The expression "Publish or perish," first appeared in 1942. It signified the rising importance of publication as a means to obtain research funds and establish a secure academic career. The expression is still highly relevant, but increasingly problematic. Perhaps it should be revised to read “Publish and Perish”. We have reached a point where researchers, especially in non-English speaking countries, are no longer able to afford to publish their research. There seems little point in undertaking research if we can no longer disseminate or, indeed, apply the wisdom gained from it.