Born too soon and vulnerable: the disproportionate burden of RSV among preterm babies in LMICs

• Published in: The Lancet (British edition) Vol. 403; no. 10433; pp. 1206 - 1207
• Main Authors: Torres-Fernandez, David, Bassat, Quique
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 30.03.2024; Elsevier Limited
• Subjects: Breast feeding; COVID-19; Diagnostic tests; Disease prevention; Epidemiology; Fatalities; Gestational age; Global health; Hospitals; Industrialized nations; Infections; Monoclonal antibodies; Neonates; Pandemics; Patient admissions; Pharmaceutical industry; Pharmaceuticals; Premature babies; Public health; Quality of life; R&D; Research & development; Respiratory syncytial virus; Systematic review
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(24)00254-X

[...]although methodologically robust, the analyses presented by Wang and colleagues4 include comparatively much fewer studies from LMICs than from high-income countries and the authors acknowledge the substantial difficulties in assessing gestational age data. A woman breastfeeding a baby in public with other people sitting around on a sofa. wilpunt/Getty Images WHO has identified RSV-associated ALRI prevention in LMICs as a global health priority.3 During the COVID-19 pandemic it was shown that non-pharmaceutical preventive interventions remain effective but on their own are insufficient to address the global picture.8,9 In spite of WHO's recommendations to focus on the development of products with single-dose regimens, which can be shipped and stored in warm temperatures, and importantly, with a cost per dose under US$5,10 the current research and development of pharmaceutical products against RSV are still severely biased to their use in high-income countries.3 Several products in the pipeline, including long-acting monoclonal antibodies for neonates, and vaccines for infants and mothers,3 have shown efficacy and cost-effectiveness to reduce RSV-associated hospitalisations and improve quality of life.11 However, the current prohibitive costs and associated production and distribution challenges of these treatments hinder their potential implementation in LMICs, where they could have more impact and benefit. [...]our global efforts should prioritise the wider implementation of public health measures and preventive pharmaceutical programmes in LMICs, while simultaneously striving to improve access to, and the quality of, their health-care systems.