Search Results (270)

Background: The Global Action Plan for Influenza Vaccines, launched by the World Health Organization in 2006, aimed to expand global manufacturing capacity, ensure equitable access to influenza vaccines, and reduce global vaccine shortages. The Institute of Virology, Vaccines and Sera “Torlak” was recognized as a partner and participated in a technology transfer programme to improve national production capabilities. Preclinical studies conducted in 2013 and 2014 provided comprehensive toxicological evidence supporting the safety of the trivalent influenza vaccine manufacturing platform. Nearly a decade later, this validated platform enabled the independent development of a quadrivalent influenza vaccine. Subsequent preclinical studies conducted in accordance with European Medicines Agency guidelines demonstrated preserved immunogenicity despite the inclusion of an additional antigen. Methods: Preclinical evaluation included standard safety and immunogenicity assessments in animal models. Safety assessment included evaluation of systemic parameters (general health status, leukocyte profile, blood biochemistry, and histopathology) and local reactions. Immunogenicity of both trivalent and quadrivalent formulations was assessed using haemagglutination inhibition and microneutralization assays. Results: No significant systemic or local adverse effects were observed. Both trivalent and quadrivalent formulations induced robust immune responses, with immunogenicity comparable to that of corresponding commercial vaccines. Conclusions: These findings confirm the safety profile and demonstrate strong immunogenicity for both the trivalent and quadrivalent formulations, supporting the successful establishment of a national influenza vaccine platform, contributing to increased pandemic preparedness and sustainable influenza vaccine production. Full article

The COVID-19 pandemic exposed significant vulnerabilities in the European Union’s health security architecture and highlighted the need for stronger coordination mechanisms for managing cross-border health threats. In response, the European Union established the Health Emergency Preparedness and Response Authority (HERA) as a central body responsible for strengthening preparedness, coordinating procurement, and supporting the development and availability of medical countermeasures. This study examines the potential role of drug repurposing as a strategic tool within the evolving EU health crisis preparedness framework. A narrative literature review and policy analysis were conducted using scientific publications indexed in PubMed and Scopus, as well as institutional and regulatory documents from the European Commission, the European Medicines Agency (EMA), and other relevant organisations. The findings indicate that drug repurposing offers important advantages during health emergencies, including shorter development timelines, lower research costs, and the possibility of leveraging existing manufacturing and regulatory infrastructures. At the same time, several challenges remain, particularly regarding regulatory coordination, intellectual property considerations, and the scalability of pharmaceutical production during periods of increased demand. The analysis suggests that drug repurposing could evolve from an ad hoc response mechanism into a more institutionalised component of EU health crisis preparedness. Integrating repurposing strategies into HERA’s threat prioritisation, regulatory coordination, and industrial preparedness mechanisms may significantly enhance the European Union’s ability to respond rapidly and effectively to future health emergencies. Full article

Background/Objectives: The COVID-19 pandemic imposed logistical challenges on health systems, particularly for mass vaccination campaigns under emergency conditions. In decentralized health systems, the absence of a structured preparedness phase may compromise coordination, allocation, and operational performance. This study analyzes the vaccination campaign in a municipality in southern Brazil, examining how the overlap of the preparedness and response phases affected outcomes and how alternative logistical scenarios could have altered campaign performance. Methods: An empirical analysis was conducted using scenario-based simulation with stock and flow structures. The model represents vaccine procurement, distribution across national, state, regional, and municipal levels, and municipal vaccination capacity. Real data from the 2021 vaccination campaign in the municipality were used to build a Business-as-Usual scenario, compared with alternative scenarios involving changes in procurement predictability, allocation rules, and operational capacity. Results: Vaccination outcomes were strongly conditioned by upstream allocation decisions, particularly at the national state level. Isolated adjustments at intermediate supply chain levels produced limited improvements when upstream constraints persisted. Scenarios combining improved alignment between forecasted and acquired doses with operational capacity showed higher vaccination potential, revealing a gap between observed performance and system capacity. Conclusions: The findings reinforce that preparedness is a critical determinant of vaccination performance and must precede response in emergency contexts. Supply predictability alone is insufficient without coordinated allocation mechanisms and operational readiness across governance levels. This study provides empirical evidence on how preparation-related decisions shape vaccination outcomes in decentralized health systems and inform logistical coordination in future emergencies. Full article

Infections caused by arboviruses, a diverse group of viral pathogens transmitted by biting arthropod vectors, mainly mosquitoes, ticks, and midges, can cause a range of illnesses in humans, from mild, influenza-like symptoms to severe neurological complications including encephalitis and viral hemorrhagic fever. According to 2024 World Health Organization statistics, vector-borne diseases collectively account for over 700,000 human deaths annually, with mosquito-borne infections such as dengue, chikungunya, Zika, and yellow fever constituting a growing and significant proportion of this burden. What was once considered a problem localized to poorly resourced settings in tropical and subtropical regions is now becoming a pervasive global challenge. This is due largely to a combination of factors including climate change, transcontinental travel, and urbanization, with the geographical spread and intensity of arboviral outbreaks reaching unprecedented levels during the current century. In much the same way that the escalating global burden of bacterial infections resistant to antibiotics has been described as a silent pandemic, the insidious rise of arboviruses begs questions regarding outbreak preparedness, prevention and control. Here, we highlight the pressing need for comprehensive strategies that incorporate various health sectors to mitigate the emergence and resurgence of arboviral diseases. Future directives that should be prioritized are outlined. As demonstrated by epidemiological trends and historical outbreak data, an orchestrated global response is critical not only for managing current threats but also for preventing future epidemics. Full article

Background: The resurgence of Mpox (formerly known as monkeypox) since the 2022 global outbreak has exposed weaknesses in surveillance, diagnosis, and public risk communication systems. Despite increased clinical understanding, limitations in knowledge, attitudes, and practices (KAP) among both healthcare workers (HCWs) and the general population continue to challenge prevention and control measures. Numerous systematic reviews have been published on KAP toward Mpox, yet their findings remain fragmented. This review aimed to consolidate the existing evidence from published systematic reviews to provide a unified understanding of global KAP levels related to Mpox. Methods: We followed the PRISMA guidelines for this systematic review of systematic reviews. The article search was conducted in PubMed, Embase, and the Cochrane Library for systematic reviews published between January 2010 and October 2025. Data was extracted on study design, population, and reported quantitative outcomes. Results: Five studies met the inclusion criteria: three focused on HCWs, while two focused on the general population. Among HCWs, knowledge ranged from 26.0% to 46.7%, and attitudes from 28.2% to 62.2%. In the general population, knowledge ranged from 33.0% to 46.6%, attitudes from 40.0% to 71.9%, and perceptions averaged around 40.0%. Across both groups, Mpox knowledge was limited, attitudes were moderately positive, and preventive behaviors remained consistently low, revealing a persistent gap between awareness and practice. Conclusions: This review highlights persistent gaps in knowledge, attitudes, and practices among HCWs and the general population. Although global attention increased substantially following the 2022 outbreak, important weaknesses remain in translating knowledge into consistent preventive behaviors. Addressing these gaps requires structured and context-specific interventions. Integrating Mpox-focused modules into mandatory Continuing Medical Education credits for HCWs could ensure sustained competency in diagnosis, infection prevention, and outbreak response beyond peak epidemic periods. For the general population, strategic risk communication campaigns should leverage trusted community leaders and social media influencers in high-risk regions to counter misinformation, reduce stigma, and promote evidence-based preventive behaviors. Embedding these targeted strategies within broader pandemic preparedness and global health security frameworks will be essential to strengthening early detection, public trust, and coordinated outbreak response in future Mpox or other emerging infectious disease events. Full article

Background: Highly pathogenic avian influenza H5N1 viruses of clade 2.3.4.4b have spread globally since 2021, causing extensive outbreaks in avian populations and repeated spillovers into diverse mammalian hosts, including humans. These cross-species transmission events highlight ongoing pandemic risks and underscore the need for vaccine strategies that reflect viral evolution at the human–animal interface. Despite the availability of licensed H5 vaccines and newly recommended World Health Organization (WHO) candidate vaccine viruses (CVVs), the extent to which these vaccines elicit cross-reactive antibody responses against contemporary clade 2.3.4.4b viruses, including mammalian spillover isolates of avian origin, remains incompletely characterized. Method: In this study, ferret antisera were generated using four WHO-recommended H5 CVVs, including a clade 1 strain (A/Vietnam/1194/2004) and three clade 2.3.4.4b strains (A/Astrakhan/3212/2020, A/American wigeon/South Carolina/22-000345-001/2021, and A/Ezo red fox/Hokkaido/1/2022), formulated with alum adjuvant to reflect licensed vaccine formulation used in national preparedness programs. Antibody responses and cross-reactive activity were evaluated using hemagglutination inhibition (HI) and microneutralization (MN) assays against homologous vaccine strains and a feline-origin clade 2.3.4.4b H5N1 field isolate from Korea, A/Feline/Korea/SNU-01/2023. Results: Antisera induced by clade 2.3.4.4b CVVs showed cross-reactive antibody responses against homologous and heterologous clade 2.3.4.4b viruses and demonstrated measurable HI and MN responses against the feline-origin field isolate. In contrast, antisera raised against the clade 1 Vietnam CVV exhibited limited cross-reactivity against clade 2.3.4.4b viruses. Overall, clade 2.3.4.4b CVVs generally showed higher antibody responses than the clade 1 vaccine strain across multiple panels. Conclusions: These findings provide descriptive insights into antigenic differences between clade 1 and clade 2.3.4.4b viruses and support the antigenic relevance of clade 2.3.4.4b CVVs for contemporary H5N1 strains. This study highlights the importance of ongoing antigenic evaluation to inform vaccine strain selection within a One Health framework. Full article

Africa reported lower COVID-19-related morbidity and mortality compared to other continents, despite widespread SARS-CoV-2 transmission and limited vaccine access. Proposed immunological explanations include potential pre-existing immunity such as cross-reactive humoral or cellular responses from earlier coronavirus exposures. However, functional immune responses to SARS-CoV-2 in African populations remain poorly characterized. To address this gap, we assessed post-pandemic neutralizing antibody responses against the SARS-CoV-2 D614G variant. We analyzed plasma samples from 989 participants in a cross-sectional survey in Ghana’s Eastern and Greater Accra regions. A live virus neutralization assay using Vero E6 TMPRSS2 cells was employed to quantify SARS-CoV-2 D614G-specific neutralizing antibodies. Responses were assessed across collected demographic data. Urban participants exhibited higher median neutralizing antibody titers than rural counterparts, in both vaccinated and unvaccinated groups (p < 0.0001). Among unvaccinated individuals, median neutralizing antibody titers were comparable across age groups in urban settings. Vaccinated individuals showed elevated median titers across all age groups, with urban residents demonstrating stronger responses. Significant sex-based differences in neutralizing titres were also identified. Our findings reveal marked disparities in functional antibody responses between urban and rural populations, likely shaped by differences in SARS-CoV-2 exposure and vaccination. Continued surveillance and immunological profiling remain key for informing vaccine strategies and future pandemic preparedness. Full article

This study seeks to inform emergency preparedness efforts by summarizing the pandemic’s impacts on access to opioid use disorder (OUD) recovery support as reported by women in recovery. In-depth interviews were completed with adult women in recovery from OUD. We used a primarily deductive approach to coding and analysis. Two coders analyzed transcripts; discrepancies were resolved through discussion. Seventeen women completed interviews from June to October 2020. Pandemic impacts primarily focused on engagement in care and retention at community and interpersonal levels. Community-level barriers to engagement included facilities’ halting intake of patients and fear of COVID-19 infection in treatment settings. Interpersonal barriers to engagement included loss of childcare support and the sudden transition to virtual services. Community-level retention barriers included perception of facility staff’s lack of adherence to infection prevention protocols and strict enforcement of infection prevention protocols on residents within facilities. Interpersonal barriers to retention included reduced availability of mutual aid meetings. Participants also highlighted how the pandemic worsened the addiction crisis and increased women’s caretaking burden. Leaders and administrators must be prepared to simultaneously balance responses for two public health crises: a novel infectious disease and addiction. Lessons learned from the pandemic can mitigate barriers to care and recovery when future emergencies arise. Full article

Infectious diseases remain a major cause of mortality and disability worldwide. This burden is driven, in part, by antimicrobial resistance (AMR) and the re-emergence of epidemic and pandemic threats, underscoring the need for translational research to address knowledge gaps exposed by recent pandemics. Despite significant advances enabled by antibiotics and antivirals, their effectiveness is increasingly constrained by resistance development, limited pathogen spectra, and prolonged development timelines that fail to keep pace with rapidly shifting epidemiology. Diagnostic limitations impede timely pathogen identification and hinder the development of treatment regimens informed by pathogen mechanisms of action. Severe infections frequently involve dysregulated host responses, including hyperinflammation, inflammasome activation, and endothelial or immunothrombotic injury, which may progress to sepsis, immunoparalysis, or chronic sequelae, highlighting the limitations of pathogen-centered paradigms. Conventional biomarkers and culture-based microbiology are often slow or nonspecific, while molecular assays may not reliably distinguish colonization from active infection or capture host-response heterogeneity shaped by age, immune competence, and disease stage. This review synthesizes mechanistic and translational insights across three interrelated axes: (i) host–pathogen interactions, with a focus on innate immune sensing networks (e.g., Toll-like receptors, inflammasomes, RIG-I-like receptors, and cGAS-STING) and microbial replication and immune evasion strategies; (ii) clinical and public health implications, spanning acute organ dysfunction syndromes, post-acute infection syndromes, and AMR-driven health system strain; and (iii) emerging therapeutics along a continuum of pathogen-, virulence-, host-, and immune-directed approaches. Emphasis is placed on anti-virulence therapeutics, bacteriophage therapy, monoclonal antibodies, and engineered immune modalities within frameworks of quantitative translational pharmacology and implementation science. Finally, an integrative conceptual framework encompassing mechanistic phenotypes, host-response diagnostics, and stage-adapted therapeutic combinations is proposed to guide rational intervention across endemic infections and future pandemic preparedness. Full article

Background: Nurses, the largest segment of the global health workforce, play vital roles in managing disease outbreaks and boosting community resilience during public health emergencies. Purpose: This study explored the experiences of senior nurses in leading health facilities in Ghana during the COVID-19 pandemic. Methods: We employed a qualitative, exploratory, descriptive approach and purposive sampling to recruit 30 senior nurses involved in frontline care during the COVID-19 pandemic. We used telephone interviews to examine how nurses’ roles are changing during public health crises. Results: Nurses navigated challenges related to infection prevention and control, team dynamics and social support, resource limitations, stigma against those affected, and leadership. Some of the nurses drew on their prior experience to navigate the complexities of COVID-19. The significance of inter-professional working and the flexible delegation of tasks is reinforced by the current study, which suggests that professional boundaries became more blurred during the crisis. Optimal responses to outbreaks are influenced by professional preparedness and adaptive learning. Conclusions: Nurses displayed extraordinary resilience and determination, yet faced enormous challenges, including PPE shortages, stigmatization from within their own communities and organizations, and a lack of welfare support. The findings from this analysis are intended to support national and global efforts in pandemic preparedness and healthcare worker assistance, highlighting the essential role nurses play in creating more resilient health systems for future crises. Full article

The COVID-19 pandemic exposed large cross-country differences in mortality that cannot be explained by short-run policy responses alone. This study investigates how pre-pandemic electrification and human capital jointly shaped pandemic outcomes, emphasizing their potential non-linear complementarity. Using cross-country data and pre-pandemic averages of electricity access and schooling, we examine how long-run development conditions influenced COVID-19 mortality during 2020–2021. We estimate fixed-effects models and a threshold regression framework that allows the interaction between electrification and human capital to vary across infrastructure regimes. The results identify a sharp electrification threshold at approximately 96 percent. Below this threshold, higher levels of schooling are not associated with lower pandemic mortality and may even coincide with increased vulnerability, consistent with binding infrastructure constraints that prevent human capital from being effectively deployed during a health crisis. Above the threshold, the interaction between electrification and schooling becomes statistically insignificant, indicating that in highly electrified economies, the benefits of human capital are already embedded within integrated systems of healthcare delivery, communication, and public health governance. These findings reveal a non-linear complementarity between infrastructure and human capital. Education alone does not enhance pandemic resilience when basic infrastructure remains incomplete, while in near-universally electrified societies its protective role is largely internalized. The results highlight the importance of long-run infrastructure completion as a structural prerequisite for translating human capital into effective pandemic preparedness and resilience. Full article

Artificial intelligence (AI) is rapidly transforming virology by strengthening pandemic preparedness, enhancing our molecular understanding of virus–host interactions, and accelerating the discovery and development of novel antiviral therapies. Yet, the same technologies also pose urgent biosecurity risks, particularly by enabling the development of bioweapons or identifying strategies that maximize harm. This paper presents a critical content analysis of current and emerging AI applications in virology, including tools used to detect synthetic alterations in viral genomes, assess the severity of new variants, and design clinical vectors for gene therapy. It also highlights the potential for misuse, whether intentional or due to poor data quality and flawed model training. Drawing on case studies, public databases, and documented applications from research institutions and biotechnology firms, the analysis shows that AI can integrate large datasets to reduce reliance on animal testing in drug development, improve therapeutic precision, and allocate resources more effectively during outbreaks. However, the increasing accessibility of AI tools and genomic data also creates vulnerabilities, especially as models become capable of autonomously interpreting the scientific literature and mining bioinformatics databases. To address this dual-use dilemma, the paper proposes targeted and adaptable policy recommendations for governments, research institutions, and commercial biotech firms, emphasizing pre-emptive oversight, responsible innovation, and ethical AI deployment. These recommendations are designed for immediate relevance yet flexible enough to evolve alongside the expanding role of AI in global health. Full article

Introduction: The COVID-19 pandemic exposed structural weaknesses in European public health systems while simultaneously accelerating institutional and digital reforms at the European Union (EU) level. This study examines how the EU has evolved from reactive crisis management toward a governance paradigm conceptualized as transformative resilience, understood as the institutional capacity to anticipate, adapt, and structurally reconfigure health governance in response to systemic shocks. Methods: This study employs a structured qualitative policy analysis based on a purposive corpus of key EU legislative and strategic documents (2020–2025), complemented by a contextual review of selected EU-level indicators. The analysis focuses on reforms associated with the European Health Union, including the establishment of the Health Emergency Preparedness and Response Authority (HERA), the development of the European Health Data Space (EHDS), and the adoption of the Artificial Intelligence Act. Results: The findings indicate progressive consolidation of supranational coordination mechanisms, deeper integration of digital infrastructure into health governance, and strategic incorporation of health security into the EU’s broader security architecture. Rather than assessing policy effectiveness, the analysis documents a structural and regulatory shift toward anticipatory and embedded preparedness. Persistent challenges remain, including uneven implementation capacity across member states, disparities in digital maturity, and tensions between innovation and data protection. Conclusions: The EU’s post-pandemic trajectory reflects a distinctive governance model in which health security, digital sovereignty, and democratic safeguards are framed as mutually reinforcing dimensions of resilience within an increasingly complex risk environment. Full article

Genomic surveillance is a cornerstone of pandemic response; it has helped guide public health interventions worldwide. However, North Africa stands between limited surveillance resources and efforts to address the data gap in this strategic geographic region that links sub-Saharan Africa and Europe. In this study, we present the first comprehensive evolutionary investigation of Algerian SARS-CoV-2 genomes, revealing their phylogeny, continuous phylogeography within the country, mutation analysis, and a super-spreading event through haplotype network analysis. We characterized the genetic diversity and unique mutation pattern of 449 Algerian sequences, revealing multiple independent introductions into the country since the first reported case on the 25th of February 2020 followed by numerous local transmissions that facilitated the virus’s rapid propagation. This study highlights both the importance of molecular epidemiology and equitable access to resources in implementing genomic epidemiology and in increasing sequencing efforts to strengthen pandemic preparedness. Full article

The world is constantly challenged by complex crises—from the COVID-19 pandemic and geopolitical tensions to economic uncertainty and severe environmental disasters. During these critical times, individuals need to reflect on ethical values and demonstrate responsible decision-making, integrity, and preparedness to mitigate the impact of future crises. Education can play an instrumental role in these endeavours. This study presents the user experience and usability evaluation of PREPARED App—an educational mobile application developed to raise users’ awareness on the ethical dimensions of global challenges through real-life case studies. The captivating narratives, clear structure, ease-of-use, and multimedia content were reported as key strengths of the mobile app by both users (n = 54) and experts (n = 4). Suggestions were also captured for enriching the learning experience through enhanced customisation options, personalised feedback mechanisms, and accessibility features. A set of pedagogical guidelines is extracted to enable instructional designers, educators, and mobile application developers to create accessible and engaging mobile learning experiences. Full article