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Bartoletti M, Bussini L, Bavaro DF, Cento V. What do clinicians mean by epidemics' preparedness. Clin Microbiol Infect 2024; 30:586-591. [PMID: 37327873 DOI: 10.1016/j.cmi.2023.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Infectious disease pandemics and epidemics pose significant global threats, and the risk of emerging infectious diseases has increased because of factors such as international connections, travel, and population density. Despite investments in global health surveillance, much of the world remains unprepared to manage infectious disease threats. OBJECTIVES This review article discusses the general considerations and lessons learned from the COVID-19 pandemic in terms of epidemic preparedness. SOURCES Non-systematic search on PubMed, scientific society websites, and scientific newspapers (performed in April 2023). CONTENT Key factors for preparedness include robust public health infrastructure, adequate allocation of resources, and effective communication between stakeholders. This narrative review emphasizes the need for timely and accurate dissemination of medical knowledge, as well as addressing the challenges of misinformation and infodemics. It also highlights the importance of quick availability of diagnostic tests and vaccines, ensuring equitable access to these technologies. The role of scientific coordination in developing treatment strategies and the safety and mental well-being of healthcare workers are discussed. Lastly, it should be emphasized the need for medical training, multidisciplinary teams, new technologies and artificial intelligence, and the active role of infectious disease physicians in epidemic preparedness efforts. IMPLICATIONS From clinicians' perspective, healthcare authorities play a crucial role in epidemic preparedness even by providing resource management plans, ensuring availability of essential supplies and training, facilitating communication, and improving safe infection management.
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Affiliation(s)
- Michele Bartoletti
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Infectious Disease Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
| | - Linda Bussini
- Infectious Disease Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Davide Fiore Bavaro
- Clinic of Infectious Diseases, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari "Aldo Moro", Bari, Italy
| | - Valeria Cento
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy; Microbiology, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
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2
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Duran-Fernandez R, Bernal-Serrano D, Garcia-Huitron JA, Hutubessy R. Financing for pandemic preparedness and response measures: a systematic scoping review. Bull World Health Organ 2024; 102:314-322F. [PMID: 38680465 PMCID: PMC11046164 DOI: 10.2471/blt.23.290207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/07/2023] [Accepted: 01/25/2024] [Indexed: 05/01/2024] Open
Abstract
Objective To obtain insights into reducing the shortfall in financing for pandemic preparedness and response measures, and reducing the risk of another pandemic with social and economic costs comparable to those of the coronavirus disease. Methods We conducted a systematic scoping review using the databases ScienceDirect, Scopus, JSTOR, PubMed® and EconLit. We included articles published in any language until 1 August 2023, and excluded grey literature and publications on epidemics. We categorized eligible studies according to the elements of a framework proposed by the World Health Organization Council on the Economy of Health for All: (i) root/structural causes; (ii) social position/foundations; (iii) infrastructure and systems; and (iv) communities, households and individuals. Findings Of the 188 initially identified articles, we included 60 in our review. Most (53/60) were published after 2020, when academic interest had shifted towards global financing mechanisms. Most (37/60) addressed two or more of the council framework elements. The most frequently addressed element was infrastructure and systems (54/60), discussing topics such as health systems, financial markets and innovation ecosystems. The roots/structural causes were discussed in 25 articles; communities, households and individuals in 22 articles; and social positions/foundations in 11. Conclusion Our review identified three important gaps: a formal definition of pandemic preparedness and response, impeding the accurate quantification of the financing shortfall; research on the extent to which financing for pandemic preparedness and response has been targeted at the most vulnerable households; and an analysis of specific financial instruments and an evaluation of the feasibility of their implementation.
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Affiliation(s)
- Roberto Duran-Fernandez
- Tecnológico de Monterrey, Escuela de Gobierno y Transformación Pública, Eugenio Garza Lagüera y, Av. Rufino Tamayo, Valle Oriente, San Pedro Garza García 66269, Mexico
| | - Daniel Bernal-Serrano
- Tecnológico de Monterrey, Escuela de Gobierno y Transformación Pública, Eugenio Garza Lagüera y, Av. Rufino Tamayo, Valle Oriente, San Pedro Garza García 66269, Mexico
| | | | - Raymond Hutubessy
- Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
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Bacigalupo ML, Pignataro MF, Scopel CT, Kondratyuk S, Mellouk O, Chaves GC. Unveiling patenting strategies of therapeutics and vaccines: evergreening in the context of COVID-19 pandemic. Front Med (Lausanne) 2023; 10:1287542. [PMID: 38126073 PMCID: PMC10731306 DOI: 10.3389/fmed.2023.1287542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
In the pharmaceutical sector, evergreening is considered a range of practices applied to extend monopoly protection on existing products. Filing several patent applications related to the same active pharmaceutical ingredient (API) is one of the most common manifestations of evergreening. During the COVID-19 pandemic, several health technologies were developed. This study aimed to analyze the extension of evergreening for selected health technologies for SARS-CoV-2 through patent filing strategies. Starting with the selection of three antivirals, one biological and two vaccines, a patent landscape was built based on public and private databases. Regarding these selected technologies, we analyzed some of the evergreening strategies used by different applicants, academic institutions or pharmaceutical companies and found a total of 29 applications (10 after the pandemic) for antivirals, 3 applications for a biological drug (1 after the pandemic), and 41 applications for vaccines (23 after the pandemic). Despite differences among the technologies, a common aspect found in all analyzed cases is the intense patent filing after the pandemic, aligned to the fact that those technologies were moving through the R&D process up to regulatory approval. The evergreening approach pursued has already been found in other diseases, with the risk of monopoly extension and also bringing legal uncertainty due to the lack of transparency of newer patent applications covering specific medical indications. Therefore, efforts to address evergreening should be pursued by countries, including the adoption of a public health approach to the patent examination of those technologies to prevent the granting of undeserved patents.
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Affiliation(s)
| | | | | | - Sergiy Kondratyuk
- International Treatment Preparedness Coalition Global (ITPC-Global), Bryanston, South Africa
| | - Othoman Mellouk
- International Treatment Preparedness Coalition Global (ITPC-Global), Bryanston, South Africa
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4
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Gisondi P, Simon D, Alarcon I, Pournara E, Puig L. Immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in patients receiving secukinumab: a literature review. J DERMATOL TREAT 2023; 34:2167487. [PMID: 36625506 DOI: 10.1080/09546634.2023.2167487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Purpose: There is a paucity of evidence on the impact of immune-mediated inflammatory disease (IMID) treatments on the immunogenicity of SARS-CoV-2 vaccination. The purpose of this literature review is to address the question of whether patients with IMIDs receiving secukinumab, a fully human anti-interleukin-17A monoclonal antibody, have an adequate immune response after SARS-CoV-2 vaccination. Materials and Methods: Clinical studies that evaluated the effect of secukinumab on immune responses in patients with IMIDs after SARS-CoV-2 vaccination were searched in publication databases, including Medline and Embase, until May 2022. Results: From the 53 articles identified, a total of 11 articles were included. Overall, the majority of the patients treated with secukinumab elicited an adequate immune response to SARS-CoV-2 vaccines. Patients receiving secukinumab for IMIDs developed cellular immune responses following vaccination with the BNT162b2 vaccine, and there were no significant differences in the overall humoral and cellular immune responses between patients and healthy individuals. The third dose of the BNT162b2 mRNA vaccine resulted in a positive antibody response in secukinumab-treated patients. Conclusion: The available data provide no evidence of impairment in immunological response to SARS-CoV-2 vaccines by secukinumab in patients with IMIDs.
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Affiliation(s)
- Paolo Gisondi
- Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
| | - David Simon
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie (DZI), Friedrich Alexander University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | | | - Lluís Puig
- Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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5
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Pitsillou E, Beh RC, Liang JJ, Tang TS, Zhou X, Siow YY, Ma Y, Hu Z, Wu Z, Hung A, Karagiannis TC. EpiMed Coronabank Chemical Collection: Compound selection, ADMET analysis, and utilisation in the context of potential SARS-CoV-2 antivirals. J Mol Graph Model 2023; 125:108602. [PMID: 37597309 DOI: 10.1016/j.jmgm.2023.108602] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/08/2023] [Accepted: 08/13/2023] [Indexed: 08/21/2023]
Abstract
Antiviral drugs are important for the coronavirus disease 2019 (COVID-19) response, as vaccines and antibodies may have reduced efficacy against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. Antiviral drugs that have been made available for use, albeit with questionable efficacy, include remdesivir (Veklury®), nirmatrelvir-ritonavir (Paxlovid™), and molnupiravir (Lagevrio®). To expand the options available for COVID-19 and prepare for future pandemics, there is a need to investigate new uses for existing drugs and design novel compounds. To support these efforts, we have created a comprehensive library of 750 molecules that have been sourced from in vitro, in vivo, and in silico studies. It is publicly available at our dedicated website (https://epimedlab.org/crl/). The EpiMed Coronabank Chemical Collection consists of compounds that have been divided into 10 main classes based on antiviral properties, as well as the potential to be used for the management, prevention, or treatment of COVID-19 related complications. A detailed description of each compound is provided, along with the molecular formula, canonical SMILES, and U.S. Food and Drug Administration approval status. The chemical structures have been obtained and are available for download. Moreover, the pharmacokinetic properties of the ligands have been characterised. To demonstrate an application of the EpiMed Coronabank Chemical Collection, molecular docking was used to evaluate the binding characteristics of ligands against SARS-CoV-2 nonstructural and accessory proteins. Overall, our database can be used to aid the drug repositioning process, and for gaining further insight into the molecular mechanisms of action of potential compounds of interest.
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Affiliation(s)
- Eleni Pitsillou
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia; School of Science, STEM College, RMIT University, VIC, 3001, Australia
| | - Raymond C Beh
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia; School of Science, STEM College, RMIT University, VIC, 3001, Australia
| | - Julia J Liang
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia; School of Science, STEM College, RMIT University, VIC, 3001, Australia
| | - Thinh Sieu Tang
- Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Xun Zhou
- Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Ya Yun Siow
- Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Yinghao Ma
- Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Zifang Hu
- Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Zifei Wu
- Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Andrew Hung
- School of Science, STEM College, RMIT University, VIC, 3001, Australia
| | - Tom C Karagiannis
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia; Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia; Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia.
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Pitsillou E, Yu Y, Beh RC, Liang JJ, Hung A, Karagiannis TC. Chronicling the 3-year evolution of the COVID-19 pandemic: analysis of disease management, characteristics of major variants, and impacts on pathogenicity. Clin Exp Med 2023; 23:3277-3298. [PMID: 37615803 DOI: 10.1007/s10238-023-01168-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/10/2023] [Indexed: 08/25/2023]
Abstract
Announced on December 31, 2019, the novel coronavirus arising in Wuhan City, Hubei Province resulted in millions of cases and lives lost. Following intense tracking, coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) in 2020. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as the cause of COVID-19 and the continuous evolution of the virus has given rise to several variants. In this review, a comprehensive analysis of the response to the pandemic over the first three-year period is provided, focusing on disease management, development of vaccines and therapeutics, and identification of variants. The transmissibility and pathogenicity of SARS-CoV-2 variants including Alpha, Beta, Gamma, Delta, and Omicron are compared. The binding characteristics of the SARS-CoV-2 spike protein to the angiotensin-converting enzyme 2 (ACE2) receptor and reproduction numbers are evaluated. The effects of major variants on disease severity, hospitalisation, and case-fatality rates are outlined. In addition to the spike protein, open reading frames mutations are investigated. We also compare the pathogenicity of SARS-CoV-2 with SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV). Overall, this study highlights the strengths and weaknesses of the global response to the pandemic, as well as the importance of prevention and preparedness. Monitoring the evolution of SARS-CoV-2 is critical in identifying and potentially predicting the health outcomes of concerning variants as they emerge. The ultimate goal would be a position in which existing vaccines and therapeutics could be adapted to suit new variants in as close to real-time as possible.
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Affiliation(s)
- Eleni Pitsillou
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia
- School of Science, STEM College, RMIT University, Melbourne, VIC, 3001, Australia
| | - Yiping Yu
- Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Raymond C Beh
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia
- School of Science, STEM College, RMIT University, Melbourne, VIC, 3001, Australia
| | - Julia J Liang
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia
- School of Science, STEM College, RMIT University, Melbourne, VIC, 3001, Australia
| | - Andrew Hung
- School of Science, STEM College, RMIT University, Melbourne, VIC, 3001, Australia
| | - Tom C Karagiannis
- Epigenomic Medicine Laboratory at prospED, Carlton, VIC, 3053, Australia.
- Department of Microbiology and Immunology, The University of Melbourne, Parkville, VIC, 3010, Australia.
- Department of Clinical Pathology, The University of Melbourne, Parkville, VIC, 3010, Australia.
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7
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Gorsky M, Arnold-Forster A. The Lancet 1823-2023: the best science for better lives. Lancet 2023; 402:1284-1293. [PMID: 37805219 DOI: 10.1016/s0140-6736(23)02042-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/25/2023] [Accepted: 09/20/2023] [Indexed: 10/09/2023]
Abstract
The Lancet celebrates its 200th anniversary in 2023. In this survey of the journal's history, we explore how it has contributed to shaping medicine both in the UK and internationally, and how it has demonstrated a commitment to "The best science for better lives". For two centuries, the journal has published pioneering articles on key developments in medical science and the organisation of health care. We explore the campaigning and advocacy work of the journal through several indicative areas where science and policy meet, balancing national and global themes over the 19th and 20th centuries. Themes include the raising of professional standards; environmental health in urbanising Britain; the transformation of surgery; the emergence of tropical medicine; the science and politics of vaccination; the advance towards universal health coverage; and the transition from international to global health. In the imperial era, both the journal's research reports and editorial stance were sometimes inflected with colonial attitudes, although it consistently presented medicine as an international endeavour. The Lancet's blend of science and advocacy demonstrates a track record of campaigning for medicine in the cause of social betterment.
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Affiliation(s)
- Martin Gorsky
- Centre for History in Public Health, London School of Hygiene & Tropical Medicine, London, UK.
| | - Agnes Arnold-Forster
- School of History, Classics and Archaeology, University of Edinburgh, Edinburgh, UK
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8
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Ansah-Mensah K, Osman A, Yalley CE, Adu-Boahen K. Global outlook of the multiplier effect of research and development on environmental sustainability. PLoS One 2023; 18:e0291370. [PMID: 37733665 PMCID: PMC10513248 DOI: 10.1371/journal.pone.0291370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 08/26/2023] [Indexed: 09/23/2023] Open
Abstract
In a time of severe environmental problems and growing public and private expenditure to promote a sustainable society, studies on the impact of Research and Development (R&D) on environmental sustainability hardly ever exist. This study looked at how R&D promotes the attainment of environmentally sustainable goals, globally. Data at the country level was compiled from the United Nations-Sustainable Development Goals (UN-SDG) database and the World Bank, then processed and analysed using spatial techniques such as spatial merge, autofill, autocorrelation, and geographic weighted regression. Expenditure on R&D and publications in scientific journals had a positive impact on SDGs 8 and 11 for all nations. R&D expenditure on SDG 8 was higher for Southern African countries. The impact of scientific and technical journal articles was greater for Middle East countries. Also, scientific and technical journal articles had greater effects on attainment of SDG 11 in Africa. Exports of high technology from South America and Europe were important for achieving SDG 15. However, the effect of patent and trademark applications had minimal effect on achieving environmentally sustainable goals. The study recommends boosting R&D expenditure by governments and international organisations, particularly in Africa because the multiplier impact extends beyond economic development to environmental sustainability which is necessary for the continent to abate the challenges of climate change.
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Affiliation(s)
- Kow Ansah-Mensah
- Department of Geography Education, University of Education, Winneba, Ghana
| | - Adams Osman
- Department of Geography Education, University of Education, Winneba, Ghana
| | | | - Kofi Adu-Boahen
- Department of Geography Education, University of Education, Winneba, Ghana
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9
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Wouters OJ, Forman R, Anderson M, Mossialos E, McKee M. The launch of the EU Health Emergency Preparedness and Response Authority (HERA): Improving global pandemic preparedness? Health Policy 2023; 133:104844. [PMID: 37269803 DOI: 10.1016/j.healthpol.2023.104844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 05/22/2023] [Accepted: 05/26/2023] [Indexed: 06/05/2023]
Abstract
The crowded global health landscape has been joined by the European Union Health Emergency Preparedness and Response Authority (HERA). HERA will assume four broad areas of responsibility: horizon scanning for major health threats; research and development; support for capacity to manufacture drugs, vaccines, and equipment; and procuring and stockpiling key medical countermeasures. In this Health Reform Monitor article, we outline the reform process and describe HERA's structure and responsibilities, explore issues that arise from the creation of this new organisation, and suggest options for collaboration with existing bodies in Europe and beyond. The COVID-19 pandemic and other infectious disease outbreaks have shown the need to treat health as a cross-border issue, and there is now a broad consensus that greater direction and coordination at the European level is needed. This ambition has been matched with a considerable increase in EU funding to tackle cross-border health threats, and HERA can be used to deploy this funding in an effective manner. Yet this is contingent upon clearly defining its role and responsibilities vis-à-vis existing agencies to reduce redundancies.
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Affiliation(s)
- Olivier J Wouters
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom.
| | - Rebecca Forman
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| | - Michael Anderson
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, United Kingdom
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
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10
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Treating COVID-19: Targeting the Host Response, Not the Virus. Life (Basel) 2023; 13:life13030712. [PMID: 36983871 PMCID: PMC10054780 DOI: 10.3390/life13030712] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/19/2023] [Accepted: 01/31/2023] [Indexed: 03/09/2023] Open
Abstract
In low- and middle-income countries (LMICs), inexpensive generic drugs like statins, ACE inhibitors, and ARBs, especially if used in combination, might be the only practical way to save the lives of patients with severe COVID-19. These drugs will already be available in all countries on the first pandemic day. Because they target the host response to infection instead of the virus, they could be used to save lives during any pandemic. Observational studies show that inpatient statin treatment reduces 28–30-day mortality but randomized controlled trials have failed to show this benefit. Combination treatment has been tested for antivirals and dexamethasone but, with the exception of one observational study in Belgium, not for inexpensive generic drugs. Future pandemic research must include testing combination generic drug treatments that could be used in LMICs.
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Chen J, He J, Bergquist R. Challenges and response to pandemics as seen in a One Health perspective. SCIENCE IN ONE HEALTH 2023:100010. [PMCID: PMC9974521 DOI: 10.1016/j.soh.2023.100010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
The global pandemic caused by the coronavirus disease 2019 not only exposed the fragility of global preparedness and response to public health emergence, but also illustrated the fragmentation and gaps of research and development ecosystem. This emphasizes the need for planned actions against the potentiality of new pandemics and requires research to better understand how viruses bridge the animal/human divide making human-to-human transmission of new diseases possible. Major challenges to response to new epidemics under the current health framework reside in the so called 4-CC approach that focuses on Concept, Communication, Coherence, and Continuity. There is a need to also add a One Health perspective with emphasis on governance, surveillance, capacity building and multi-disciplinary research to achieve a holistic and better integrated system. Using a regulatory framework to equip professionals might facilitate the function of a multi-sector approach that recognizes the value of their mandates and a One Health approach in their work. Collaborative, multisectoral actions under the global regulations and guidance would make evidence-based One Health approaches sustainable and accessible to everyone.
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Affiliation(s)
- Jin Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention; NHC Key Laboratory for Parasites and Vectors Biology; WHO Collaborating Center for Tropical Diseases, Shanghai 200025, People’s Republic of China,School of Public Health, Fudan University, Shanghai 200025, People’s Republic of China
| | - Jian He
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, People’s Republic of China
| | - Robert Bergquist
- Geospatial Health, Department of Veterinary Medicine and Animal Production, University of Naples Federico II, Naples, Italy,Corresponding author
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Hook DW, Wilsdon JR. The pandemic veneer: COVID-19 research as a mobilisation of collective intelligence by the global research community. COLLECTIVE INTELLIGENCE 2023; 2:26339137221146482. [PMID: 37766916 PMCID: PMC7615127 DOI: 10.1177/26339137221146482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
The global research community responded with speed and at scale to the emergence of COVID-19, with around 4.6% of all research outputs in 2020 related to the pandemic. That share almost doubled through 2021, to reach 8.6% of research outputs. This reflects a dramatic mobilisation of global collective intelligence in the face of a crisis. It also raises fundamental questions about the funding, organisation and operation of research. In this Perspective article, we present data that suggests that COVID-19 research reflects the characteristics of the underlying networks from which it emerged, and on which it built. The infrastructures on which COVID-19 research has relied - including highly skilled, flexible research capacity and collaborative networks - predated the pandemic, and are the product of sustained, long-term investment. As such, we argue that COVID-19 research should not be viewed as a distinct field, or one-off response to a specific crisis, but as a 'pandemic veneer' layered on top of longstanding interdisciplinary networks, capabilities and structures. These infrastructures of collective intelligence need to be better understood, valued and sustained as crucial elements of future pandemic or crisis response.
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Affiliation(s)
- Daniel W Hook
- Digital Science, London, UK
- Research on Research Institute (RoRI), UCL Department of Science, Technology, Engineering and Public Policy (STEaPP), University College London, London, UK
| | - James R Wilsdon
- Research on Research Institute (RoRI), UCL Department of Science, Technology, Engineering and Public Policy (STEaPP), University College London, London, UK
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Fialho BC, Gauss L, Soares PF, Medeiros MZ, Lacerda DP. Vaccine Innovation Meta-Model for Pandemic Contexts. J Pharm Innov 2023; 18:1-49. [PMID: 36818394 PMCID: PMC9924881 DOI: 10.1007/s12247-023-09708-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 02/16/2023]
Abstract
Purpose Over the past decade, successive outbreaks and epidemics of infectious diseases have challenged the emergency preparedness and response systems of global public health institutions, a context in which vaccines have become the centerpiece to strengthening global health security. Nevertheless, vaccine research and development (R&D) is a complex, lengthy, risky, uncertain, and expensive process. Alongside strict, time-consuming regulatory compliance, it takes multiple candidates and many years to register a new vaccine. This is certainly not welcome in a global health crisis such as the COVID-19 pandemic. Therefore, this study aims to understand the R&D paradigm shift in pandemic contexts and its impacts on the value chain of vaccine innovation. Methods To that end, this paper carried out a systematic literature review and meta-synthesis of 27 articles and reports (2011-2021) that addressed vaccine R&D in contexts of global health threats, disease outbreaks, epidemics, or pandemics. Results The research findings are synthesized in a meta-model, which describes a fast-track R&D for pandemic contexts, its driving forces, innovations, mechanisms, and impacts in the value chain of vaccine innovation. Conclusions The study demonstrates that, in pandemic contexts, a fast-track R&D process based on close collaboration among regulators, industry, and academia and leveraging enabling technologies can drastically reduce the time required to bring safe, stable, and effective vaccines to market by an average of 11 years compared to the traditional R&D process. Furthermore, pharmacovigilance and rigorous monitoring of real-world evidence became critical to ensuring that quality and safe products were authorized for use during a pandemic.
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Affiliation(s)
- Beatriz C. Fialho
- Bio-Manguinhos/Fiocruz Immunobiological Technology Institute, Rio de Janeiro, RJ Brazil
| | - Leandro Gauss
- Production and Systems Engineering Graduate Program, Unisinos, São Leopoldo, RS Brazil
| | - Priscila F. Soares
- Bio-Manguinhos/Fiocruz Immunobiological Technology Institute, Rio de Janeiro, RJ Brazil
| | - Maurício Z. Medeiros
- Bio-Manguinhos/Fiocruz Immunobiological Technology Institute, Rio de Janeiro, RJ Brazil
| | - Daniel P. Lacerda
- Production and Systems Engineering Graduate Program, Unisinos, São Leopoldo, RS Brazil
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14
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Fieldhouse JK, Randhawa N, Fair E, Bird B, Smith W, Mazet JA. One Health timeliness metrics to track and evaluate outbreak response reporting: A scoping review. EClinicalMedicine 2022; 53:101620. [PMID: 36097540 PMCID: PMC9463558 DOI: 10.1016/j.eclinm.2022.101620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/31/2022] [Accepted: 08/03/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND As the global population soars, human behaviours are increasing the risk of epidemics. Objective performance evaluation of outbreak responses requires that metrics of timeliness, or speed in response time, be recorded and reported. We sought to evaluate how timeliness data are being conveyed for multisectoral outbreaks and make recommendations on how One Health metrics can be used to improve response success. METHODS We conducted a scoping review of outbreaks reported January 1, 2010- March 15, 2020, in organizational reports and peer-reviewed literature on PubMed and Embase databases. We tracked 11 outbreak milestones and calculated timeliness metrics, the median time in days, between the following: 1) Predict; 2) Prevent; 3) Start; 4) Detect; 5) Notify; 6) Verify; 7) Diagnostic; 8) Respond; 9) Communication; 10) End; and 11) After-Action Review. FINDINGS We identified 26783 outbreak reports, 1014 of which involved more than just the human health sector. Only six of the eleven milestones were mentioned in >50% of reports. The time between most milestones was on average shorter for outbreaks reporting both Predict (alert of a potential outbreak) and Prevent (response to predictive alert) events. INTERPRETATION Tracking progress in timeliness during outbreaks can focus efforts to prevent outbreaks from evolving into epidemics or pandemics. Response to predictive alerts demonstrated improved expediency in time to most milestones. We recommend the adoption of universally defined One Health outbreak milestones, including After Action Review, such that timeliness metrics can be used to assess outbreak response improvements over time. FUNDING This study was made possible by the United States Agency for International Development's One Health Workforce-Next Generation Project (Cooperative Agreement 7200AA19CA00018).
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Affiliation(s)
- Jane K. Fieldhouse
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- One Health Institute, University of California, Davis, California, USA
- Corresponding authors at: One Health Institute, 1089 Veterinary Medicine Drive VetMed 3B, Ground Floor West, Davis, CA 95616, USA.
| | - Nistara Randhawa
- One Health Institute, University of California, Davis, California, USA
| | - Elizabeth Fair
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of California, San Francisco, California, USA
| | - Brian Bird
- One Health Institute, University of California, Davis, California, USA
| | - Woutrina Smith
- One Health Institute, University of California, Davis, California, USA
| | - Jonna A.K. Mazet
- Institute for Global Health Sciences, University of California, San Francisco, California, USA
- One Health Institute, University of California, Davis, California, USA
- Corresponding authors at: One Health Institute, 1089 Veterinary Medicine Drive VetMed 3B, Ground Floor West, Davis, CA 95616, USA.
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15
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Pandemic origins and a One Health approach to preparedness and prevention: Solutions based on SARS-CoV-2 and other RNA viruses. Proc Natl Acad Sci U S A 2022; 119:e2202871119. [PMID: 36215506 PMCID: PMC9586299 DOI: 10.1073/pnas.2202871119] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
COVID-19 is the latest zoonotic RNA virus epidemic of concern. Learning how it began and spread will help to determine how to reduce the risk of future events. We review major RNA virus outbreaks since 1967 to identify common features and opportunities to prevent emergence, including ancestral viral origins in birds, bats, and other mammals; animal reservoirs and intermediate hosts; and pathways for zoonotic spillover and community spread, leading to local, regional, or international outbreaks. The increasing scientific evidence concerning the origins of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is most consistent with a zoonotic origin and a spillover pathway from wildlife to people via wildlife farming and the wildlife trade. We apply what we know about these outbreaks to identify relevant, feasible, and implementable interventions. We identify three primary targets for pandemic prevention and preparedness: first, smart surveillance coupled with epidemiological risk assessment across wildlife–livestock–human (One Health) spillover interfaces; second, research to enhance pandemic preparedness and expedite development of vaccines and therapeutics; and third, strategies to reduce underlying drivers of spillover risk and spread and reduce the influence of misinformation. For all three, continued efforts to improve and integrate biosafety and biosecurity with the implementation of a One Health approach are essential. We discuss new models to address the challenges of creating an inclusive and effective governance structure, with the necessary stable funding for cross-disciplinary collaborative research. Finally, we offer recommendations for feasible actions to close the knowledge gaps across the One Health continuum and improve preparedness and response in the future.
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16
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Rai PK, Sonne C, Song H, Kim KH. The effects of COVID-19 transmission on environmental sustainability and human health: Paving the way to ensure its sustainable management. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 838:156039. [PMID: 35595144 PMCID: PMC9113776 DOI: 10.1016/j.scitotenv.2022.156039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/02/2022] [Accepted: 05/14/2022] [Indexed: 05/02/2023]
Abstract
The transmission dynamics and health risks of coronavirus disease 2019 (COVID-19) pandemic are inextricably linked to ineract with environment, climate, air pollution, and meteorological conditions. The spread of COVID-19 infection can thus perturb the 'planetary health' and livelihood by exerting impacts on the temporal and spatial variabilities of environmental pollution. Prioritization of COVID-19 by the health-care sector has been posing a serious threat to economic progress while undermining the efforts to meet the United Nations' Sustainable Development Goals (SDGs) for environmental sustainability. Here, we review the multifaceted effects of COVID-19 with respect to environmental quality, climatic variables, SDGs, energy resilience, and sustainability programs. It is well perceived that COVID-19 may have long-lasting and profound effects on socio-economic systems, food security, livelihoods, and the 'nexus' indicators. To seek for the solution of these problems, consensus can be drawn to establish and ensure a sound health-care system, a sustainable environment, and a circular bioeconomy. A holistic analysis of COVID-19's effects on multiple sectors should help develop nature-based solutions, cleaner technologies, and green economic recovery plans to help maintain environmental sustainability, ecosystem resilience, and planetary health.
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Affiliation(s)
- Prabhat Kumar Rai
- Phyto-Technologies and Plant Invasion Lab, Department of Environmental Science, School of Earth Sciences and Natural Resources Management, Mizoram University, Aizawl, Mizoram, India
| | - C Sonne
- Department of Ecoscience, Arctic Research Centre, Aarhus University, Frederiksborgvej 399, DK-4000 Roskilde, Denmark
| | - H Song
- Department of Environment and Energy, Sejong University, Seoul 05006, Republic of Korea
| | - Ki-Hyun Kim
- Department of Civil and Environmental Engineering, Hanyang University, 222 Wangsimni-Ro, Seoul 04763, Republic of Korea.
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17
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Are the Current Processes and Regulations Fit for Purpose to Deliver Novel Therapies During Pandemics? A Perspective on COVID-19 from the UK. Pharmaceut Med 2022; 36:275-278. [PMID: 35902537 PMCID: PMC9333354 DOI: 10.1007/s40290-022-00439-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2022] [Indexed: 12/15/2022]
Abstract
The COVID-19 pandemic was the first ‘stress test’ to assess whether the current regulations in the United Kingdom (UK) are fit for purpose to develop novel therapies during pandemics. It saw innovations and collaborations across the spectrum of the drug development and regulatory pathways, including extraordinary collaborations between the various stakeholders involved in the process, the repositioning of medicines, the deployment of multi-arm, multi-interventional adaptive trials, the institution of operational simplicity and flexibility across various trial activities, and regulatory innovations. The question arises whether the innovative flexibilities and the urgency that were instituted could have resulted in compromises to the integrity of the process. An assessment of the conduct of the RECOVERY trial and the speedy approval of dexamethasone by the UK Medicines and Healthcare products Regulatory Agency demonstrates that no compromises were made to the ethical and scientific integrity of the process. Lessons learnt could be applied for future pandemics and to enhance R&D productivity and contribute to global health by improving access to medicines, especially in low- and middle-income countries and for neglected or rare diseases. What is needed is not a major transformation in the process but the flexible adaptation of existing regulations to reduce bureaucracy and handover times. Arriving at an optimal balance between scientific standards, regulations and commercial conflicts of interest will pose considerable challenges but what the COVID-19 pandemic has shown is that where there is will, there is always a way.
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18
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Antohi VM, Ionescu RV, Zlati ML, Mirica C. Approaches related to the effects of Covid-19 pandemics on financing of the healthcare system in Romania. Front Public Health 2022; 10:940021. [PMID: 35968420 PMCID: PMC9363635 DOI: 10.3389/fpubh.2022.940021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThe healthcare financial system faced a significant disturbance of the budget balance after the outbreak of the pandemic, amid government measures to combat the disease. These measures have led to shifts in funding weights within the income and expenditure budget structure, with a focus on prevention and treatment of patients infected with SARS-COV 2. The purpose of this research is to analyse the financial balance of the healthcare system and the related modelling to support decision-makers in adopting and implementing appropriate financing measures for the pandemic.MethodsThe working hypotheses of this study were tested using an econometric linear regression model based on the financing budgetary function, which matches funding to the specific need for each expenditure heading. SPSS 25 statistical software was used to define the model and to test the homogeneity of the data and their statistical relevance to the phenomenon under analysis.ResultsThe proposed model showed that there is a significant correlation of the dependent variable, Dynamics of budget revenues in the healthcare sector (TIM), with the regressors. We believe that a problem-solving rebalancing of allocations could help to eliminate the synergy in health. This redistribution should take into account the impact that economic and budgetary factors have on healthcare factors and vice versa, so that at some point after successive adjustments the minimum distance between forecast and realisation or between need and financing of need can be reached. The used data were analysed dynamically to assess changes in trend as absolute data do not allow the construction of an overall picture. Relative data captures changes in financing from year to year and can be linked to events such as pandemics, financial crises or inflation.ConclusionsIn relation to the objectives of the research, it emerges that, under the impact of pandemic stress, measures to improve healthcare management, increase performance and streamline financial allocation are vulnerable and cannot counteract the effects that the pandemic has on the healthcare of the population as reflected in the morbidity and mortality indicators collected during the pandemic. In this regard, it is necessary a rethinking of the strategic healthcare management, a better planning of the procurement of medicines and healthcare supplies, a rethinking of the partnerships with the European Commission and other global entities. This approach can effectively improve the impact of the pandemic on the healthcare status of the population, a rebalancing of the demand-supply balance in healthcare and a maintenance of the strategic programmes, according to the objectives assumed in the planning, given that these programmes protect categories of people already medically affected.
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Affiliation(s)
- Valentin Marian Antohi
- Department of Business Administration, Dunarea de Jos University, Galati, Romania
- Department of Finance, Accounting and Economic Theory, Transylvania University, Brasov, Romania
- *Correspondence: Valentin Marian Antohi
| | - Romeo Victor Ionescu
- Department of Administrative Sciences and Regional Studies, Dunarea de Jos University, Galati, Romania
| | - Monica Laura Zlati
- Department of Accounting, Audit and Finance, Stefan cel Mare University, Suceava, Romania
| | - Cristian Mirica
- Department of Business Administration, Dunarea de Jos University, Galati, Romania
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19
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Han X, Guo Y, Xue P, Wang X, Zhu W. Impacts of COVID-19 on Nutritional Intake in Rural China: Panel Data Evidence. Nutrients 2022; 14:nu14132704. [PMID: 35807889 PMCID: PMC9268832 DOI: 10.3390/nu14132704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023] Open
Abstract
The COVID-19 pandemic introduced risks and challenges to global food and nutrition security. In this paper, we examine the impact of the COVID-19 pandemic on the nutritional intake of China’s rural residents using panel data and a fixed effects model. The data were collected in 2019 and 2020 and covered nine provinces and 2631 households in rural China. The results reveal that an increase of 100 confirmed cases in a county resulted in a 1.30% (p < 0.01), 1.42% (p < 0.01), 1.65% (p < 0.01), and 1.15% (p < 0.01) decrease in per capita intake of dietary energy, carbohydrates, fats, and proteins, respectively. Moreover, the COVID-19 pandemic had a significant and negative effect on dietary macronutrient intake in the low-income group at the 5% level of significance. Our study indicates that the potential insufficient nutrition situation, nutritional imbalance, and dietary imbalance of low-income rural residents should be addressed appropriately.
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Affiliation(s)
- Xinru Han
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (X.H.); (P.X.); (X.W.)
| | - Yufei Guo
- School of Advanced Agricultural Sciences, Peking University, Beijing 100871, China;
- School of Economics, Central University of Finance and Economics, Beijing 102206, China
| | - Ping Xue
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (X.H.); (P.X.); (X.W.)
| | - Xiudong Wang
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China; (X.H.); (P.X.); (X.W.)
| | - Wenbo Zhu
- Rural Development Institute, Chinese Academy of Social Sciences, Beijing 100732, China
- Correspondence:
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20
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Kandagalla S, Rimac H, Gurushankar K, Novak J, Grishina M, Potemkin V. Withasomniferol C, a new potential SARS-CoV-2 main protease inhibitor from the Withania somnifera plant proposed by in silico approaches. PeerJ 2022; 10:e13374. [PMID: 35673392 PMCID: PMC9167582 DOI: 10.7717/peerj.13374] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 04/13/2022] [Indexed: 01/13/2023] Open
Abstract
Exploring potent herbal medicine candidates is a promising strategy for combating a pandemic in the present global health crisis. In Ayurveda (a traditional medicine system in India), Withania somnifera (WS) is one of the most important herbs and it has been used for millennia as Rasayana (a type of juice) for its wide-ranging health benefits. WS phytocompounds display a broad spectrum of biological activities (such as antioxidant, anticancer and antimicrobial) modulate detoxifying enzymes, and enhance immunity. Inspired by the numerous biological actions of WS phytocompounds, the present investigation explored the potential of the WS phytocompounds against the SARS-CoV-2 main protease (3CLpro). We selected 11 specific withanolide compounds, such as withaphysalin, withasomniferol, and withafastuosin, through manual literature curation against 3CLpro. A molecular similarity analysis showed their similarity with compounds that have an established inhibitory activity against the SARS-CoV-2. In silico molecular docking and molecular dynamics simulations elucidated withasomniferol C (WS11) as a potential candidate against SARS-CoV-2 3CLpro. Additionally, the present work also presents a new method of validating docking poses using the AlteQ method.
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Affiliation(s)
- Shivananada Kandagalla
- Higher Medical & Biological School, Laboratory of Computational Modeling of Drugs, South Ural State University, Chelyabinsk, Chelyabinsk, Russia
| | - Hrvoje Rimac
- Department of Medicinal Chemistry, University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - Krishnamoorthy Gurushankar
- Higher Medical & Biological School, Laboratory of Computational Modeling of Drugs, South Ural State University, Chelyabinsk, Chelyabinsk, Russia,Department of Physics, Kalasalingam Academy of Research and Education, Krishnankoil, Tamilnadu, India
| | - Jurica Novak
- Higher Medical & Biological School, Laboratory of Computational Modeling of Drugs, South Ural State University, Chelyabinsk, Chelyabinsk, Russia
| | - Maria Grishina
- Higher Medical & Biological School, Laboratory of Computational Modeling of Drugs, South Ural State University, Chelyabinsk, Chelyabinsk, Russia
| | - Vladimir Potemkin
- Higher Medical & Biological School, Laboratory of Computational Modeling of Drugs, South Ural State University, Chelyabinsk, Chelyabinsk, Russia
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21
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Khan U, Lotia-Farrukh I, Akhtar A, Khowaja SN, Khan S, Madhani F, Parekh A, Adnan S, Ahmed S, Chaudhry M, Hussain H, Habib A, Butt S, Siddiqui MR, Ijaz R, Jamal S, Khan AB, Keshavjee S, Khan AJ, Salahuddin N, Khan PY. Re-Evaluating the Merits of Decentralisation as a Core Strategy for Effective Delivery of Drug-Resistant Tuberculosis Care in Pakistan. Health Policy Plan 2022; 37:979-989. [PMID: 35527232 PMCID: PMC9384034 DOI: 10.1093/heapol/czac038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/04/2022] [Accepted: 05/08/2022] [Indexed: 11/14/2022] Open
Abstract
Decentralized, person-centred models of care delivery for drug-resistant tuberculosis (DR-TB) continue to be under-resourced in high-burden TB countries. The implementation of such models—made increasingly urgent by the COVID-19 pandemic—are key to addressing gaps in DR-TB care. We abstracted data of rifampicin-resistant (RR)/multidrug-resistant tuberculosis (MDR-TB) patients initiated on treatment at 11 facilities between 2010 and 2017 in Sindh and Balochistan provinces of Pakistan. We analysed trends in treatment outcomes relating to programme expansion to peri-urban and rural areas and estimated driving distance from patient residence to treatment facility. Among the 5586 RR/MDR-TB patients in the analysis, overall treatment success decreased from 82% to 66% between 2010 and 2017, as the programme expanded. The adjusted risk ratio for unfavourable outcomes was 1.013 (95% confidence interval 1.005–1.021) for every 20 km of driving distance. Our analysis suggests that expanding DR-TB care to centralized hubs added to increased unfavourable outcomes for people accessing care in peri-urban and rural districts. We propose that as enrolments increase, expanding DR-TB services close to or within affected communities is essential.
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Affiliation(s)
- Uzma Khan
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | | | - Ahwaz Akhtar
- Indus Hospital and Health Network, Sindh, Pakistan
| | - Saira N Khowaja
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | | | | | - Asra Parekh
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | - Sana Adnan
- Indus Hospital and Health Network, Sindh, Pakistan
| | - Saman Ahmed
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | - Mariam Chaudhry
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | - Hamidah Hussain
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | - Ali Habib
- Interactive Health Solutions, Karachi, Sindh, Pakistan
| | - Shahid Butt
- Indus Hospital and Health Network, Sindh, Pakistan
| | - Muhammad R Siddiqui
- Provincial TB Program, Sindh, Pakistan
- Institute of Chest Diseases, Kotri, Sindh, Pakistan
| | - Raafia Ijaz
- Indus Hospital and Health Network, Sindh, Pakistan
| | - Saba Jamal
- Indus Hospital and Health Network, Sindh, Pakistan
| | - Abdul B Khan
- Indus Hospital and Health Network, Sindh, Pakistan
| | - Salmaan Keshavjee
- Harvard University, Cambridge, Massachusetts, USA
- Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Aamir J Khan
- Interactive Research and Development, Karachi, Sindh, Pakistan
| | | | - Palwasha Y Khan
- Interactive Research and Development, Karachi, Sindh, Pakistan
- London School of Hygiene & Tropical Medicine, London, United Kingdom
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22
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Olliaro P, Torreele E. Global challenges in preparedness and response to epidemic infectious diseases. Mol Ther 2022; 30:1801-1809. [PMID: 35218930 PMCID: PMC8864962 DOI: 10.1016/j.ymthe.2022.02.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/16/2022] [Accepted: 02/21/2022] [Indexed: 12/15/2022] Open
Abstract
Lessons drawn from successes and failures with coronavirus disease 2019 (COVID-19) and Ebola virus disease (EVD) should help shaping a robust health innovation system for infectious disease epidemics. Epidemic response research and development (R&D) can be mobilized quickly for public health priorities and yield medicinal products within months. However, to resolve epidemics, technological advances must be equitably accessible and deployed, and these examples expose the limitations of a supply-driven, fragmented R&D ecosystem relying primarily on the private sector to deliver health products. Efficient epidemic response requires a coordinated public health-focused, end-to-end R&D ecosystem for the development, registration, availability, and use of pharmaceutical products. Because pivotal clinical trials can only be conducted during outbreaks, significant preparation must be done beforehand: strengthening clinical research capacity and developing pre-positioned trial protocols and clinical characterization protocols, as well as conducting discovery and pre-clinical research, manufacturing, and early clinical testing of candidate products. This will allow for speedy execution of clinical research early into an outbreak and delivering products within a short time. Effective interventions should be adopted and deployed ensuring equitable access during the ongoing outbreak. Measures to make products available where and when needed must be integrated throughout the R&D value chain.
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Affiliation(s)
- Piero Olliaro
- ISARIC Global Support Centre, International Severe Acute Respiratory and Emerging Infection Consortium, Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, New Richards Building, Old Road Campus, Roosevelt Drive, Oxford OX3 7FZ, UK.
| | - Els Torreele
- Visiting Fellow, Institute for Innovation and Public Purpose, University College London, London, UK
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23
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Cheng A, Chen T, Jiang G, Han X. Can Major Public Health Emergencies Affect Changes in International Oil Prices? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12955. [PMID: 34948563 PMCID: PMC8701035 DOI: 10.3390/ijerph182412955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/16/2022]
Abstract
In order to deepen the understanding of the impact of major public health emergencies on the oil market and to enhance the risk response capability, this study analyzed the logical relationship between major public health emergencies and international oil price changes, identified the change points, and calculated the probability of abrupt changes to international oil prices. Based on monthly data during six major public health emergencies from 2009 to 2020, this study built a product partition model. The results show that only the influenza A (H1N1) and COVID-19 pandemics were significant reasons for abrupt changes in international oil prices. Furthermore, the wild poliovirus epidemic, the Ebola epidemic, the Zika epidemic, and the Ebola epidemic in the Democratic Republic of the Congo had limited effects. Overall, the outbreak of a Public Health Emergency of International Concern (PHEIC) in major global economies has a more pronounced impact on international oil prices.
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Affiliation(s)
- An Cheng
- Wu Jinglian School of Economics, Changzhou University, Changzhou 213159, China; (A.C.); (G.J.)
- Jiangsu Energy Strategy Research Base, Changzhou University, Changzhou 213159, China
| | - Tonghui Chen
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China;
| | - Guogang Jiang
- Wu Jinglian School of Economics, Changzhou University, Changzhou 213159, China; (A.C.); (G.J.)
- Jiangsu Energy Strategy Research Base, Changzhou University, Changzhou 213159, China
| | - Xinru Han
- Institute of Agricultural Economics and Development, Chinese Academy of Agricultural Sciences, Beijing 100081, China;
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24
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Stein RA, Ometa O, Broker TR. COVID-19: The Pseudo-Environment and the Need for a Paradigm Change. Germs 2021; 11:468-477. [PMID: 35096665 DOI: 10.18683/germs.2021.1283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Richard A Stein
- MD, PhD, NYU Tandon School of Engineering, Department of Chemical and Biomolecular Engineering, 6 MetroTech Center, Brooklyn, NY 11201, USA
| | - Oana Ometa
- PhD, Department of Journalism and Digital Media, Faculty of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Thomas R Broker
- PhD, Department of Biochemistry and Molecular Genetics, University of Alabama at Birmingham, Birmingham, Alabama 35294-0024, USA
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25
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Ragan EJ, McCallum C, Marathe J, Cole M, Hofman M, Henderson AJ, Flack T, Miller NS, Burks EJ, Zhao GQ, Denis R, Lin NH, Jacobson KR, Andry CD, Pelton SI, Duffy ER, Bhadelia N. Pandemic Response Requires Research Samples: A U.S. Safety-Net Hospital's Experience and Call for National Action. Ann Intern Med 2021; 174:1727-1732. [PMID: 34724402 DOI: 10.7326/m21-2857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Biorepositories provide a critical resource for gaining knowledge of emerging infectious diseases and offer a mechanism to rapidly respond to outbreaks; the emergence of the novel coronavirus, SARS-CoV-2, has proved their importance. During the COVID-19 pandemic, the absence of centralized, national biorepository efforts meant that the onus fell on individual institutions to establish sample repositories. As a safety-net hospital, Boston Medical Center (BMC) recognized the importance of creating a COVID-19 biorepository to both support critical science at BMC and ensure representation in research for its urban patient population, most of whom are from underserved communities. This article offers a realistic overview of the authors' experience in establishing this biorepository at the onset of the COVID-19 pandemic during the height of the first surge of cases in Boston, Massachusetts, with the hope that the challenges and solutions described are useful to other institutions. Going forward, funders, policymakers, and infectious disease and public health communities must support biorepository implementation as an essential element of future pandemic preparedness.
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Affiliation(s)
- Elizabeth J Ragan
- Section of Infectious Diseases and Research Operations, Boston Medical Center, Boston, Massachusetts (E.J.R.)
| | - Caitryn McCallum
- Section of Infectious Diseases, Boston Medical Center, and Center for Emerging Infectious Diseases Policy and Research, Boston University, Boston, Massachusetts (C.M.)
| | - Jai Marathe
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts (J.M., N.H.L., K.R.J.)
| | - Manisha Cole
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts (M.C., N.S.M., E.J.B., G.Q.Z.)
| | - Melissa Hofman
- Clinical Data Warehouse, Boston Medical Center, Boston, Massachusetts (M.H.)
| | - Andrew J Henderson
- Section of Infectious Diseases, Boston Medical Center, and Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts (A.J.H.)
| | - Tyler Flack
- Research Operations, Boston Medical Center, Boston, Massachusetts (T.F.)
| | - Nancy S Miller
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts (M.C., N.S.M., E.J.B., G.Q.Z.)
| | - Eric J Burks
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts (M.C., N.S.M., E.J.B., G.Q.Z.)
| | - Grace Qing Zhao
- Department of Pathology and Laboratory Medicine, Boston Medical Center, Boston, Massachusetts (M.C., N.S.M., E.J.B., G.Q.Z.)
| | - Ridiane Denis
- General Clinical Research Unit, Boston University, Boston, Massachusetts (R.D.)
| | - Nina H Lin
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts (J.M., N.H.L., K.R.J.)
| | - Karen R Jacobson
- Section of Infectious Diseases, Boston Medical Center, Boston, Massachusetts (J.M., N.H.L., K.R.J.)
| | - Christopher D Andry
- Department of Pathology and Laboratory Medicine, Boston Medical Center, and Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts (C.D.A., E.R.D.)
| | - Stephen I Pelton
- Section of Pediatric Infectious Diseases, Department of Pediatrics, Boston University Medical Center, Department of Epidemiology, Boston University School of Public Health, and Maxwell Finland Laboratory for Infectious Diseases, Boston, Massachusetts (S.I.P.)
| | - Elizabeth R Duffy
- Department of Pathology and Laboratory Medicine, Boston Medical Center, and Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, Massachusetts (C.D.A., E.R.D.)
| | - Nahid Bhadelia
- Section of Infectious Diseases, Boston Medical Center, and Center for Emerging Infectious Diseases Policy and Research and National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts (N.B.)
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Ramchandani R, Kazatchkine M, Liu J, Sudan P, Dybul M, Matsoso P, Nordström A, Phelan A, Legido-Quigley H, Singh S, Mabuchi S. Vaccines, therapeutics, and diagnostics for covid-19: redesigning systems to improve pandemic response. BMJ 2021; 375:e067488. [PMID: 34840135 PMCID: PMC8624067 DOI: 10.1136/bmj-2021-067488] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rohit Ramchandani and colleagues propose a framework to ensure essential public health tools are fairly distributed in future pandemics
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Affiliation(s)
- Rohit Ramchandani
- Antara Global Health Advisors, Toronto, Canada
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
- University of Waterloo School of Public Health Sciences, Waterloo, Canada
- Balsillie School of International Affairs, Waterloo, Canada
| | | | - Joanne Liu
- Independent Panel for Pandemic Preparedness and Response
- McGill University's School of Population and Global Health, Montreal, Canada
| | - Preeti Sudan
- Independent Panel for Pandemic Preparedness and Response
| | - Mark Dybul
- Independent Panel for Pandemic Preparedness and Response
- Georgetown University, USA
| | | | - Anders Nordström
- Independent Panel for Pandemic Preparedness and Response Secretariat
| | - Alexandra Phelan
- Independent Panel for Pandemic Preparedness and Response Secretariat
- Georgetown University, USA
| | - Helena Legido-Quigley
- Independent Panel for Pandemic Preparedness and Response Secretariat
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Sudhvir Singh
- Independent Panel for Pandemic Preparedness and Response Secretariat
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Shunsuke Mabuchi
- Independent Panel for Pandemic Preparedness and Response Secretariat
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
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Yi ZM, Song ZW, Li XY, Hu Y, Cheng YC, Wang GR, Zhao RS. The implementation of a FIP guidance for COVID-19: insights from a nationwide survey. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1479. [PMID: 34734031 PMCID: PMC8506715 DOI: 10.21037/atm-21-4157] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/18/2021] [Indexed: 11/23/2022]
Abstract
Background The International Pharmaceutical Federation (FIP) has established an interim guidance of coronavirus disease 2019 (COVID-19) for pharmacists worldwide. The aim of this study was to identify the implementation of FIP guidance in China and provide applicable strategies for further actions. Methods A nationwide cross-sectional survey on Chinese pharmacists was distributed electronically through groups of WeChat between 9 December 2020 and 18 December 2020. The 29-item questionnaire for the survey was designed based on the FIP guidance and knowledge, attitudes, and practices (KAP) framework. Results A total of 237 responses from 237 pharmacists (69.20% females) were received. Most pharmacists (81.86%) participated in work related to COVID-19. Respondents referred to other guidelines or consensus more than they did to FIP guidance. Most participants were qualified for the knowledge-based questions regarding COVID-19 (67.51%), had positive attitudes towards pharmacists’ roles and actions (61.18%), and were qualified in the practices of prevention measures, infection risk monitoring, and pharmacists’ advice (50.63%). Several factors were revealed as having impact on pharmacists’ KAP, such as the relevance of participating in work related to COVID-19, work entailments, and information source. Conclusions The FIP guidance has a certain degree of dissemination and implementation in China, which can be improved through effective actions directed towards impact factors.
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Affiliation(s)
- Zhan-Miao Yi
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China.,Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing, China
| | - Zai-Wei Song
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China.,Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing, China
| | - Xin-Ya Li
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China.,Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Yang Hu
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China.,Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Yin-Chu Cheng
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China.,Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing, China
| | - Guan-Ru Wang
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China.,Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Rong-Sheng Zhao
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Institute for Drug Evaluation, Peking University Health Science Center, Beijing, China.,Therapeutic Drug Monitoring and Clinical Toxicology Center, Peking University, Beijing, China
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28
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Zanoletti A, Cornelio A, Bontempi E. A post-pandemic sustainable scenario: What actions can be pursued to increase the raw materials availability? ENVIRONMENTAL RESEARCH 2021; 202:111681. [PMID: 34273363 PMCID: PMC9749895 DOI: 10.1016/j.envres.2021.111681] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/30/2021] [Accepted: 07/08/2021] [Indexed: 05/17/2023]
Abstract
On January 30, 2020, COVID-19 outbreak, detected for the first time in Wuhan (China), was declared by WHO a Public Health Emergency. In a strongly connected world, the consequent slowdown of the Chinese economy contributed to disrupt the global supply chains of several products. In a post-pandemic scenario, the expected rapid increase in demand of critical raw materials (associated with the transition to more green energy sources), coupled with the problems that some mining activities are relegated only in certain countries and regions, must be considered in a sustainable perspective. This work analyses the literature about (critical) raw materials and COVID-19, not only to present the impact of the pandemic on their supply, but also to propose some actions that should be pursued in a post-pandemic renaissance scenario, to increase raw materials availability, with great attention to most critical ones, in the frame of circular economy principles. The post-pandemic possibilities are evaluated and suitable actions are suggested to secure the raw materials availability for the foreseen increase of investments in crucial and strategic sectors, in accord with the UN Sustainable Development Goals (SDGs). The proposed actions can be summarized as policy, strategy, economy, and technology activities.
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Affiliation(s)
- Alessandra Zanoletti
- INSTM and Chemistry for Technologies Laboratory, Department of Mechanical and Industrial Engineering, University of Brescia, via Branze, 38, 25123, Brescia, Italy.
| | - Antonella Cornelio
- INSTM and Chemistry for Technologies Laboratory, Department of Mechanical and Industrial Engineering, University of Brescia, via Branze, 38, 25123, Brescia, Italy.
| | - Elza Bontempi
- INSTM and Chemistry for Technologies Laboratory, Department of Mechanical and Industrial Engineering, University of Brescia, via Branze, 38, 25123, Brescia, Italy.
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29
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Jit M, Ananthakrishnan A, McKee M, Wouters OJ, Beutels P, Teerawattananon Y. Multi-country collaboration in responding to global infectious disease threats: lessons for Europe from the COVID-19 pandemic. THE LANCET REGIONAL HEALTH. EUROPE 2021; 9:100221. [PMID: 34642675 PMCID: PMC8495250 DOI: 10.1016/j.lanepe.2021.100221] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/29/2022]
Abstract
Since 2005, the world has faced several public health emergencies of international concern arising from infectious disease outbreaks. Of these, the COVID-19 pandemic has had by far the greatest health and economic consequences. During these emergencies, responses taken by one country often have an impact on other countries. The implication is that coordination between countries is likely to achieve better outcomes, individually and collectively, than each country independently pursuing its own self-interest. During the COVID-19 pandemic, gaps in multilateral cooperation on research and information sharing, vaccine development and deployment, and travel policies have hampered the speed and equity of global recovery. In this Health Policy article, we explore how multilateral collaboration between countries is crucial to successful responses to public health emergencies linked to infectious disease outbreaks. Responding to future global infectious disease threats and other health emergencies will require the creation of stronger mechanisms for multilateral collaboration before they arise. A change to the governance of multilateral institutions is a logical next step, with a focus on providing equal ownership and leadership opportunities to all member countries. Europe can be an example and advocate for stronger and better governed multilateral institutions.
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Affiliation(s)
- Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, UK
- School of Public Health, University of Hong Kong, Hong Kong SAR, China
| | - Aparna Ananthakrishnan
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Thailand
| | - Martin McKee
- Department of Health Services and Policy, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Olivier J. Wouters
- Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Philippe Beutels
- Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine & Infectious Diseases Institute, University of Antwerp, Antwerp, Belgium
- School of Public health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Yot Teerawattananon
- Health Intervention and Technology Assessment Program, Ministry of Public Health, Thailand
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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30
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Sharp A, Jain V, Alimi Y, Bausch DG. Policy and planning for large epidemics and pandemics - challenges and lessons learned from COVID-19. Curr Opin Infect Dis 2021; 34:393-400. [PMID: 34342301 PMCID: PMC8452318 DOI: 10.1097/qco.0000000000000778] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic is a global catastrophe that has led to untold suffering and death. Many previously identified policy challenges in planning for large epidemics and pandemics have been brought to the fore, and new ones have emerged. Here, we review key policy challenges and lessons learned from the COVID-19 pandemic in order to be better prepared for the future. RECENT FINDINGS The most important challenges facing policymakers include financing outbreak preparedness and response in a complex political environment with limited resources, coordinating response efforts among a growing and diverse range of national and international actors, accurately assessing national outbreak preparedness, addressing the shortfall in the global health workforce, building surge capacity of both human and material resources, balancing investments in public health and curative services, building capacity for outbreak-related research and development, and reinforcing measures for infection prevention and control. SUMMARY In recent years, numerous epidemics and pandemics have caused not only considerable loss of life, but billions of dollars of economic loss. The COVID-19 pandemic served as a wake-up call and led to the implementation of relevant policies and countermeasures. Nevertheless, many questions remain and much work to be done. Wise policies and approaches for outbreak control exist but will require the political will to implement them.
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Affiliation(s)
- Ashley Sharp
- UK Public Health Rapid Support Team, Public Health England/London School of Hygiene & Tropical Medicine
| | - Vageesh Jain
- Institute for Global Health, University College London, London, UK
| | - Yewande Alimi
- Africa Centres for Disease Control and Prevention, Addis Ababa, Ethiopia
| | - Daniel G. Bausch
- UK Public Health Rapid Support Team, Public Health England/London School of Hygiene & Tropical Medicine
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Charlebois S, Music J. SARS-CoV-2 Pandemic and Food Safety Oversight: Implications in Canada and Coping Strategies. Foods 2021; 10:2241. [PMID: 34681290 PMCID: PMC8534857 DOI: 10.3390/foods10102241] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 12/19/2022] Open
Abstract
The SARS-CoV-2 pandemic has created enormous societal disruptions in the Western world, including Canada, with serious implications for food safety. Since the start of the pandemic, many scholars have investigated the issue of food safety through different lenses. In this review, two research thrusts were identified, the epidemiology of the virus and food safety oversight. Both were challenged by the pandemic in Canada and elsewhere. In this paper, we first present how Canada experienced the pandemic. We then present how epidemiology and food safety oversight were affected by the virus and how the spread exposed gaps in Canada's food safety system. We explain how Canada was not adequately prepared to face the food safety challenges posed by SARS-CoV-2. The review ends with an explanation on how risk perceptions will be altered by the pandemic in Canada and how food safety systems will adjust to better anticipate systemic risks in the future.
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Affiliation(s)
| | - Janet Music
- Faculty of Agriculture, Dalhousie University, Halifax, NS B2X 3T5, Canada;
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Abstract
[Figure: see text].
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Affiliation(s)
- Stanley A Plotkin
- University of Pennsylvania and CEO of Vaxconsult, Doylestown, PA 18902, USA.
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de Carvalho Lima EN, Diaz RS, Justo JF, Castilho Piqueira JR. Advances and Perspectives in the Use of Carbon Nanotubes in Vaccine Development. Int J Nanomedicine 2021; 16:5411-5435. [PMID: 34408416 PMCID: PMC8367085 DOI: 10.2147/ijn.s314308] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 07/21/2021] [Indexed: 12/15/2022] Open
Abstract
Advances in nanobiotechnology have allowed the utilization of nanotechnology through nanovaccines. Nanovaccines are powerful tools for enhancing the immunogenicity of a specific antigen and exhibit advantages over other adjuvant approaches, with features such as expanded stability, prolonged release, decreased immunotoxicity, and immunogenic selectivity. We introduce recent advances in carbon nanotubes (CNTs) to induce either a carrier effect as a nanoplatform or an immunostimulatory effect. Several studies of CNT-based nanovaccines revealed that due to the ability of CNTs to carry immunogenic molecules, they can act as nonclassical vaccines, a quality not possessed by vaccines with traditional formulations. Therefore, adapting and modifying the physicochemical properties of CNTs for use in vaccines may additionally enhance their efficacy in inducing a T cell-based immune response. Accordingly, the purpose of this study is to renew and awaken interest in and knowledge of the safe use of CNTs as adjuvants and carriers in vaccines.
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Affiliation(s)
- Elidamar Nunes de Carvalho Lima
- Telecommunication and Control Engineering Department, Polytechnic School of the University of São Paulo, São Paulo, Brazil
- Infectious Diseases Division, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - Ricardo Sobhie Diaz
- Infectious Diseases Division, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil
| | - João Francisco Justo
- Electronic Systems Engineering Department, Polytechnic School of the University of São Paulo, São Paulo, Brazil
| | - José Roberto Castilho Piqueira
- Telecommunication and Control Engineering Department, Polytechnic School of the University of São Paulo, São Paulo, Brazil
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Tracking Development Assistance for Health: A Comparative Study of the 29 Development Assistance Committee Countries, 2011-2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168519. [PMID: 34444267 PMCID: PMC8394202 DOI: 10.3390/ijerph18168519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 11/16/2022]
Abstract
Development assistance for health (DAH) is an important part of financing healthcare in low- and middle-income countries. We estimated the gross disbursement of DAH of the 29 Development Assistance Committee (DAC) member countries of the Organisation for Economic Co-operation and Development (OECD) for 2011–2019; and clarified its flows, including aid type, channel, target region, and target health focus area. Data from the OECD iLibrary were used. The DAH definition was based on the OECD sector classification. For core funding to non-health-specific multilateral agencies, we estimated DAH and its flows based on the OECD methodology for calculating imputed multilateral official development assistance (ODA). The total amount of DAH for all countries combined was 18.5 billion USD in 2019, at 17.4 USD per capita, with the 2011–2019 average of 19.7 billion USD. The average share of DAH in ODA for the 29 countries was about 7.9% in 2019. Between 2011 and 2019, most DAC countries allocated approximately 60% of their DAH to primary health care, with the remaining 40% allocated to health system strengthening. We expect that the estimates of this study will help DAC member countries strategize future DAH wisely, efficiently, and effectively while ensuring transparency.
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IJsselmuiden C, Ntoumi F, Lavery JV, Montoya J, Karim SA, Kaiser K. Should global financing be the main priority for pandemic preparedness? Lancet 2021; 398:388. [PMID: 34332678 PMCID: PMC8321441 DOI: 10.1016/s0140-6736(21)01387-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/16/2021] [Indexed: 01/25/2023]
Affiliation(s)
- Carel IJsselmuiden
- Council on Health Research for Development, Geneva 1218, Switzerland; School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
| | - Francine Ntoumi
- Fondation Congolaise pour la Recherche Médicale, Brazzaville, Republic of the Congo; Institute for Tropical Medicine, University of Tübingen, Tübingen, Germany
| | - James V Lavery
- Rollins School of Public Health and Center for Ethics, Emory University, Atlanta, GA, USA
| | - Jaime Montoya
- Philippine Council for Health Research and Development, Manila, Philippines
| | - Salim Abdool Karim
- Centre for the AIDS Programme of Research in South Africa, Durban, South Africa
| | - Kirsty Kaiser
- Council on Health Research for Development, Geneva 1218, Switzerland
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Lurie N, Keusch GT, Dzau VJ. Should global financing be the main priority for pandemic preparedness? - Authors' reply. Lancet 2021; 398:388-389. [PMID: 34332679 PMCID: PMC9755536 DOI: 10.1016/s0140-6736(21)01382-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 06/16/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Nicole Lurie
- Coalition for Epidemic Preparedness Innovations, Oslo, Norway; Harvard Medical School, Boston, MA, USA
| | - Gerald T Keusch
- National Emerging Infectious Diseases Laboratory, Boston University, Boston, MA 02118, USA.
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Calisher CH, Carroll D, Colwell R, Corley RB, Daszak P, Drosten C, Enjuanes L, Farrar J, Field H, Golding J, Gorbalenya AE, Haagmans B, Hughes JM, Keusch GT, Lam SK, Lubroth J, Mackenzie JS, Madoff L, Mazet JK, Perlman SM, Poon L, Saif L, Subbarao K, Turner M. Science, not speculation, is essential to determine how SARS-CoV-2 reached humans. Lancet 2021; 398:209-211. [PMID: 34237296 PMCID: PMC8257054 DOI: 10.1016/s0140-6736(21)01419-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 01/05/2023]
Affiliation(s)
| | - Dennis Carroll
- Scowcroft Institute of International Affairs, Texas A&M, College Station, TX, USA
| | | | - Ronald B Corley
- National Emerging Infectious Diseases Laboratory Institute, Boston University, Boston, MA 02118, USA
| | | | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Luis Enjuanes
- Centro Nacional de Biotecnología, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | | | - Hume Field
- School of Veterinary Science, The University of Queensland, Brisbane, QLD, Australia
| | | | | | | | | | - Gerald T Keusch
- National Emerging Infectious Diseases Laboratory Institute, Boston University, Boston, MA 02118, USA.
| | - Sai Kit Lam
- University of Malaya, Kuala Lumpur, Malaysia
| | - Juan Lubroth
- Lubroth One Health Consultancies, Casaprota, Italy
| | - John S Mackenzie
- Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Larry Madoff
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | - Stanley M Perlman
- Roy J and Lucille A Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Leo Poon
- The University of Hong Kong, Hong Kong, China
| | - Linda Saif
- The Ohio State University, Columbus, OH, USA
| | | | - Michael Turner
- Institute of Infection Immunity & Inflammation, University of Glasgow, Glasgow, UK
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Layne SP, Taubenberger JK. Increasing threats from SARS-CoV-2 variants: Time to establish global surveillance. Sci Transl Med 2021; 13:eabj6984. [PMID: 34233952 PMCID: PMC11000441 DOI: 10.1126/scitranslmed.abj6984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 06/16/2021] [Indexed: 12/29/2022]
Abstract
Winning the battle against the deadly airborne virus SARS-CoV-2 demands new political, administrative, and scientific actions, including global surveillance of variants.
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Affiliation(s)
- Scott P Layne
- Saint Johns Cancer Institute, Santa Monica, CA and is Emeritus Professor at the Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA.
- Chief of the Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
| | - Jeffery K Taubenberger
- Saint Johns Cancer Institute, Santa Monica, CA and is Emeritus Professor at the Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA.
- Chief of the Viral Pathogenesis and Evolution Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA.
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Operational Research to Assess the Real-Time Impact of COVID-19 on TB and HIV Services: The Experience and Response from Health Facilities in Harare, Zimbabwe. Trop Med Infect Dis 2021; 6:tropicalmed6020094. [PMID: 34072803 PMCID: PMC8261627 DOI: 10.3390/tropicalmed6020094] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/20/2021] [Accepted: 05/27/2021] [Indexed: 12/27/2022] Open
Abstract
When COVID-19 was declared a pandemic, there was concern that TB and HIV services in Zimbabwe would be severely affected. We set up real-time monthly surveillance of TB and HIV activities in 10 health facilities in Harare to capture trends in TB case detection, TB treatment outcomes and HIV testing and use these data to facilitate corrective action. Aggregate data were collected monthly during the COVID-19 period (March 2020–February 2021) using EpiCollect5 and compared with monthly data extracted for the pre-COVID-19 period (March 2019–February 2020). Monthly reports were sent to program directors. During the COVID-19 period, there was a decrease in persons with presumptive pulmonary TB (40.6%), in patients registered for TB treatment (33.7%) and in individuals tested for HIV (62.8%). The HIV testing decline improved in the second 6 months of the COVID-19 period. However, TB case finding deteriorated further, associated with expiry of diagnostic reagents. During the COVID-19 period, TB treatment success decreased from 80.9 to 69.3%, and referral of HIV-positive persons to antiretroviral therapy decreased from 95.7 to 91.7%. Declining trends in TB and HIV case detection and TB treatment outcomes were not fully redressed despite real-time monthly surveillance. More support is needed to transform this useful information into action.
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40
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Saggam A, Limgaokar K, Borse S, Chavan-Gautam P, Dixit S, Tillu G, Patwardhan B. Withania somnifera (L.) Dunal: Opportunity for Clinical Repurposing in COVID-19 Management. Front Pharmacol 2021; 12:623795. [PMID: 34012390 PMCID: PMC8126694 DOI: 10.3389/fphar.2021.623795] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/30/2021] [Indexed: 12/13/2022] Open
Abstract
As the COVID-19 pandemic is progressing, the therapeutic gaps in conventional management have highlighted the need for the integration of traditional knowledge systems with modern medicine. Ayurvedic medicines, especially Ashwagandha (Withania somnifera (L.) Dunal, WS), may be beneficial in the management of COVID-19. WS is a widely prescribed Ayurvedic botanical known as an immunomodulatory, antiviral, anti-inflammatory, and adaptogenic agent. The chemical profile and pharmacological activities of WS have been extensively reported. Several clinical studies have reported its safety for use in humans. This review presents a research synthesis of in silico, in vitro, in vivo, and clinical studies on Withania somnifera (L.) Dunal (WS) and discusses its potential for prophylaxis and management of COVID-19. We have collated the data from studies on WS that focused on viral infections (HIV, HSV, H1N1 influenza, etc.) and noncommunicable diseases (hypertension, diabetes, cancer, etc.). The experimental literature indicates that WS has the potential for 1) maintaining immune homeostasis, 2) regulating inflammation, 3) suppressing pro-inflammatory cytokines, 4) organ protection (nervous system, heart, lung, liver, and kidney), and 5) anti-stress, antihypertensive, and antidiabetic activities. Using these trends, the review presents a triangulation of Ayurveda wisdom, pharmacological properties, and COVID-19 pathophysiology ranging from viral entry to end-stage acute respiratory distress syndrome (ARDS). The review proposes WS as a potential therapeutic adjuvant for various stages of COVID-19 management. WS may also have beneficial effects on comorbidities associated with the COVID-19. However, systematic studies are needed to realize the potential of WS for improving clinical outcome of patients with COVID-19.
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Affiliation(s)
- Akash Saggam
- AYUSH Center of Excellence, Center for Complementary and Integrative Health, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Kirti Limgaokar
- Division of Biochemistry, Department of Chemistry, Fergusson College (Autonomous), Pune, India
| | - Swapnil Borse
- AYUSH Center of Excellence, Center for Complementary and Integrative Health, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Preeti Chavan-Gautam
- AYUSH Center of Excellence, Center for Complementary and Integrative Health, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | | | - Girish Tillu
- AYUSH Center of Excellence, Center for Complementary and Integrative Health, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Bhushan Patwardhan
- AYUSH Center of Excellence, Center for Complementary and Integrative Health, Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
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Benlidayi IC. A BETTER FUTURE WOULD BE POSSIBLE THROUGH VACCINATION WORLDWIDE. CENTRAL ASIAN JOURNAL OF MEDICAL HYPOTHESES AND ETHICS 2021. [DOI: 10.47316/cajmhe.2021.2.1.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A BETTER FUTURE WOULD BE POSSIBLE THROUGH VACCINATION WORLDWIDE
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