Dengue is a climate-sensitive infectious disease and the world's fastest-growing vector-borne disease. It disproportionately affects low- and middle-income countries (LMICs), with children most severely affected. Dengvaxia (CYD-TDV) and Qdenga (TAK-003) are the only two licensed dengue vaccines currently available, while Butantan-DV (TV003) is an advanced candidate with promising Phase 3 clinical trial results. Despite the commercial availability of dengue vaccines, coverage remains low in areas with the greatest need. This is driven by technical, social, and geopolitical challenges, as well as growing vaccine hesitancy. There is also an added layer of clinical complexity associated with vaccination against dengue due to the antibody-dependent enhancement (ADE) phenomenon, which can lead to vaccine-enhanced disease. Here, we review the current global landscape of dengue vaccine licensure and coverage, focusing on countries with the highest disease burden. We show that in many countries with a high dengue incidence, dengue vaccines have yet to be licensed, particularly in parts of Africa and South Asia. Even in regions where licensure is more widespread, such as Latin America and Southeast Asia, dengue vaccines are not well integrated into national immunisation programmes and can only be obtained through out-of-pocket payment. We therefore identify several state and market-driven systemic factors, as well as declining vaccine confidence, as barriers to scaling up dengue vaccine access in LMICs. These barriers must be addressed through creative solutions to ensure the equitable distribution of dengue vaccines to the populations and countries that need them the most.

Sentinel node technologies in low-resource settings: Current evidence and future perspectives.

Caribbean and South American team-based strategy to control hypertension (CATCH): Rationale and study design of a cluster randomized trial.

Antenatal Care and Perinatal Mortality in Low- and Middle-Income Countries: Insights for Maternal and Newborn Health System.

Long-term survival for high-risk neuroblastoma has increased from 40% to 60% by optimizing chemotherapy, surgery, radiation therapy, and the addition of anti-GD2 antibody therapy. However, the high cost of this antibody presents access issues globally. This study evaluates the availability, financial coverage, and barriers to accessing these therapies across diverse healthcare settings. An online survey collected data on demographics, treatment practices, financial coverage, regulatory status, and barriers to anti-GD2 therapy. Fisher's exact test was used to compare categorical variables between high-income countries (HICs) and low- and middle-income countries (LMICs). A retrospective cost analysis estimated the financial burden of anti-GD2 therapies using standardized dosing for a representative 3-year-old patient. Responses came from 100 facilities in 80 cities and 59 countries. Anti-GD2 therapy for frontline maintenance was available in 93% of HIC centers, but only 21% of LMIC centers; 65% of LMIC centers reported no access, while the remainder had limited or irregular availability (p < 0.0001, Fisher's exact test). When unavailable, isotretinoin was most often used alone. Financial coverage differed significantly: HICs relied on government or insurance funding, while LMICs depended on out-of-pocket or non-profit support. Cost analysis showed a full treatment course would cost approximately $192,750 for dinutuximab, $142,695 for dinutuximab beta, and $610,800 for naxitamab, highlighting the substantial financial burden these therapies impose. Global access to anti-GD2 therapy is highly unequal. Strategic measures, including negotiations for reduced drug costs, research-based access, and WHO Essential Medicines List inclusion, could help address these disparities.

Maternal immunization against group B Streptococcus: Immune correlates, microbiome trade-offs, and global implementation challenges.

Artificial intelligence in the diagnosis of Hirschsprung disease: A scoping review and rationale for a multicentric approach.

A dataset on adolescent mental health in Kenya.

Long-Term Care as a Global Challenge: The Role of the World Health Organization.

Rapid urbanisation in Low- and Middle-Income Countries (LMICs) has driven the expansion of urban and peri-urban farming to enhance food security. However, these systems are highly vulnerable to contaminated irrigation waters, urban runoff, open defecation and inadequate sanitation, and anthropogenic pollution, such as plastic and microplastic waste. Here, we investigated the role of plastic debris as a reservoir and vector for multidrug-resistant (MDR) enteric bacterial pathogens in a real-world agronomic setting. Focusing on two peri-urban agricultural sites in Dar es Salaam, Tanzania, we analysed 140 environmental samples (soil, water, vegetation, and surface and buried plastic debris) for the presence of four key enteric pathogens: E. coli, Salmonella spp., V. cholerae, and K. pneumoniae. The concentration of total culturable pathogens was higher on plastic debris compared to soil, water and vegetation, with presumptive E. coli loads of ∼1×103CFU per individual piece of plastic debris. Importantly, plastic debris harboured a greater proportion of MDR strains; specifically, 69% of E. coli isolates were resistant to two or more antimicrobials, with plastics at one site accounting for over half of all MDR E. coli. While MDR E. coli were absent from soil, plastic debris supported strains of E. coli and K. pneumoniae that were resistant to critically important antimicrobials (e.g., ciprofloxacin and cefixime).This study provides robust evidence that in a real-world setting, plastic waste can act as an ecological reservoir which concentrates and facilitates the survival of MDR pathogens. Therefore, the widespread presence of contaminated plastic in agricultural systems could pose significant occupational health risks for farmers, in addition to a potential environment-to-food risk for consumers.

The Untold story: The life of parents with children having congenital anomalies in Ethiopia, a hermeneutic phenomenological study.

"Moving through Uncertain Pathways": Health Professionals' perspectives on novel technologies for continuing care in high-risk pregnancy using the technology acceptance model.

Face it, till you ace it: Managing imposter syndrome at different stages of low- and middle-income countries (LMICs) doctors' careers.

Knowledge, belief, and self-efficacy towards autistic children in educational contexts: a global perspective in low and middle-income countries (LMICs)

Neonatal surgical mortality in East Africa: A systematic review and meta-analysis.

Target product profile to guide development of next generation diagnostic test for Salmonella enterica: Responding to the crisis of drug resistant typhoid.

Next-generation gene therapy for infectious disease: Advances, challenges, and future directions.

Abstract Fish are the most farmed and most killed animals on the planet yet remain largely invisible in mainstream ethical debate. This neglect is especially acute in low-and middle-income countries, where billions of fish are farmed each year under poor or unknown welfare conditions. This article argues that contemporary animal ethics has failed to adequately engage with the reality of fish suffering in these contexts and that its continued omission threatens the moral credibility and global relevance of the field. Drawing on examples from aquaculture in Egypt and Kenya, I outline why the ethical lives of aquatic animals matter—and why justice, sustainability, and development frameworks must not bypass them.

Challenges of RSV prevention strategy implementation in middle-income countries.

Prevalence of mental health symptoms following child loss: A population-based study of bereaved mothers in Bangladesh.