The global mRNA pipeline beyond COVID-19 is broad and growing, but LMIC participation remains limited.
Evidence
This systematic review mapped publicly available clinical development data for 244 mRNA vaccine and therapeutic candidates, including 123 for and 121 for .
Caveat
The review is based on publicly available pipeline sources and maps development activity rather than testing candidate efficacy, access, or implementation outcomes.
Simplified
demonstrated transformative potential during the COVID-19 pandemic, yet global access to mRNA research, development, and manufacturing capacity remains unequal. This review systematically maps the global mRNA clinical development landscape beyond COVID-19, based on publicly available sources. A total of 244 vaccine and therapeutic candidates were identified: 123 targeting 23 and 121 targeting 69 , including 102 cancer-focused candidates. Two hundred and twenty-seven candidates (93%) were in early clinical development phases and 12 in late-stage development. Eighty-five developers (50 companies, 35 institutes/hospitals) are engaged in this space. Low- and Middle-Income Countries (LMICs) participation was limited to 57 candidates, primarily in upper-middle-income countries. This study reveals a rapidly expanding pipeline for diverse diseases, many aligned with LMIC public health priorities, yet with limited LMIC participation. Equitable inclusion, and collaborations are vital for sustainable global development. This study could inform future LMIC-led mRNA development and manufacturing initiatives.
Key numbers
244
Total mRNA Candidates
Includes 123 targeting and 121 targeting .
57
LMIC Participation
Candidates tested in low- and middle-income countries.
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