Meeting the challenge of influenza pandemic preparedness in developing countries.
Meeting the challenge of influenza pandemic preparedness in developing countries.
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DOI：
10.3201/eid1503.080857
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发表时间：
2009-03
影响因子：
11.8
通讯作者：
Fedson DS
中科院分区：
文献类型：
--
作者：
Fedson DS
目录的一句话总结：这些国家应该考虑使用廉价的仿制药来应对下一次大流行。发展中国家面临着为流感大流行做准备的独特困难。我们目前自上而下的方法不会为这些国家提供足够的疫苗和抗病毒药物。因此，他们将不得不使用一种基于廉价仿制药的自下而上的方法，这些仿制药要么改变宿主对流感病毒的反应，要么充当抗病毒药物。其中几种药物显示出了希望，其中许多目前在发展中国家生产。研究人员必须首先确定控制人群感染的因素，而不是简单地寻求它们如何发挥作用的解释。他们必须确定这些制剂是在哪些国家生产的，并确定分销模式和成本。由于流行前研究无法确定这些药物在大流行中是否有效，必须在新的大流行病毒出现后立即开始随机对照试验。如果没有这项研究，工业化国家和发展中国家可能面临前所未有的健康危机。
One-sentence summary for table of contents: These countries should consider using inexpensive generic agents to confront the next pandemic. Developing countries face unique difficulties preparing for an influenza pandemic. Our current top-down approach will not provide these countries with adequate supplies of vaccines and antiviral agents. Consequently, they will have to use a bottom-up approach based on inexpensive generic agents that either modify the host response to influenza virus or act as antiviral agents. Several of these agents have shown promise, and many are currently produced in developing countries. Investigators must primarily identify agents for managing infection in populations and not simply seek explanations for how they work. They must determine in which countries these agents are produced and define patterns of distribution and costs. Because prepandemic research cannot establish whether these agents will be effective in a pandemic, randomized controlled trials must begin immediately after a new pandemic virus has emerged. Without this research, industrialized and developing countries could face an unprecedented health crisis.