RESUMO
Pandemic preparedness and response have relied primarily on market dynamics to drive development and availability of new health products. Building on calls for transformation, we propose a new value proposition that instead prioritises equity from the research and development (R&D) stage and that strengthens capacity to control outbreaks when and where they occur. Key elements include regional R&D hubs free to adapt well established technology platforms, and independent clinical trials networks working with researchers, regulators, and health authorities to better study questions of comparative benefit and real-world efficacy. Realising these changes requires a shift in emphasis: from pandemic response to outbreak control, from one-size-fits-all economies of scale to R&D and manufacture for local need, from de novo product development to last-mile innovation through adaptation of existing technologies, and from proprietary, competitive R&D to open science and financing for the common good that supports collective management and sharing of technology and know-how.
Assuntos
Motivação , Saúde Pública , Humanos , Pandemias/prevenção & controle , Pesquisa , Surtos de DoençasAssuntos
Betacoronavirus , Defesa Civil , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Medição de Risco , Fatores Etários , Aneurisma Infectado , Betacoronavirus/genética , Betacoronavirus/patogenicidade , COVID-19 , Comorbidade , Busca de Comunicante , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Países em Desenvolvimento , Apoio Financeiro , Humanos , Pandemias/prevenção & controle , Isolamento de Pacientes , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Vigilância da População , Quarentena , SARS-CoV-2 , Organização Mundial da SaúdeRESUMO
Ebola virus disease (EVD) is a deadly zoonotic disease caused by the Ebola virus. There is no specific treatment approved for EVD. Supportive care and management of complications are mainstays of treatment. Effective outbreak control requires a multidisciplinary team effort applying case management, infection prevention and control practices, surveillance and contact tracing, a good laboratory service, safe and dignified burials, and social and community mobilization. This article highlights the epidemiology, clinical features, diagnosis, management, and prevention of EVD. The emerging diagnostic technologies, rapid viral characterization, geospatial mapping of EVD transmission, and new treatments and vaccines are discussed.
Assuntos
Ebolavirus/fisiologia , Doença pelo Vírus Ebola/epidemiologia , Doença pelo Vírus Ebola/virologia , África/epidemiologia , Animais , Surtos de Doenças/história , Vacinas contra Ebola/imunologia , Doença pelo Vírus Ebola/prevenção & controle , História do Século XX , História do Século XXI , Humanos , ZoonosesRESUMO
The current strategy used by many funding agencies for determining how money is spent on research to help prevent infectious disease outbreaks is based on pathogen-specific priority lists. Listing disease threats provides focus for business and research planning conducive to specific goals of developing a drug, or a vaccine, or other particular product. But, this singular type of focus has consequences. This perspective explores the consequences of lists, and describes how parallel programming independent of disease lists that address what we need to do to prevent and mitigate emerging disease risks may provide benefits out of reach of a singular focus on what products we need to have.
Assuntos
Bactérias/patogenicidade , Surtos de Doenças/prevenção & controle , Administração Financeira , Pesquisa/economia , Vírus/patogenicidade , Infecções Bacterianas/economia , Infecções Bacterianas/prevenção & controle , Doenças Transmissíveis Emergentes/economia , Surtos de Doenças/economia , Humanos , Viroses/economia , Viroses/prevenção & controleRESUMO
Zika virus (ZIKV) is mainly transmitted by mosquitoes bites. However, transmission by sexual contacts has been reported in 11 non endemic countries. The rapid spread of ZIKV in Latin American and Caribbean Countries (LCR), person-to-person transmission and perceived risk on people's well being can affect the emerging economies of LCR which historically dependent on truism. Here we present an analysis on economic outputs for assessing the current impact of ZIKV on markets. Our analysis show an unexpected resilience of LCR markets to international alerts. This positive response represents an opportunity to scale-up interventions for preventing the further spreading of the ZIKV epidemic.
Assuntos
Surtos de Doenças/economia , Infecção por Zika virus/economia , Infecção por Zika virus/epidemiologia , Zika virus , Humanos , América Latina/epidemiologia , México , Fatores de Tempo , Índias Ocidentais/epidemiologiaAssuntos
Antivirais/uso terapêutico , Produtos Biológicos/uso terapêutico , Controle de Doenças Transmissíveis/organização & administração , Ensaios de Uso Compassivo/ética , Drogas em Investigação/uso terapêutico , Ética Médica , Doença pelo Vírus Ebola/tratamento farmacológico , Animais , Antivirais/economia , Produtos Biológicos/economia , Canadá , Ensaios de Uso Compassivo/economia , Drogas em Investigação/economia , Financiamento Governamental/economia , Financiamento Governamental/ética , Doença pelo Vírus Ebola/epidemiologia , Humanos , Soros Imunes , Libéria , Camundongos , Estados UnidosRESUMO
BACKGROUND: The emergence and global spread of the pandemic H1N1 2009 influenza virus have raised questions regarding the protective effect of available seasonal vaccines and the efficacy of a newly produced matched vaccine. METHODS: Ferrets were immunized with the 2008-2009 formulations of commercially available live attenuated (FluMist; MedImmune) or split-inactivated (Fluviral; GlaxoSmithKline) vaccines, a commercial swine vaccine (FluSure; Pfizer), or a laboratory-produced matched inactivated whole-virus vaccine (A/Mexico/InDRE4487/2009). Adaptive immune responses were monitored, and the animals were challenged with A/Mexico/InDRE4487/2009 after 5 weeks. RESULTS: Only animals that received the swine or matched vaccines developed detectable hemagglutination-inhibiting antibodies against the challenge virus, whereas a T cell response was exclusively detected in animals vaccinated with FluMist. After challenge, all animals had high levels of virus replication in the upper respiratory tract. However, preexisting anti-pandemic H1N1 2009 antibodies resulted in reduced clinical signs and improved survival. Surprisingly, FluMist was associated with a slight increase in mortality and greater lung damage, which correlated with early up-regulation of interleukin-10. CONCLUSIONS: The present study demonstrates that a single dose of matched inactivated vaccine confers partial protection against a pandemic H1N1 2009 virus, and it suggests that a higher dose or prime-boost regimen may be required. The consequences of mismatched immunity to influenza merit further investigation.