Bringing essential dengue vaccines to vulnerable regions with PodTech™

“Health officials in the Florida Keys issue a dengue fever alert”

“Dengue cases in Bengaluru cross 2,000; over 9K residents tested since January 1”

“A record surge in dengue cases in Latin America spurs a warning”

“Burkina Faso: more than 350 deaths from dengue fever in a month”

“Dengue will ‘take off’ in southern Europe, US, Africa this decade, WHO scientist says”

Dengue-endemic countries in Asia, Africa and the Americas have long borne the brunt of this potentially lethal vector-borne disease. But a quick search of the news will reveal that dengue has been claiming a larger territory in recent years. Historically restricted to tropical and sub-tropical climates, dengue has been piggybacking on climate change to enter new geographies. Today, the disease, transmitted by the bite of an infected mosquito, is leaving scars in pretty much every part of the world.

Unfortunately, dengue is only growing from strength to strength.

In 2019, the global dengue caseload was twice as high as the previous year’s. A record high then, last year, it was outdone.

2023 marked a record high for the global dengue caseload. With 6.5 million cases and 7,300+ dengue-related deaths, 80 countries across all regions of the World Health Organisation (WHO) were affected. Ongoing transmission was exacerbated by unexpected spikes to make history for the vector-borne disease.

The threat of dengue.

The global dengue burden is already concerning, but it shows no signs of relenting.

The WHO reckons that climate change and urbanisation will make conditions more favourable for the spread of dengue vectors, mainly Aedes aegypti and Aedes albopictus mosquitoes. Already, these vectors have been infiltrating previously dengue-naïve countries. El Niño in 2023 only added to the impacts of climate change, namely higher temperatures, rainfall, and humidity – all suitable conditions for mosquito growth. Moreover, the Covid-19 pandemic left some health systems fragile or overwhelmed, while political and financial instabilities faced countries with humanitarian challenges.

Today, dengue is endemic in 100+ countries across Africa, Southeast Asia, the Americas, the Eastern Mediterranean, and the Western Pacific. Populations in previously risk-free areas in Europe, the Eastern Mediterranean, and South America are also experiencing greater dengue risks.

The good news: The prequalification of Qdenga.

Dengue is only growing from strength to strength, but so is the global health community’s response to it.

Sanofi’s Dengvaxia (CYD-TDV) – a tetravalent live-attenuated vaccine – received its first marketing authorisations in 2015. It is currently approved for use in the United States, the European Union, and some countries in Asia and Latin America. It is also on the WHO Essential Medicines List.

The first dengue vaccine to be prequalified by the WHO, Dengvaxia was a game-changer when it came out. In 2017, its label was updated, followed by a change in WHO recommendations, to restrict the use of the vaccine only to people who had already been exposed to the dengue virus. The need to screen people before vaccinating them with Dengvaxia means that its uptake is fairly low. Nonetheless, it is an important tool in preventing subsequent, potentially more severe, dengue infections.

Fortunately, this was far from the end of the road in the fight against dengue.

On 10 May 2024, the WHO prequalified Qdenga, or TAK-003, developed by the Japanese pharma company Takeda. The second dengue vaccine to be prequalified by the WHO, Qdenga is also a live-attenuated vaccine. It contains weakened versions of all four serotypes of the dengue-causing virus. Recommended for use in children between the ages of 6 and 16 years, in areas with high dengue burdens and high transmission intensity, Qdenga can put up a tough fight against the potentially lethal disease.

Prequalification plays an important role in making this crucial vaccine accessible to the populations that need it the most. With prequalification, Qdenga is now eligible for procurement by United Nations (UN) agencies – the United Nations Children’s Fund (UNICEF) is likely to make good use of this update, as is the Pan American Health Organisation (PAHO), considering the growing burden of dengue in the American region.

While the WHO Director for Regulation and Prequalification noted the importance of this prequalification, he also encouraged more vaccine developers to bring dengue vaccine candidates to the WHO for assessment. After all, more vaccines mean that more people across the world can access life-saving interventions.

Taking Qdenga to every corner of the world.

As dengue reaches every corner of the world, so must its vaccine.

WHO’s prequalification of Qdenga marks an important regulatory step, easing the expansion of global access to the vaccine. However, this move must be accompanied by decisive action to ramp up the production of this vaccine, especially in the regions that are struggling with overwhelming burdens of the disease.

Unfortunately, low- and middle-income countries (LMICs) in tropical countries are the worst-affected victims. Adding to the mix, dengue has some formidable cousins – chikungunya, yellow fever, Zika virus, and other Aedes aegypti-transmitted diseases – that are also expanding their reach as more and more geographies become suitable to their vectors.

Prequalification serves to address health crises in areas that depend on the UN and other agencies for support. Most often, these are resource-constrained areas without well-developed infrastructure or systems to produce essential vaccines at the required scale.

Prefabricated factory systems are the best way to meet the required demand and fulfil the potential unlocked by Qdenga’s prequalification.

4.5 million dengue cases and 2,300 deaths were reported in the WHO Region of the Americas in 2023. Imagine what one manufacturing facility (or many!) could achieve if set up in Brazil. Bangladesh recorded 321,179 hospitalisations and 1,705 deaths from dengue in 2023. Imagine what diagnostic laboratories at the worst affected sites could achieve.

Prefabricated pharma factory systems can help transform these visions into a reality in no time. As experts suggest that the dengue epidemic will only get worse in the future, with climate change and urbanisation to blame, there is no time to lose. The modular construction of prefab factories is ideal for addressing these shortened timelines, especially as vaccine manufacturing is most needed in resource-constrained settings that don’t have the most developed health systems.

Unpredictable weather courtesy of climate change, fluctuating market demand for vaccines, and the vast spread of dengue across the world. These are the challenges that the global health community has to contend with. These are also the very challenges that prefab factory systems are designed to address.

PodTech™’s steel podules™ are seismically constructed, double-insulated, and weatherproof. Flexible, adaptable, relocatable, and quick to set up, they are just what the doctor ordered in response to the threat of dengue. Invest in a podule™ to fortify the global supply of dengue vaccines. Invest in a podule™ to bring early screening to the communities that most need it. Invest in PodTech™ to invest in global health.