Transforming drug and vaccine delivery for equitable access in global health

Ensuring equitable access to medicines and vaccines remains a major global health challenge, especially in low- and middle-income countries (LMICs), where infrastructure, cost, and supply chain constraints limit the reach of essential therapies. Conventional delivery methods often rely on cold-chain logistics, multi-dose regimens, trained personnel, and centralized manufacturing-factors that hinder effective distribution in resource-limited settings. This review highlights how emerging drug and vaccine delivery technologies can overcome these barriers and advance global health equity. We discuss key design requirements-such as thermostability, ease of administration, single-dose potential, and scalable production-that must be met for delivery platforms to be viable in low-resource environments. Promising technologies include controlled-release systems that provide sustained or pulsatile dosing, microneedle patches that enable painless, self-administered delivery, and dry formulation strategies like lyophilization and spray drying that reduce cold-chain dependence. Oral and edible vaccines leveraging nanoparticle carriers offer non-invasive immunization routes, while digital tools such as smart packaging, ingestible sensors, and wearable devices improve adherence and support remote care. Despite their potential, these innovations face challenges in regulatory approval, large-scale manufacturing, and end-user adoption. Global initiatives such as the Vaccine Innovation Prioritisation Strategy (VIPS) and the African Vaccine Manufacturing Accelerator (AVMA) reflect growing efforts to address these hurdles and translate innovation into access. By aligning technical advances with the practical realities of underserved communities, next-generation delivery technologies offer a pathway toward more inclusive and sustainable healthcare systems.