Building global vaccine manufacturing capacity: Spotlight on Africa.

Africa is set to experience a three-fold increase in vaccine demand by 2040, yet the continent possesses few domestic capabilities for vaccine production. This lack of production capacity, heavy reliance on foreign aid, disruptions of hard-won immunization progress due to the effects of the COVID-19 pandemic, and fluctuating vaccine market dynamics threaten to hinder ongoing efforts to increase vaccination rates on the continent. In order meet the vaccine demands of a rapidly growing population, and to be able to provide novel vaccines to its population in the future, the African continent must develop a sustainable vaccine manufacturing infrastructure. The African Union, in partnership with the Africa Centres for Disease Control and Prevention, recently set forth its Program for African Vaccine Manufacturing Framework for Action, which sets the goal of Africa producing 60 % of its vaccine needs by 2040. To meet these goals, African governments and their multinational, philanthropic, and private sector partners must work to secure low-cost financing and provide a favourable regulatory environment for nascent African vaccine manufacturers. Doing so will save lives, safeguard the health of the continent's current and future citizens, and contribute to economic growth through the development of local bioeconomies.

Novel spatiotemporal glycome changes in the murine placenta during placentation based on BS-I lectin binding patterns.

Although spatiotemporal changes of the glycome (full set of glycans, otherwise known as saccharides or carbohydrates) during placenta formation (placentation) are functionally and clinically important, they are poorly defined. Here, we elucidated novel aspects of the glycome during mouse placentation, from embryonic day 6.5 (E6.5) to E12.5, by investigating the largely unexplored binding distribution of lectin I from Bandeiraea simplicifolia (BS-I lectin), a glycan-binding protein that recognizes the DGalNAc and DGal glycans found at the terminal ends of specific oligosaccharides attached to lipids or proteins. We show that BS-I lectin binding marks all trophoblast cells during early placentation (E7.5 and E8.5 stages), continues in labyrinthine and junctional zone trophoblast but is lost from parietal trophoblast giant cells by E10.5/E11.5 (definitive placenta stage) and is lost from all trophoblast types, but marks the fetal capillary endothelium of the labyrinth, by E12.5. In the decidua basalis (the maternal part of the placenta), BS-I lectin positivity mainly marks the decidual stroma cells of the venous sinusoid area (E7.5 and E8.5 stages) and the entire decidua basalis by E10.5, as well as the osteopontin-positive subset of uterine natural killer (uNK) cells from E7.5 onwards. This work provides the first comprehensive description of the hitherto ill-defined spatiotemporal binding distribution of BS-I lectin in the fetal and maternal placenta between E6.5 and E12.5, thereby contributing to glycome elucidation during placentation. It also establishes BS-I lectin positivity as a novel pan-trophoblast marker during early placentation and as a new marker for mature uNK cells from E7.5 onwards.

Patent Pools for ARVs: Industry Perspectives from ASPEN.

AFFORDABILITY THROUGH REDUCED PRICING IS ONLY ONE PART OF ENHANCING ACCESS TO TREATMENT IN PUBLIC HEALTH EMERGENCIES: Supply Security and the guarantee of supply consistency is the other. To the extent that Patent Pooling is able to create Regional African Manufacturing capability, Africans will support the concept. However, to the extent that if further decentralises manufacture away from the continent and increases Africa's dependence on imports, Patent Pooling can potentially weaken supply security and will continue to relegate Africa a Continent of dependency, rather than one that invests in its own capability. Patent Pooling, should be viewed guardedly on the African Continent and will only be embraced, provided it is consistent with the AU Heads of State call for an African Manufacturing Plan and Africa's aspiration to more from "converting charity dollars into sustainable, long term investment dollars".

What strategies to boost production of affordable fixed-dose anti-retroviral drug combinations for children in the developing world?

BACKGROUND: No more than 8% of HIV positive children needing treatment in low- and middle-income countries have access to antiretroviral drugs (ARVs). Children presently account for about 4% of all treated patients, while for equitable access they should make up at least 13%. AIMS: This study explores key issues, implications and interaction dynamics to boost production of easy-to-use and affordable fixed-dose combination (FDC) ARVs for children in the developing world. Potentials for equitable solutions are examined including priority steps and actions, appropriate treatment options and reliable forecasting methods for paediatric ARVs, as well as combination incentives to generic companies against market unattractiveness and enforced intellectual property (IP) rights. Moreover, implementation strategies to enhance the development and production of affordable ARV paediatric formulations and appropriate supply systems to ensure availability are investigated. RESULTS: The current market for FDC paediatric ARVs is already substantial and will only grow with improved and scaled up diagnosis and monitoring of children. This provides an argument for immediate increase of production and development of FDC ARVs for children. These formulations must be low cost and included in the list of Essential Medicines to avoid children continuing to lag behind in access to treatment. Access-oriented, long-term drug policy strategies with the ability to pass muster of governments, the UN system, as well as generic and research-based enterprises are needed to let children gain expanded and sustained access to FDC ARVs. Under the requirements listed above, IP-bound Voluntary License (VL) flexibilities do appear, if coupled with substantial combination incentives to generic firms, as a fitting tool into the needs. Policies must consider enhancing human resource capacity in the area of caregivers and social and health workers aiming to spread correct information and awareness on effectiveness and rationale of FDC ARVs for children. Policies should urge that paediatric ARV treatment programmes entwine with extant interventions on prevention of mother-to-child transmission, as well as with HIV treatment initiatives focused on mothers and household members. Policies, again, should consider centralising functions and pooling resources to help overcome drug supply barriers. WHO's brokering role in VL-based agreements between wealthy and developing country industries, as well as its technical guidance in setting international standards should not be waived while looking for sustained access to optimised ARV treatments for children. Strategies discussed in this paper, while taking unavoidability of marketing and profit rules into account, look closely into the trade and drug policy directions of China and India according to frontier crossing implications of their IP management trends as well as their multi-faceted penetration strategies of both the wealthy and under-served markets the world over.