The magnitude and cross reactivity of SARS-CoV-2 specific antibody responses in Sri Lankan children and association with the nutritional status – BMC Infectious Diseases

Report on Global Health Challenges and the Role of Scientific Research in Achieving Sustainable Development Goals

Introduction: The COVID-19 Pandemic and its Implications for SDG 3

The Coronavirus (COVID-19) pandemic has presented an unprecedented challenge to global health systems, significantly impacting progress towards Sustainable Development Goal 3 (SDG 3): Good Health and Well-being. Comprehensive tracking of the pandemic and real-time analysis of pathogen evolution have been critical in formulating public health responses. This report synthesizes findings from various studies to explore the multifaceted aspects of the pandemic, from molecular epidemiology to the influence of nutrition on immune responses, all within the framework of the SDGs.

Vaccination, Immune Response, and Health Equity

Vaccination remains a cornerstone of the global strategy to combat COVID-19 and ensure progress on SDG 3. However, the effectiveness of vaccination campaigns is influenced by several factors, including viral evolution and individual health status.

Key Areas of Investigation

• Viral Evolution: The continuous emergence of SARS-CoV-2 variants with properties of immune escape necessitates ongoing research and adaptation of vaccination strategies, including the development and deployment of booster shots.
• Immune Memory: Studies confirm that vaccination induces immunological T-cell memory capable of cross-recognizing variants, which is fundamental for long-term protection.
• Antibody Response: The level of neutralizing antibodies is a key indicator of protection. Research has focused on understanding these responses in diverse populations, including healthcare workers and individuals with varying disease severity.

The Intersection of Nutrition and Disease: A Challenge for SDG 2 and SDG 3

The pandemic has highlighted the critical link between nutrition and health outcomes, directly connecting SDG 2 (Zero Hunger) and SDG 3. Both undernutrition and overnutrition (obesity) have been identified as significant risk factors that can compromise immune function and vaccine efficacy, thereby exacerbating health inequalities (SDG 10: Reduced Inequalities).

Impact of Nutritional Status on Immunity

1. Obesity: A growing body of evidence indicates that obesity is associated with altered antibody responses to COVID-19 vaccination, potentially reducing protective immunity. This is a major concern given the rising rates of childhood obesity, which also correlates with increased hospitalizations for other infectious diseases like dengue.
2. Undernutrition: Malnutrition has long been known to impair immune responses to various microbial antigens and vaccinations. Studies on other vaccines have shown that undernutrition in children can lead to lower serum antibody titers, compromising the effectiveness of public health immunization programs.

Epidemiological Insights and Scientific Innovation

National and regional epidemiological studies are vital for tailoring public health interventions. Research conducted in Sri Lanka provides a valuable case study on tracking viral sub-lineages, seroprevalence, and the genomic landscape of SARS-CoV-2, contributing essential data for local and global health strategies.

Advancements in Research and Diagnostics

• Genomic Surveillance: Molecular epidemiology has been instrumental in tracking the spread of specific variants, such as the Delta sub-lineages AY.28 and AY.104 in Sri Lanka.
• Antibody Testing: The development of rapid and effective antibody detection methods, such as haemagglutination tests and surrogate virus neutralization tests, has been crucial for assessing immunity at a population level.
• Collaborative Research: The extensive list of collaborative studies underscores the importance of SDG 17 (Partnerships for the Goals), where international scientific cooperation is essential to address global health crises effectively.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The provided article references highlight issues that are directly connected to several Sustainable Development Goals (SDGs). Based on the themes of infectious diseases, nutrition, public health, and global cooperation, the following SDGs are addressed:

• SDG 2: Zero Hunger: The references repeatedly mention the impact of nutritional status on health outcomes. Specifically, papers on “nutritional risk factors for SARS-CoV-2 infection” (Ref 7), “pediatric malnutrition” (Ref 20), “undernutrition and antibody response” (Ref 27), and the link between “childhood obesity rates” and disease (Ref 21) connect directly to the goal of ending all forms of malnutrition.
• SDG 3: Good Health and Well-being: This is the most prominent SDG in the article. The entire collection of references revolves around the COVID-19 pandemic, including its epidemiology (Ref 1, 4, 6), pathogen evolution (Ref 2), vaccination and immune responses (Ref 3, 8, 9, 13, 14, 17, 25), and the impact on specific populations like children (Ref 5). The mention of other diseases like dengue (Ref 11, 21) further strengthens this connection.
• SDG 17: Partnerships for the Goals: The article cites global collaborative platforms like “Our World in Data” (Ref 1) and “Nextstrain” (Ref 2) for tracking the pandemic and pathogen evolution. This reliance on shared data, technology, and international research (evidenced by the numerous multi-author international publications) underscores the importance of global partnerships in addressing health crises.

2. What specific targets under those SDGs can be identified based on the article’s content?

Several specific targets under the identified SDGs can be linked to the content of the article’s references:

1. Under SDG 2 (Zero Hunger):
   • Target 2.2: “By 2030, end all forms of malnutrition…” This target is directly relevant as the references discuss the full spectrum of malnutrition, from “undernutrition” (Ref 27, 28) to “obesity” and “severe obesity” (Ref 8, 9, 21), and their significant impact on immune responses to both infection and vaccination.
2. Under SDG 3 (Good Health and Well-being):
   • Target 3.3: “By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.” The core focus on the “Coronavirus Pandemic (COVID-19)” (Ref 1) and other communicable diseases like dengue (Ref 11) aligns perfectly with this target’s aim to combat epidemics.
   • Target 3.8: “Achieve universal health coverage, including… access to safe, effective, quality and affordable essential medicines and vaccines for all.” The extensive discussion on COVID-19 vaccines, boosters (Ref 3), and antibody responses to vaccination (Ref 8, 17) highlights the global effort towards vaccine access and effectiveness, which is a cornerstone of this target.
   • Target 3.d: “Strengthen the capacity of all countries… for early warning, risk reduction and management of national and global health risks.” The references to “real-time tracking of pathogen evolution” (Nextstrain, Ref 2), “molecular epidemiology” (Ref 4), and seroprevalence studies (Ref 12) are all examples of strengthening capacity for risk management and surveillance of global health threats like pandemics.
3. Under SDG 17 (Partnerships for the Goals):
   • Target 17.16: “Enhance the global partnership for sustainable development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology…” The citation of global public databases like “Our World in Data” (Ref 1) and pathogen tracking platforms like “Nextstrain” (Ref 2) demonstrates the critical role of such partnerships in sharing knowledge and technology to manage a global health crisis.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article’s references mention or imply several indicators that can be used to measure progress:

• For Target 2.2 (End Malnutrition):
  • Prevalence of malnutrition (overweight and underweight): The references on “childhood obesity rates” (Ref 21), “people with obesity” (Ref 8), “undernutrition” (Ref 27), and “pediatric malnutrition” (Ref 20) directly imply the use of indicators related to nutritional status. The mention of “child & teen BMI” (Ref 19) points to a specific metric (Body Mass Index) used to measure this. This corresponds to official SDG indicator 2.2.2.
• For Target 3.3 (End Epidemics):
  • Incidence and prevalence of communicable diseases: Studies on the “seroprevalence of SARS-CoV-2” (Ref 12) and the “burden of dengue” (Ref 11) are direct measures of disease prevalence in a population, which is a key indicator for tracking the state of an epidemic.
  • Mortality rate attributed to communicable diseases: Reference 5, which discusses “Deaths from COVID,” directly refers to mortality as a critical outcome measure for disease severity and public health impact.
• For Target 3.8 (Universal Health Coverage/Vaccines):
  • Vaccine coverage and effectiveness: The numerous papers on “COVID-19 vaccination” (Ref 8), “COVID boosters” (Ref 3), and “antibody response to SARS-CoV-2 vaccines” (Ref 9, 17) imply the measurement of vaccination rates and the immunological effectiveness of these vaccines in the population. This relates to SDG indicator 3.b.1 (Proportion of the target population covered by all vaccines).
• For Target 3.d (Health Risk Management):
  • Capacity for disease surveillance: The references to “real-time tracking of pathogen evolution” (Ref 2) and “genomic and epidemiological analysis” (Ref 29) serve as indicators of a country’s scientific and technical capacity to monitor and respond to health emergencies.

4. Summary Table of SDGs, Targets, and Indicators

Source: bmcinfectdis.biomedcentral.com