Vaccines for neglected and emerging diseases in Brazil by 2030: the "valley of death" and opportunities for RD&I in Vaccinology 4.0

Molecular and Immunological Properties of a Chimeric Glycosyl Hydrolase 18 Based on Immunoinformatics Approaches: A Design of a New Anti-Leishmania Vaccine

Leishmaniasis is a chronic inflammatory zoonotic illness caused by protozoan flagellates belonging to the Leishmania genus. Current data suggest that over 1 billion people worldwide are susceptible to infection, primarily in tropical and subtropical countries, where up to 2 million new cases are reported annually. Therefore, the development of a vaccine is crucial to combating this disease. This study employed immunoinformatics approaches to design a multiepitope anti-Leishmania vaccine, GH18-cpLeish, based on a cluster of six glycosyl hydrolases 18. We identified six helper T lymphocyte (HTL) epitopes and twenty-six cytotoxic T lymphocyte (CTL) epitopes with IC50 values <50 nM, indicating high affinity. Additionally, we also identified 20 continuous and twenty-six discontinuous B-cell epitopes. Analysis for allergenicity and toxicity showed no potential to induce these phenomena. All data obtained from in silico tools suggest that physicochemical and biological studies indicate that the GH18-cpLeish chimeric protein is a promising candidate for an anti-Leishmania vaccine. Docking analysis showed that the Pep1-cpLeish::TLR1, Pep1-cpLeish::TLR2, Pep1-cpLeish::/TLR3, and Pep1-cpLeish::/TLR4 complexes maintained a stable form. The best interaction cluster score was observed in the complex Pep1-cpLeish::TLR2 (center = -622.6 and lowest energy = -841.7 kcal.mol-1) followed by the complexes Pep1-cpLeish::TLR4 (center = -590.3 and lowest energy = -590.3 kcal.mol-1), Pep1-cpLeish::TLR3 (center = -589.1 and lowest energy = -657.0 kcal.mol-1), and Pep1-cpLeish::TLR1 (center = -504.1 and lowest energy = -602.9 kcal.mol-1), respectively. This study suggests that GH18-cpLeish may be suitable for constructing second-generation anti-Leishmania and even third-generation vaccines, given that its gene sequence is optimized for this purpose.

Covid-19 Outbreak in Brazil: Health, Social, Political, and Economic Implications

COVID-19 outbreak quickly spread to all corners of the globe. In Brazil, the outbreak was particularly frightening because it worsened existing health, political, economic, and social problems. The results already observed show the contagion ripple-spreading process across the country, causing the death of thousands of people each day and counting, added to a very serious wave of unemployment, scientific denial, and social precariousness. Based on this, this study reviews recent research that looked at the role of the government, the Brazilian health system, and the main economic and social impacts fostered by the pandemic. We perform a scoping review according to the PRISMA-ScR to structure the qualitative synthesis of the 67 associated documents. The results reinforce the negative effects of the country's mismanagement and its consequent impacts on the Brazilian economy and society. The battleground against COVID-19 has fueled political tensions, shaken the health system, and unleashed social despair tinged with thousands of deaths. Finally, in the present scoping review, we discuss concerns about the impacts of the COVID-19 outbreak in Brazil and what the world hopes the country has learned from the current crisis.

Overcoming enduring inequalities in Global Value Chains? Interpreting the case of Brazil’s Covid-19 vaccine supply through a chess metaphor

This article draws on the Covid-19 vaccine supply chain to illustrate the structural inequalities characterising Global Value Chains. We show how the highly unequal vaccine distribution between the Global North and the Global South is shaped by the concentration of high-added value activities of vaccine development and production in the Global North and their nationalistic economic policies. These policies are short-sighted, as they fail to take account of the health risks that low vaccination rates in the Global South entail, not only for the North, but for the whole world. Using the metaphor of pawns moving in a chess game, we advance two possible scenarios. In the first, regional suppliers from low- and middle-income Global South countries will remain unimportant actors in the global vaccine supply chain, leaving inequalities intact. In the second, these suppliers will upgrade their activities in the vaccine supply chain, supported by public policies fostering industrial infrastructure, systems reforms and technological standardisation, leading to a more polycentric supply chain configuration. The persisting concentration of the governance of Global Value Chains in the Global North, we argue, will not only exacerbate current inequalities, but also likely lead to worldwide health, economic and social vulnerabilities.

Advancing sustainable development goals through immunization: a literature review

BACKGROUND

Immunization directly impacts health (SDG3) and brings a contribution to 14 out of the 17 Sustainable Development Goals (SDGs), such as ending poverty, reducing hunger, and reducing inequalities. Therefore, immunization is recognized to play a central role in reaching the SDGs, especially in low- and middle-income countries (LMICs). Despite continuous interventions to strengthen immunization systems and to adequately respond to emergency immunization during epidemics, the immunization-related indicators for SDG3 lag behind in sub-Saharan Africa. Especially taking into account the current Covid19 pandemic, the current performance on the connected SDGs is both a cause and a result of this.

METHODS

We conduct a literature review through a keyword search strategy complemented with handpicking and snowballing from earlier reviews. After title and abstract screening, we conducted a qualitative analysis of key insights and categorized them according to showing the impact of immunization on SDGs, sustainability challenges, and model-based solutions to these challenges.

RESULTS

We reveal the leveraging mechanisms triggered by immunization and position them vis-à-vis the SDGs, within the framework of Public Health and Planetary Health. Several challenges for sustainable control of vaccine-preventable diseases are identified: access to immunization services, global vaccine availability to LMICs, context-dependent vaccine effectiveness, safe and affordable vaccines, local/regional vaccine production, public-private partnerships, and immunization capacity/capability building. Model-based approaches that support SDG-promoting interventions concerning immunization systems are analyzed in light of the strategic priorities of the Immunization Agenda 2030.

CONCLUSIONS

In general terms, it can be concluded that relevant future research requires (i) design for system resilience, (ii) transdisciplinary modeling, (iii) connecting interventions in immunization with SDG outcomes, (iv) designing interventions and their implementation simultaneously, (v) offering tailored solutions, and (vi) model coordination and integration of services and partnerships. The research and health community is called upon to join forces to activate existing knowledge, generate new insights and develop decision-supporting tools for Low-and Middle-Income Countries' health authorities and communities to leverage immunization in its transformational role toward successfully meeting the SDGs in 2030.