The politics of COVID-19 vaccination in middle-income countries: Lessons from Brazil.
The politics of COVID-19 vaccination in middle-income countries: Lessons from Brazil.
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DOI：
10.1016/j.socscimed.2021.114093
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Bastos FI
中科院分区：
文献类型：
--
作者：
Fonseca EMD;Shadlen KC;Bastos FI
随着世界努力应对COVID-19疫苗接种的挑战，需要更多关注不同收入水平国家所面临的问题。中等收入国家通常缺乏资源和监管能力来实施富裕国家所拥有的战略，但它们也面临着与低收入国家不同的挑战和机遇。我们专注于疫苗接种的三个方面：采购和生产;营销注册的监管;以及分配和吸收。对于每个维度，我们展示了中等收入国家面临的独特挑战和机遇。我们以巴西为例说明了这些挑战和机遇，展示了每个维度如何受到激烈的政治冲突的影响。巴西的采购和生产战略建立在当地生产和技术转让的长期轨道上，但由于中央政府和州政府之间的冲突而千疮百孔。监管审批程序以拉丁美洲最受尊敬的监管机构之一为基础，也受到政府间和政府内部严重冲突的影响。在分配和接种方面，面对高度不确定性，即使巴西拥有坚实的卫生基础设施，在促进疫苗交付方面也遇到困难。研究还揭示了在巴西和其他地区协调这些方面的重要性。大流行病的准备和应对必须包括分享如何生产疫苗的知识，并认识到采购、监管、交付和使用之间的关键联系，这对于确保获得这些产品是必要的。
As the world struggles to meet the challenges of vaccination against COVID-19, more attention needs to be paid to issues faced by countries at different income levels. Middle-income countries (MICs) typically lack the resources and regulatory capacities to pursue strategies that wealthier countries do, but they also face different sets of challenges and opportunities than low-income countries (LICs). We focus on three dimensions of vaccination: procurement and production; regulation of marketing registration; and distribution and uptake. For each dimension we show the distinct challenges and opportunities faced by MICs. We illustrate these challenges and opportunities with the case of Brazil, showing how each dimension has been affected by intense political conflicts. Brazil's procurement and production strategy, which builds on a long trajectory of local production and technology transfer, has been riddled by conflicts between the national government and state governments. The regulatory approval process, based around one of Latin America's most highly-regarded regulatory authorities, has also been subject to acute inter- and intra-governmental conflicts. And with regard to distribution and uptake, in the face of high uncertainty, even with a solid health infrastructure, Brazil encounters difficulties in promoting vaccine delivery. The research also reveals the importance of coordination among these dimensions, in Brazil and beyond. Pandemic preparedness and response must include sharing knowledge of how to produce vaccines and recognition of the crucial linkages between procurement, regulation, delivery, and uptake that are necessary for ensuring access to these products.
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影响因子：
56.9
作者：
Castro, Marcia C.;Kim, Sun;Singer, Burton H.
通讯作者：
Singer, Burton H.
DOI：
10.1016/s1473-3099(21)00159-6
发表时间：
2021-04
期刊：
The Lancet. Infectious diseases
影响因子：
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发表时间：
2021-01-30
期刊：
Lancet (London, England)
影响因子：
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作者：
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通讯作者：
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影响因子：
9.7
作者：
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通讯作者：
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