[The shapeshifting landscape of academic publishing in pediatrics: focus on Open Access]

Over the past two decades, academic publishing has undergone substantial transformation, largely driven by digitalization and increased global Internet access. In parallel, the Open Access (OA) movement has played a critical role in advancing equitable access to scientific knowledge by eliminating paywalls and licensing restrictions. While these developments have yielded considerable benefits -particularly in enhancing the dissemination and democratization of research- they have also generated complex ethical and structural challenges. Notably, the consolidation of publishing power among a few major editorial houses, the emergence of profit-driven publication models, and the shifting of publication costs onto authors, have contributed to a growing crisis in academic medicine. These trends have raised concerns regarding transparency, editorial independence, and the overall integrity of the scientific record. This manuscript aims to delineate the historical and structural evolution of academic publishing, assess its current landscape, and critically examine the key challenges facing the field in the context of Open Access. Particular attention is given to the implications for pediatric researchers in Latin America, who are disproportionately affected by these systemic barriers.