Objectives
To examine how national innovation and policy configurations enabled vaccine development in Brazil, Cuba, India, and Iran, and to distil lessons for low- and middle-income country (LMIC) vaccine sovereignty.
Methods
Narrative review of peer-reviewed and grey literature (2020–2023), guided by a structured search and screening approach; synthesis mapped to national and sectoral innovation system perspectives and technology readiness levels.
Results
Cuba and Iran leveraged mission-oriented public research and development (R&D) and domestic platforms; India combined indigenous R&D with large-scale licensed manufacturing; Brazil’s scientific capacity was constrained by fragmented governance and supply-chain dependence. Adaptive regulation (e.g., emergency use authorization/conditional approvals), targeted technology transfer, and South–South partnerships accelerated progress but raised longer-term questions about intellectual property (IP) control and economic sustainability.
Conclusion
Institutional coherence, strategic IP management, and regional manufacturing alliances are as critical as scientific capacity for LMIC vaccine self-reliance. Policy priorities include pre-negotiated tech-transfer frameworks, regulatory preparedness, and investment in public R&D linked to distributed manufacturing.

Objectives
This study aimed to describe and compare health-related quality of life (QoL) as measured by the World Health Organization Quality of Life–BREF (WHOQoL-BREF) and the EuroQol-5 Dimensions (EQ-5D) among the Malaysian population, examining differences by sociodemographic characteristics including age, income, sex, ethnicity, educational level, and occupation. Methods: This cross-sectional study used data from 19,402 individuals collected as part of a health and demographic surveillance system survey conducted in the Segamat district of Malaysia in 2018–2019. Descriptive statistics and measures of central tendency were produced. Differences in QoL among demographic sub-groups were examined using the t-test and analysis of variance, while the correlations between the WHOQoL-BREF and EQ-5D were evaluated using Pearson correlation coefficients. Results: Based on complete case analysis (n=19,129), the average scores for the 4 WHOQoLBREF domains were 28.2 (physical), 24.1 (psychological), 12.0 (social relationships), and 30.4 (environment). The percentages of participants not in full health for each EQ-5D dimension were 12.8% (mobility), 3.1% (self-care), 6.9% (usual activities), 20.9% (pain/discomfort), and 6.8% (anxiety/depression). Correlations between the 4 WHOQoL-BREF domains and the 5 EQ-5D dimensions were relatively weak, ranging from –0.06 (social relationships with self-care and pain/discomfort; p<0.001) to –0.42 (physical with mobility; p<0.001). Conclusion: Although health-related QoL as measured by the WHOQoL-BREF and the EQ-5D are correlated, these 2 measures should not be considered interchangeable. The choice between them should be guided by the specific research questions and the intended use of the data.