Strengthening Public Health Responses to Infectious Diseases in Low- and Middle-income Countries through Vaccine Accessibility, Antibiotic Stewardship, and Community Engagement

Despite the various challenges we have encountered with infectious diseases, public health has advanced significantly in containing these infectious diseases, as illustrated by success in eradicating smallpox and near eradication of poliomyelitis. Low- and middle-income countries are confronted with enormous challenges, including chronic infectious disease foci fueled by political turmoil, poor living standards, and poor health infrastructure. The creation of antibiotic-resistant strains because of excessive use, and the absence of vaccines for most pathogens, is a life-and-death issue for public health. Due to delays in embracing cost-saving and effective vaccines hundreds of thousands of deaths have been reported annually in these areas. While there is a progressive advance against some of the tropical diseases, malaria, tuberculosis, and others still remain challenging global issues. To address these obstacles, new methods for vaccine access, antibiotic stewardship, and effective community outreach are necessary. Since almost one-quarter of child deaths under the age of five are due to vaccine-preventable disease, increasing vaccine delivery can have a dramatic impact on child survival worldwide. To be able to effectively address these obstacles, we need to strengthen policies for enhancing prevention, detection, and infectious disease control. These include promoting the integration of clinical practice into health care, promoting community engagement in disease prevention, developing global outbreak response capacity, addressing antimicrobial resistance, and promoting a "One Health" approach to reduce the emergence and spread of zoonotic diseases.