Building long-term vaccine manufacturing capacity for the world: a framework for sustainable development in LMICs

The recent global pandemic has put in the spotlight the urgent need for low- and middle-income countries (LMICs) to develop sustainable vaccine manufacturing capacity to ensure equitable access to life-saving vaccines in future health crises. This paper reviews current practices and highlights an informed framework for building long-term vaccine manufacturing capacity in LMICs, emphasizing the importance of local, regional, and global cooperation. Key recommendations include strengthening domestic leadership and technical training, creating a workable locally achievable regulatory environment, fostering public–private partnerships. Additionally, the framework outlines a phased approach to capacity building, with immediate priorities focused on infrastructure and technology transfer, followed by medium-term goals of scaling production and ensuring self-sufficiency. The paper also proposes metrics for success, including the number of doses produced locally, the percentage of vaccines procured from LMIC manufacturers, and the speed of vaccine development during outbreaks. The framework aims to empower LMICs to lead in vaccine production, reducing dependency on high-income countries and promoting a more equitable, resilient global health system.Graphical abstract.Powering global health from the ground up: a visual journey through the pillars of sustainable vaccine manufacturing in LMICs.