For some years now it has been the policy of the BMJ Publishing Group, which jointly owns Heart with the British Cardiac Society, to give gratis subscriptions to their journals to applicants from countries in the developing world. However, in practice this has had its difficulties. Many developing countries have either poor or non-existent postal services, and granting a print subscription can often be problematic and expensive—for example, the marginal cost of sending Heart to Africa is around £25 each year.

An editorial in BMJ has set out the arguments very clearly.1 We know that the gap between …