WHO R&D Blueprint...19 September 2017 | R&D Blueprint – priori:zaon of diseases The vision the...
Transcript of WHO R&D Blueprint...19 September 2017 | R&D Blueprint – priori:zaon of diseases The vision the...
WHOR&DBlueprint
Processesandmethodsforpriori:za:onofdiseases
19September2017|R&DBlueprint–priori:za:onofdiseases
ThevisiontheBlueprintisaworldinwhichourR&DresponsetoPHEICcausedbyemergingpathogensisfasterandmoreeffec:vethaneverbefore and inwhichwe are able to ensure that a con:nuous effortaiming to accelerate the results of research but also adapt to thescien:fic,logis:calandsocialchallengesthatarespecifictoepidemics.
19September2017|R&DBlueprint–priori:za:onofdiseases
InMay2015,theSixty-EighthWorldHealthAssembly:
…welcomed the development of a blueprint, in consulta6on withMember States and relevant stakeholders, for accelera6ng researchanddevelopment in epidemics or health emergency situa6onswherethereareno,or insufficient,preven6ve,andcura6vesolu6ons,takingintoaccountotherrelevantworkstreamswithinWHO.
19September2017|R&DBlueprint–priori:za:onofdiseases
TheR&DBlueprint seeks to createanenablingenvironment throughwhich all actors, through increased funding, data sharing andpartnerships, can drive change in the public health landscape toprovideanelevatedlevelofglobalimpact.
This newenvironmentwill reduce the:me it takes for newmedicaltechnologiestoreachdevelopingcountriesinapublichealthcrisis.
19September2017|R&DBlueprint–priori:za:onofdiseases
Coreapproachesa.Assessingepidemicthreat&definingprioritypathogens
b.DevelopingR&Droadmapstoaccelerateevalua:onofdiagnos:cs,therapeu:cs&vaccines
c.Outliningappropriateregulatoryðicalpathways
19September2017|R&DBlueprint–priori:za:onofdiseases
PrioritydiseasesThere’sanurgentneedforR&Dfor:• Arenaviralhemorrhagicfevers(includingLassaFever)• CrimeanCongoHaemorrhagicFever(CCHF)• Filoviraldiseases(includingEbolaandMarburg)• MiddleEastRespiratorySyndromeCoronavirus(MERS-CoV)• Otherhighlypathogeniccoronaviraldiseases(suchasSevere
AcuteRespiratorySyndrome,(SARS))• Nipahandrelatedhenipaviraldiseases• Ri^ValleyFever(RVF)• SevereFeverwithThrombocytopeniaSyndrome(SFTS)• Zika
(Theorderofdiseasesonthislistdoesnotdenoteanyrankingofpriority.)
19September2017|R&DBlueprint–priori:za:onofdiseases
Otherpathogenswereconsidered&awiderangeofaddi:onalrelevantR&Dini:a:vesencouraged
• Cross-cu`ngR&Dtoaddressmul:plediseases• One-Healthapproach• An:-microbialresistance
Otherareasofsubstan:aloutput
1. Emergingflaviviruses(suchasKyasanurForestDiseaseorUsutu);2. EmergingBunyaviruses(suchasOropouche);3. EmergingAlphaviruses(suchasChikungunya&Mayarovirus);4. Rickegsia;5. Plague;6. Hantaviraldiseases;7. Chandipuravirusdisease.
19September2017|R&DBlueprint–priori:za:onofdiseases
ArobustmethodologywasneededRepor6nglackeddetail...Unclearhowcriteriaweredeveloped…Poten6alsourcesofbiasandmi6ga6onsarenotreported.Thepublica6onwasnotpeer-reviewedanditisunclearifanyotherreviewtookplace…Delphiscoringwaslimitedtooneround.Didnotmeetallofthekeycommunicablediseasefacets.95%confidenceintervalsusedtoaiddiscussionofdiscrepanciesinscoring
19September2017|R&DBlueprint–priori:za:onofdiseases
Timeline
May2015–WHOinterna:onalconsulta:ononBlueprintDecember2015–WHOinformalconsulta:ononprioritydiseasesEarly2016–BlueprintteamdevelopsmethodologyoutlineMay2016–SAGreviewsmethodologyoutlineSummer/Autumn2016–DetailedmethodologydevelopedDecember2016–Informalconsulta:onreviews&validatesmethodologyJanuary2017–Annualreviewoflistofprioritydiseases
Ac:vi:esundertakento-date
19September2017|R&DBlueprint–priori:za:onofdiseases
Overviewofthepriori:za:onprocess
All possible diseases & pathogens
List of contenders for prioritization
Prioritized list of diseases & pathogens
Landscape analysis
Delphi process
Ranking the diseasesAssessing confidence in the prioritized list
Promoting the prioritized list
Triaging list of diseases to be
consideredRanking the long list of diseases & pathogens
Post-prioritization
activities
Rou:nereviews Emergency
Decision instrument
Emergency prioritization exercise
New disease
19September2017|R&DBlueprint–priori:za:onofdiseases
Decisioninstrumentfornewdiseases
19September2017|R&DBlueprint–priori:za:onofdiseases
hgp://bit.ly/2ffBM6E
19September2017|R&DBlueprint–priori:za:onofdiseases
Priori:za:oncriteriaFactorsusedtopriori:zediseases
Criteria WeightsHumantransmissibility 32%Medicalcountermeasures 21.90%Severity 14.65%Human/animalinterface 9.42%Othercontribu:ngfactors 9.42%Publichealthcontextoftheaffectedarea 6.13%Poten:alsocialimpacts 4.18%Evolu:onarypoten:al 2.28%
19September2017|R&DBlueprint–priori:za:onofdiseases
Priori:za:onCommigee
Regionally&genderdiverseexpertsin:• Microbiologyofseverepathogens• Clinicalmanagementofsevereinfec:ons• Epidemiology• Publichealthpolicy• Animalhealth• Anthropology• Bioethics• Biologicalweapons
19September2017|R&DBlueprint–priori:za:onofdiseases
Rela:vescoring
19September2017|R&DBlueprint–priori:za:onofdiseases
Indica:veresults
19September2017|R&DBlueprint–priori:za:onofdiseases
Confidenceindicators
• Otherstudies• Discordanceintervals• Mul:-scenariosensi:vityanalysis
• Removalofweigh:ngs• Suppressionofhighlyweightedcriteria• Changingweightofcriteria(All+20%&+50%)
• Repe::onwithanotherscoringtool
19September2017|R&DBlueprint–priori:za:onofdiseases
Conclusions
• WHOdevelopeditsownmethodologytopriori:zediseasesofrelevancetoBlueprint
• Builtuponbestprac:ce• Correctsearliermethodologicalshortcomings• Balancesneedforrepeatablemethodologywith
expertinput• Fullypubliclyavailable• Processtoupdatemethodology(nextupdate2018)• Robustconfidenceinresultsproduced