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非洲需要发展疫苗学能力,以此作为遏制抗菌药物耐药性的一种手段。

The need for Africa to develop capacity for vaccinology as a means of curbing antimicrobial resistance.

作者信息

Akegbe Hope, Onyeaka Helen, Michael Mazi Ifeanyi, Alex Olowolafe Opeyemi, Dolapo Omotosho Adeola, Olatunji Oladunjoye Iyiola, Amuda Tajudeen Yusuf, Seun Ofeh Augustine

机构信息

Department of Microbiology, Faculty of Life Sciences, University of Benin, Benin City, Nigeria.

School of Chemical Engineering, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.

出版信息

Vaccine X. 2023 May 27;14:100320. doi: 10.1016/j.jvacx.2023.100320. eCollection 2023 Aug.

Abstract

The high prevalence of infectious diseases in Africa, combined with weak healthcare systems, poor antimicrobial stewardship, and an unchecked drug supply chain, is steadily reversing the trend in the fight against infectious diseases in this part of the world, posing severe threats to antimicrobial resistance (AMR). AMR continuously evolves and threatens to undermine antimicrobial efficacy and undo advances against infectious diseases. This brewing pandemic is now recognized as a significant worldwide health danger, implicated in several cases of morbidity, mortality, and increasing healthcare costs. Vaccine technology has been proven to be the principal remedy to this imminent danger since it prevents microbial infections. However, since Africa cannot produce its vaccines, it relies on external sources and, as a result, it is significantly affected by vaccine nationalism, hoarding, and instabilities in global supply chains. This has further adversely impacted the ability of African governments to regulate rollouts, protect their citizens, and ultimately rejoin the global economy. This dependency is a severe challenge to Africa's health resilience, as it is unsustainable. Given the inevitability of potential global pandemics and the alarming incidences of multi-drug resistance infections reported daily, Africa must develop the capability to produce its vaccines. The review utilized a systematic search of academic databases and grey literature, as well as a manual search of relevant reports and articles. In this review, we outline the public health threats and concerns that AMR poses to Africans, and the hurdles and advances achieved in vaccine development over the years. We also highlight possible strategies, particularly collaborative efforts, that will accelerate vaccine production and ease the strain of infectious diseases and antimicrobial resistance in Africa. Key findings indicate that Africa has significant gaps in its vaccine manufacturing and distribution capacity, with only a few countries having the ability to produce vaccines. Additionally, existing vaccine production facilities are often outdated and require significant investment to meet international standards. The review also highlights successful initiatives in Africa, such as the mRNA vaccine hub and the African Vaccine Manufacturing Initiative, which have demonstrated the potential for building local vaccine manufacturing capacity. The study concludes that Africa needs to prioritize investment in vaccine research and development, regulatory capacity, and infrastructure to build a sustainable vaccine manufacturing ecosystem. Overall, this review emphasizes the urgent need for Africa to develop its vaccine manufacturing capacity to improve vaccine access and strengthen its ability to respond to future pandemics. The findings underscore the importance of collaboration between African governments, international organizations, and the private sector to build a resilient vaccine ecosystem in Africa.

摘要

非洲传染病的高流行率,再加上医疗体系薄弱、抗菌药物管理不善以及药品供应链缺乏监管,正在稳步扭转该地区抗击传染病的趋势,对抗菌药物耐药性(AMR)构成严重威胁。抗菌药物耐药性不断演变,有可能破坏抗菌药物的疗效,并使抗击传染病的进展付诸东流。这场正在发酵的大流行如今被公认为是全球重大的健康危险,与多起发病、死亡病例以及不断增加的医疗成本有关。疫苗技术已被证明是应对这一紧迫危险的主要手段,因为它能预防微生物感染。然而,由于非洲无法自行生产疫苗,只能依赖外部供应,因此深受疫苗民族主义、囤积行为以及全球供应链不稳定的影响。这进一步对非洲各国政府监管疫苗推广、保护本国公民以及最终重新融入全球经济的能力产生了不利影响。这种依赖对非洲的卫生复原力构成了严峻挑战,因为它不可持续。鉴于潜在全球大流行的必然性以及每天报告的多药耐药感染的惊人发生率,非洲必须发展自行生产疫苗的能力。本综述通过系统检索学术数据库和灰色文献,以及手动检索相关报告和文章展开。在本综述中,我们概述了抗菌药物耐药性给非洲人带来的公共卫生威胁和担忧,以及多年来疫苗研发中遇到的障碍和取得的进展。我们还强调了可能的策略,特别是合作努力,这将加速疫苗生产,并缓解非洲传染病和抗菌药物耐药性的压力。主要研究结果表明,非洲在疫苗生产和配送能力方面存在巨大差距,只有少数国家具备生产疫苗的能力。此外,现有的疫苗生产设施往往过时,需要大量投资才能达到国际标准。该综述还突出了非洲的一些成功举措,如信使核糖核酸疫苗中心和非洲疫苗生产倡议,这些举措展示了建设本地疫苗生产能力的潜力。研究得出结论,非洲需要优先投资于疫苗研发、监管能力和基础设施建设,以构建一个可持续的疫苗生产生态系统。总体而言,本综述强调非洲迫切需要发展其疫苗生产能力,以改善疫苗可及性,并增强其应对未来大流行的能力。研究结果强调了非洲各国政府、国际组织和私营部门之间开展合作以在非洲建立一个有复原力的疫苗生态系统的重要性。

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本文引用的文献

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JAMA. 2021 Jun 15;325(23):2337-2338. doi: 10.1001/jama.2021.7439.
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Africa prepares for COVID-19 vaccines.非洲为新冠疫苗做准备。
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