The diseases covered by the article are summarized in Table 1, with more details on the incidence, prevalence and burden associated with these diseases provided in Table S1. This review article provides a critical assessment of the use of plant biotechnology as a means to tackle epidemic and pandemic diseases, focussing on the use of plants as bioreactors for the production of research reagents and pharmaceutical products including vaccines, antibodies and antivirals. Although the term pandemic is often associated with rapidly spreading diseases such as influenza and the current COVID‐19 pandemic caused by severe acute respiratory syndrome‐associated coronavirus 2 (SARS‐CoV‐2), which are transmitted by droplets or aerosols (CDC, 2020a Morawska and Milton, 2020 WHO, 2020a), it also applies to diseases such as HIV/AIDS caused by human immunodeficiency virus, which is transmitted more slowly via body fluids (WHO, 2020f). A pandemic disease is an epidemic that spreads over multiple large regions or worldwide (CDC, 2020b), and such diseases are more common today than in previous centuries because of the pervasive nature of global travel and trade (Morens et al., 2009). The major difference between an endemic and epidemic disease is the unexpected nature of the epidemic, and each therefore requires different tactical and strategic approaches for control. The difference between an outbreak and an epidemic is often one of scale, but each is typified by a rapid increase in cases above the typical baseline incidence. Currently, there are many epidemic diseases: cholera in Yemen (WHO, 2019), measles in Burundi (WHO, 2020g), measles and Ebola in the Democratic Republic of the Congo (WHO, 2020b, c), Ebola in Uganda (WHO, 2020e), measles in the Philippines, Kuala Koh, Samoa and New Zealand (Ministry of Health NZ, 2020) and dengue in parts of Southeast Asia and South America (WHO, 2017a). Epidemics can be contained using a combination of natural and technological factors (including therapy and vaccination) that prevent spreading to other regions. An infectious disease is defined as a transmissible disease caused by pathogens (viruses, bacteria or fungi) or parasites (both microbial and invertebrate, primarily endoparasites) but usually excludes infestations with arthropods such as ticks and lice, which typically act as ectoparasites.Īn epidemic disease is an infectious disease that may or may not be endemic in a population but spreads rapidly among communities of certain geographic areas (CDC, 2020b). The impact of infectious diseases as a proportion of all deaths has been falling decade on decade thanks to improvements in hygiene, vaccination and health care, but infectious diseases are still a major burden on national health systems. In the first years of the 21st century, infectious diseases are still responsible for ˜17% of all human deaths (Vos et al., 2020). In this review article, we consider the potential of molecular farming to address healthcare demands for the most prevalent and important epidemic and pandemic diseases, focussing on recent outbreaks of high‐mortality coronavirus infections and diseases that disproportionately affect the developing world. Molecular farming, which uses plants for protein expression, is a promising strategy to address the drawbacks of current manufacturing platforms. The provision of vaccines and biologic drugs such as antibodies is hampered by the high cost and limited scalability of traditional manufacturing platforms based on microbial and animal cells, particularly in developing countries where infectious diseases are prevalent and poorly controlled. Traditional approaches for the prevention and control of infectious diseases include vaccination programmes, hygiene measures and drugs that suppress the pathogen, treat the disease symptoms or attenuate aggressive reactions of the host immune system. Such diseases cause ˜17% of all human deaths and their management and control places an immense burden on healthcare systems worldwide. Infectious diseases, also known as transmissible or communicable diseases, are caused by pathogens or parasites that spread in communities by direct contact with infected individuals or contaminated materials, through droplets and aerosols, or via vectors such as insects.
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