After Plan S: What the cOAlition S 2026-2030 Strategy Means for Medical Authors

When cOAlition S launched Plan S in 2018, the reaction across medical publishing was somewhere between alarm and skepticism. The demands were clear: all research funded by the coalition's member agencies had to be immediately open access, with no embargo and a permissive CC BY license. Hybrid journals, those that charge subscription fees but offer optional open access at extra cost, were prohibited unless they were formally committed to converting to fully open access through a transformative agreement. For a research community that had spent decades building career reputation around a handful of high-prestige subscription journals, Plan S was not a gentle nudge.

Seven years on, cOAlition S has published its 2026-2030 strategic plan. Science/AAAS, covering the announcement, used precise language: the new plan "retreats from strict requirements." For medical researchers who built their journal selection strategy around Plan S compliance, this matters. The shift does not dismantle the open access push, but it softens the confrontational posture that made Plan S so distinctive, and it introduces new language around Publish-Review-Curate models, diamond open access, and equitable infrastructure that will shape the next phase of funder-led reform in scientific publishing.

Why Plan S Was Such a Disruption

Plan S was announced in September 2018 by Science Europe, on behalf of 11 funding organizations, most of them European. The coalition grew to 28 funders by 2026, including agencies from North America, Jordan, Zambia, South Africa, and Australia. Wellcome Trust and UK Research and Innovation (UKRI) were early signatories. The Bill and Melinda Gates Foundation joined later. The European Research Council was a member but eventually withdrew to pursue an independent open access policy through the European Commission, an exit that illustrated how much institutional friction Plan S generated even within the funder community that nominally shared its goals.

The core demand was unapologetic: no embargo, immediate open access, CC BY license, and no paywalled venue unless it was on a transformative agreement trajectory toward full OA. This forced researchers who relied on journals like the New England Journal of Medicine, The Lancet, and JAMA (none of which were fully open access journals in the Plan S sense) to weigh career reputation against funder compliance. For clinical researchers, the pressure was especially acute. Medical specialties have long concentrated prestige in a small number of high-impact subscription journals, and a mandate that effectively told authors to publish elsewhere was asking them to make a sacrifice that their institutions and hiring committees were not always ready to absorb.

The transformative journal (TJ) mechanism was introduced as a middle path. Subscription journals could qualify as Plan S compliant by committing to a schedule of increasing their open access share each year until reaching full OA. Publishers like Springer Nature, Elsevier, and Wiley entered into institutional transformative agreements that allowed authors at participating universities to publish open access in hybrid journals without paying directly for an APC. This created a patchwork system that worked well for authors at well-funded research-intensive institutions and worked poorly for those without institutional agreements, including researchers from lower- and middle-income countries and those at smaller colleges.

What the 2026-2030 Strategy Actually Changes

The 2026-2030 strategy, released in late 2025, defines three priorities for the coming period. The first is reinforcing the foundations for full, immediate, sustainable, and equitable open access to peer-reviewed articles. The second is supporting the digital infrastructure that enables open access at scale. The third is exploring financially sustainable and equitable publishing systems and tracking their outcomes. These three priorities are not a departure from the coalition's founding goals, but the implementation language is noticeably different from the Plan S era.

The most significant change is the absence of new venue mandates. cOAlition S now states that it will "endorse and advocate for a multitude of routes to open access," compared to the Plan S framework, which specified narrow compliant pathways and penalized non-compliance. The new strategy contains no mandate limiting the types of venues in which grantees publish. That absence is the clearest signal of the shift. Plan S was distinguished by its mandates. The 2026-2030 document is distinguished by declining to add new ones.

Support for transformative journals ended in December 2024, before the new strategy period began. The TJ mechanism was always intended as a time-limited bridge, and cOAlition S decided not to carry it into 2026-2030. This is not a retreat on open access principles but a recognition that the transformative journal route had run its course as a formal coalition instrument. What replaces it, in terms of the coalition's preferred routes, is the combination of fully OA journals, repository deposit of author accepted manuscripts, the Publish-Review-Curate model, and diamond open access.

The Publish-Review-Curate Model: What It Means in Practice

The most operationally interesting concept in the new strategy is the Publish-Review-Curate (PRC) model, which cOAlition S now explicitly endorses. PRC separates the three functions that journals have historically bundled together: making research public, evaluating it through peer review, and curating it through editorial selection. Under a PRC workflow, a researcher first posts work as a preprint on a server like medRxiv, bioRxiv, or a discipline-specific platform. Peer review is then organized openly, either by a journal conducting review of the preprint directly, or by an overlay service or community. The curated, reviewed version is then made permanently available through the journal or through the preprint server with linked reviews.

This is not speculative infrastructure. COAR (the Confederation of Open Access Repositories) and ASAPbio formed a PRC Alliance Interim Working Group in January 2026 to begin coordinating the diverse community of PRC implementers. The COAR Notify Protocol, a technical standard that allows preprint servers and peer review systems to exchange structured notifications when a review occurs, is already in stable release and in active use. Several journals and overlay platforms have adopted it, and the first six months of 2026 were designated as the period to define what a formal PRC Alliance would look like.

For medical researchers, PRC has a concrete implication that connects to changes already in motion. Posting a preprint on medRxiv before or simultaneously with journal submission now serves multiple purposes. The HHMI preprint mandate, which took effect in January 2026, requires researchers it funds to post a preprint before first journal submission. The Gates Foundation, which already prohibits APC payments from grants, treats preprints as a primary route to satisfying its immediate-access requirement. Under the PRC framework, that preprint is not just a parallel deposit but the start of the formal scholarly communication process. The review is layered on afterward, rather than gating access.

One reason PRC appeals to cOAlition S is that it is, by structure, a low-cost or no-cost model. Preprint servers do not charge authors. Peer review under a PRC model is typically not bundled with copyediting, typesetting, and the other services that make journal APCs expensive. This matters as funder pressure on APC costs intensifies, which is covered separately under the individual funder policies below.

Diamond Open Access in Medicine

Alongside PRC, the new cOAlition S strategy emphasizes diamond open access as a preferred model. Diamond OA refers to publishing that is free to read for anyone and free to publish in for authors, with costs borne by institutions, learned societies, national funders, or public infrastructure rather than by author-facing APCs. It is the model that predates the APC-funded gold OA approach, and it is common in fields with strong academic society publishing traditions.

Diamond OA in medicine is less common than in physics or mathematics, where arXiv and overlay journal models have existed for decades, but examples exist and the model is growing. A number of specialty medical journals operated by academic societies charge no APCs and are fully open access. The practical value of diamond OA for medical authors is simple: it removes the APC problem entirely. As the Gates Foundation bans APC payments from its grants, and as NIH continues to study proposals to cap APC expenditure from federal funds, the routes that involve no APC are comparatively more attractive with each passing year.

If your specialty has a society journal operating on a diamond or very low-cost OA model, it is worth evaluating it on editorial quality, scope, indexing, and readership rather than dismissing it because it lacks a brand-name publisher. Indexing in PubMed, Scopus, and Web of Science is the relevant check for most clinical fields. Impact factor is one metric among several, and a well-indexed society journal with a genuine peer review process in your specific specialty is a better submission choice than a large commercial journal charging a four-figure APC for gold OA in a specialty that does not reflect your audience.

What Has Not Changed: Your Funder's Policy Still Governs

The cOAlition S strategy shift does not override individual funder policies. This is the most important practical note for working researchers. The specific policies of each member funder remain in force, set by that funder's own grant conditions, and the coalition-level document does not supersede them. Several major funders tightened their positions in 2024 and early 2025, well before the new strategy period began.

Wellcome Trust stopped paying APCs in hybrid journals for grants awarded from January 2025 onward. UKRI ended support for transformative journal agreements in December 2024, meaning that researchers with UKRI funding who want to publish in a hybrid journal that lacks a separate institutional agreement must use the repository deposit route. The Bill and Melinda Gates Foundation disallowed APC payments from its grants entirely in 2024. Cancer Research UK stopped funding APCs for new submissions from April 2026. These are in force regardless of the softer tone in the coalition-level strategy document.

The European Research Council is also worth addressing directly. When the ERC withdrew from cOAlition S and moved to an independent OA policy through the European Commission, it did not relax its open access expectations; it just decoupled them from the Plan S framework. Researchers holding ERC grants should check the current ERC open access policy directly, not map it to either Plan S or the 2026-2030 strategy, since the ERC now operates its own framework.

One nuance worth noting: institutions often negotiate transformative agreements with publishers independently of funder policy. If your university has a read-and-publish agreement with a major publisher, it may cover the APC for OA publishing in that publisher's hybrid journals even when your funder does not. These institutional agreements operate alongside funder mandates. The journal checker at the Plan S website, though its framework has evolved, still provides a useful starting point for matching a specific journal against specific funder compliance status. Cross-checking with your institution's library office is the safest step, since agreement coverage changes annually.

A Practical Checklist for Authors Right Now

Before selecting a journal for your next manuscript, the clearest approach is to work from your specific funder's policy, not from the coalition-level document. The coalition sets the direction; your grant conditions set the rules. Start by identifying all funders whose money contributed to the work being published. If the work was supported by multiple funders with different policies, the most restrictive policy governs your options, unless you can separately attribute funding to specific parts of the work.

Once you know your funder constraints, check whether your target journal is fully OA, hybrid with institutional agreement coverage, or subscription-only. If it is a hybrid journal, check whether your institution has an active agreement with that publisher. If it does not, check whether the journal allows immediate CC BY deposit of the Author Accepted Manuscript in a repository like Europe PMC, PubMed Central, or a disciplinary repository. This repository route is increasingly important as the APC-funded path becomes restricted by more funders.

Building the preprint step into your workflow is worth considering independently of funder mandates. Under the PRC model that cOAlition S now promotes, a medRxiv preprint creates a timestamped record, establishes priority, and satisfies the immediate public access requirement for funders that accept preprints as a compliance route. Most major medical journals now allow preprint posting before or during submission, and many do not consider it prior publication. The overhead of posting a preprint is low; the benefit in terms of early dissemination and funder compliance is real.

The broader shift in the coalition's 2026-2030 strategy toward flexibility and infrastructure rather than venue mandates suggests that the next few years will be a period of platform building rather than compliance enforcement. That is actually useful for researchers who felt constrained by the earlier framework. The practical tradeoff is that "multiple routes" means more complexity to navigate, not less. The routes to full compliance for a given funder-journal combination are not always obvious, and the landscape changes as institutional agreements expire, journals change their OA models, and funder policies are updated in response to political pressure, particularly in the United States, where Congress held a hearing on scientific publishing practices in April 2026 and has signaled ongoing interest in APC costs and research integrity.

Where This Is Heading

The shift from confrontational to collaborative at the coalition level reflects a realistic assessment of what Plan S achieved and what it could not. It accelerated the growth of fully OA journals and of transformative agreements as a bridge mechanism. It did not displace high-prestige subscription journals or fundamentally alter the incentive structures that lead researchers to target them. The new strategy acknowledges that reality by declining to add new restrictions and instead betting on infrastructure, preprints, and alternative models to change behavior over a longer timeline.

For medical researchers, the near-term implications are mostly about what will not happen in the 2026-2030 period. There will not be a new wave of venue restrictions from cOAlition S. Transformative journals are gone as a formal mechanism, but the agreements that institutions already have in place continue to operate under their own terms. The PRC model is growing but is not yet a mainstream clinical publishing route. Diamond OA journals in medicine are increasing in number but remain a minority share of total clinical output.

What is shifting is the economic pressure. As more funders restrict APC payments and cap allowable APC costs, the cost advantage of non-APC routes will become more visible to researchers who previously relied on funder money or institutional agreements to absorb gold OA fees. That shift in economics is likely to accelerate adoption of repository deposit routes and preprint-first workflows more than any policy mandate has managed to do, simply because the alternatives are becoming less affordable. The coalition's decision to endorse a "multitude of routes" may turn out to be well-timed for a period when the routes that involve no fees are gaining ground for financial reasons rather than ideological ones.

If you are a medical author who has been navigating this landscape reactively, journal by journal and grant by grant, now is a reasonable time to build a standing compliance checklist that you update annually. The specific content of that checklist depends entirely on your funders, your institution, and the journals in your specialty. But the structure of the check, funder policy, then journal OA status, then institutional agreement, then repository route, will remain stable even as the specific answers at each step keep changing.

Further Reading