Health inequalities in respiratory tract infections - beyond COVID-19.

Purpose of review: To discuss recent findings on the global burden of respiratory tract infections in underprivileged populations, highlighting the critical role of socioeconomic factors in the incidence and severity of these diseases, with a particular focus on health disparities affecting Indigenous communities.

Recent findings: Pulmonary tuberculosis and lower respiratory tract infections, particularly those caused by Streptococcus pneumoniae and respiratory syncytial virus (RSV), continue to disproportionally impact populations in low-income countries and Indigenous communities worldwide. Indigenous children <5 years old bear the highest global burden of RSV infection, reflecting persistent social inequalities between Indigenous and non-Indigenous populations. Repeated episodes of acute pneumonia during childhood significantly contribute to the high prevalence of chronic respiratory diseases among Indigenous populations. The widespread occurrence of bronchiectasis in these communities is closely linked to adverse socioeconomic conditions.

Summary: Significant disparities in the incidence and severity of lower respiratory tract infections between affluent and impoverished populations are driven by socioeconomic inequalities. Vaccinating vulnerable population groups with newly developed vaccines has the potential to prevent infections caused by pathogens such as S. pneumoniae and RSV. However, global access to these vaccines and monoclonal antibodies remains limited due to their high costs.