, which suggests that popular fears of "predatory" journals may have outpaced more reliable information about open-access publishing.

In fact, these fears have become so widespread that the Medical Council of India has stated it will not recognise work published in e-journals in academic assessment for promotion of researcher. It's an interesting decision, but one which cannot be said to advance its researchers or address the root cause of predatory publishing.

The discussion is entering another round, and stakeholders are encouraged to join here. Dr Pakenham-Walsh would particularly welcome commentary from the editors and publishers of open-access journals; indexers; policymakers; and representatives from international initiatives such as HINARI, AJOL, AuthorAid and eIFL.

ecancermedicalscience is an open-access journal that is free to read. Our "Pay What You Can Afford" funding model means that researchers without access to funding can publish with no author fees; the majority of our authors publish for free.

If you're interested in accessible health research, you may enjoy our latest Special Issue on palliative care in Africa.