Paradigm Shifts in Surgical Publishing: The Role of Open Access in Global Equity

Abstract

The current landscape of surgical publishing often fails to align with the goal of improving patient outcomes universally, particularly affecting researchers in low- and middle-income countries. Existing models, like subscription or APC-based open access, perpetuate inequities, prioritizing publishers' financial sustainability over accessible knowledge. While emerging solutions, such as preprints and community-funded platforms, are paving the way for change, they face limitations in exclusivity, scalability, and sustainability. Established journals like Trauma Surgery & Acute Care Open have made strides toward inclusivity, but remain hindered by the APC model. Achieving true equity in surgical publishing requires a fundamental shift to structure access, authorship, and dissemination as a global public good. This necessitates collaboration among publishers, societies, funders, and researchers to create inclusive and sustainable publishing models. Without these changes, patients worldwide will continue to encounter barriers between essential knowledge and care.