Bringing Preventive RSV Monoclonal Antibodies to Infants in Low- and Middle-Income Countries: Challenges and...

Area of Science:

• Pediatrics
• Infectious Diseases
• Immunology

Background:

• Respiratory syncytial virus (RSV) is a primary cause of infant lower respiratory tract infections (LRTIs), with highest mortality in neonates and in low- and middle-income countries (LMICs).
• Current RSV prevention strategies are limited; no maternal or infant vaccines are approved, and existing monoclonal antibodies (mAbs) like palivizumab are costly and require frequent administration, hindering use in LMICs.

Purpose of the Study:

• To highlight the urgent need for safe, effective, and affordable RSV mAbs for infants in LMICs.
• To discuss the potential of next-generation, half-life extended mAbs, such as nirsevimab, as a viable prevention tool.
• To explore strategies for making RSV mAbs accessible and implementable in LMICs.

Main Methods:

• Review of current RSV burden, existing interventions, and emerging mAb technologies.
• Analysis of the potential benefits and challenges of implementing new mAbs in LMICs.
• Discussion of manufacturing efficiency improvements and stakeholder collaboration.

Main Results:

• Next-generation mAbs offer potential for season-long protection with a single dose, improving feasibility for LMICs.
• Manufacturing efficiency improvements present an opportunity to reduce costs and enhance affordability.
• Integration into healthcare systems and surveillance for resistance are key challenges.

Conclusions:

• Developing affordable, long-acting RSV mAbs is critical for reducing infant mortality in LMICs.
• Successful implementation requires addressing healthcare delivery complexities and fostering global partnerships.
• Continued research and investment in manufacturing are essential for equitable access to RSV prevention.