Bavesh D Kana et al.
Opportunities and challenges of leveraging COVID-19 vaccine innovation and technologies for developing sustnable vaccine manufacturing capabilities in Africa
The Lancet, June 2023; doi.org/10.1016/S1473-3099(22)00878-7
Abstract
The COVID-19 pandemic heralded unprecedented resource mobilisation and global scientific collaboration to rapidly develop effective vaccines. Regrettably, vaccine distribution has been inequitable, particularly in Africa where manufacturing capacity remains nominal. To address this, several initiatives are underway to develop and manufacture COVID-19 vaccines in Africa. Nevertheless, diminishing demand for COVID-19 vaccines, the cost competitiveness of producing goods locally, intellectual property rights issues, and complex regulatory environments among other challenges can undermine these ventures. We outline how extending COVID-19 vaccine manufacturing in Africa to include diverse products, multiple vaccine platforms, and advanced delivery systems will ensure sustainability. Possible models, including leveraging public–academic–private partnerships to enhance success of vaccine manufacturing capacity in Africa are also discussed. Intensifying research in vaccine discovery on the continent could yield vaccines that further bolster sustainability of local production, ensuring greater pandemic preparedness in resource-constrained environments, and long-term health systems security.
This is the first in a Series of three papers on lessons from COVID-19 to manage infectious diseases in low-income and middle-income countries. All papers in the Series are available at www.thelancet.com/series/LMICs-lessons-from-COVID-19.
Kamini Walia et al.
How can lessons from the COVID-19 pandemic enhance antimicrobial resistance surveillance and stewardship?
The Lancet, June 2023; doi.org/10.1016/S1473-3099(23)00124-X
Abstract
COVID-19 demanded urgent and immediate global attention, during which other public health crises such as antimicrobial resistance (AMR) increased silently, undermining patient safety and the life-saving ability of several antimicrobials. In 2019, WHO declared AMR a top ten global public health threat facing humanity, with misuse and overuse of antimicrobials as the main drivers in the development of antimicrobial-resistant pathogens. AMR is steadily on the rise, especially in low-income and middle-income countries across south Asia, South America, and Africa. Extraordinary circumstances often demand an extraordinary response as did the COVID-19 pandemic, underscoring the fragility of health systems across the world and forcing governments and global agencies to think creatively. The key strategies that helped to contain the increasing SARS-CoV-2 infections included a focus on centralised governance with localised implementation, evidence-based risk communication and community engagement, use of technological methods for tracking and accountability, extensive expansion of access to diagnostics, and a global adult vaccination programme. The extensive and indiscriminate use of antimicrobials to treat patients, particularly in the early phase of the pandemic, have adversely affected AMR stewardship practices. However, there were important lessons learnt during the pandemic, which can be leveraged to strengthen surveillance and stewardship, and revitalise efforts to address the AMR crisis.
Ayoade Alakija
Leveraging lessons from the COVID-19 pandemic to strengthen low-income and middle-income country preparedness for future global health threats
The Lancet, June 2023; doi.org/10.1016/S1473-3099(23)00279-7
Abstract
Although the global COVID-19 pandemic response was quick to develop medical countermeasures, it failed to fully prevent morbidity and mortality in high-income countries and low-income and middle-income countries (LMICs). As new variants and post-COVID-19 condition continue to emerge and affect health systems and economies, the full human and economic cost is yet to be felt. We should now learn from these shortcomings and implement more inclusive and equitable frameworks to prevent and respond to outbreaks. This Series offers specific learnings from COVID-19 vaccination campaigns and non-pharmaceutical interventions, highlighting the need for resilient, inclusive, and equitable health systems. Taking action to rebuild trust and invest in resilient local manufacturing capacity, supply chains, regulatory frameworks, and placing LMIC voices at the centre of decision making will help to ensure preparedness for future threats. It is time to move beyond mere talk of learning and implementing lessons and instead take action towards a more resilient future.
