Our trust in the integrity of academic publishing is the foundation of progress in biomedical science and technology. But there is now concern about an unprecedented scale of misconduct: industry-style, semi-automatic production of fake scientific publications by “paper mills”, professional agencies that fake scientific data, figures, tables, and AI-written manuscripts. While the number of fake publications was considered to be small, it now reaches concerning levels in biomedicine of 100,000+ publications annually, supporting a billion € industry. Researchers, editors, publishers and governmental funding bodies are called to action to stop this systematic attack on the permanent scientific record.