World Health Organization Methodology to Prioritize Emerging Infectious Diseases in Need of Research and Development

Abstract

The World Health Organization R&D Blueprint aims to accelerate the availability of medical technologies during epidemics by focusing on a list of prioritized emerging diseases for which medical countermeasures are insufficient or nonexistent. The prioritization process has 3 components: a Delphi process to narrow down a list of potential priority diseases, a multicriteria decision analysis to rank the short list of diseases, and a final Delphi round to arrive at a final list of 10 diseases. A group of international experts applied this process in January 2017, resulting in a list of 10 priority diseases. The robustness of the list was tested by performing a sensitivity analysis. The new process corrected major shortcomings in the pre-R&D Blueprint approach to disease prioritization and increased confidence in the results.

Keywords: Crimean-Congo hemorrhagic fever; Ebola virus; Lassa virus; Marburg virus infection; Middle East respiratory syndrome coronavirus; Nipah virus; R&D Blueprint; Rift Valley fever; South American hemorrhagic fever; World Health Organization; Zika virus; bacteria; epidemics; expert opinion; hantavirus; multicriteria decision analysis; multidisciplinary method; plague; prioritization; severe acute respiratory syndrome; severe emerging infectious diseases; severe fever with thrombocytopenia syndrome; viruses.

Figure 1

Example screenshot of tool developed in R Shiny (https://shiny.rstudio.com) using the slide bar function to compare candidate diseases for each criteria and subcriteria considered in the development of the World Health Organization R&D Blueprint to prioritize emerging infectious diseases in need of research and development. Experts were requested to compare candidate diseases to each other for each criteria, placing them in ranked order according to their knowledge. The World Health Organization Secretariat explained the meaning of the scale (0–10) to the experts before the survey. Asterisks indicate that an answer is required for each disease.

Figure 2

Process for compiling the short list of diseases for inclusion in the World Health Organization R&D Blueprint to prioritize emerging infectious diseases in need of research and development.

Figure 3

Multicriteria scores of diseases considered in the 2017 prioritization exercise for the development of the World Health Organization R&D Blueprint to prioritize emerging infectious diseases in need of research and development. A) Disease final ranking using the geometric average of the comparison matrices. B) Disease final ranking using the arithmetic average of the raw data. Error bars correspond to SD, indicating disagreement among experts. C) Disease final ranking using the SMART Vaccines prioritization tool (56). P1, Ebola virus infection; P2, Marburg virus infection; P3, Middle East Respiratory Syndrome coronavirus infection; P4, severe acute respiratory syndrome; P5, Lassa virus infection; P6, Nipah virus infection; P7, Rift Valley fever; P8, Zika virus infection; P9, Crimean-Congo hemorrhagic fever; P10, severe fever with thrombocytopenia syndrome; P11, South American hemorrhagic fever; P12, plague; P13, hantavirus infection.