The WHO R&D Blueprint: 2018 review of emerging infectious diseases requiring urgent research and development efforts

Abstract

The Research and Development (R&D) Blueprint is a World Health Organization initiative to reduce the time between the declaration of a public health emergency and the availability of effective diagnostic tests, vaccines, and treatments that can save lives and avert a public health crisis. The scope of the Blueprint extends to severe emerging diseases for which there are insufficient or no presently existing medical countermeasures or pipelines to produce them. In February 2018, WHO held an informal expert consultation to review and update the list of priority diseases, employing a prioritization methodology which uses the Delphi technique, questionnaires, multi-criteria decision analysis, and expert review to identify relevant diseases. The committee determined that, given their potential to cause a public health emergency and the absence of efficacious drugs and/or vaccines, there is an urgent need for accelerated R&D for (in no order of priority) Crimean-Congo haemorrhagic fever, Ebola virus and Marburg virus disease, Lassa fever, Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), Nipah and henipaviral diseases, Rift Valley fever and Zika virus disease. The experts also included "Disease X," representing the awareness that a previously unknown pathogen could cause a major public health emergency. This report describes the methods and results of the 2018 prioritization review.

Keywords: Experts' opinions; Multi-criteria decision analysis; Multidisciplinary method; Prioritization; Severe emerging infectious diseases.

Fig. 1

Overview of the annual prioritization exercise. The process starts by gathering diseases candidates to consider for the annual prioritization. Through a Delphi process, several diseases are eliminated. For each remaining disease, a landscape analysis is commissioned before going into ranking through an MCDA method. The output of the MCDA is a ranked list of diseases. Several sensitivity analyses are performed on this list. These results are discussed through another Delphi process to produce the annual list of priority diseases. Finally, this list is promoted.

Fig. 2

The five-step annual process to review diseases prioritized under the WHO R&D Blueprint. This figure summarises the 2 steps (gathering the diseases candidates and narrowing their number) prior to the annual review meeting and the 3 steps (review of the remaining diseases, ranking them and the generation of the priority list of diseases) during the annual review meeting.

Fig. 3

Overall multi-criteria scores for diseases analysed using MCDA during the 2018 annual prioritization review. Panel A shows the results obtained using the geometric average the comparison matrices. Panel B shows the results obtained using the arithmetic average of the comparison values collected through the online questionnaire. The discordance internal are calculated through error propagation technique and presented in panel B (Mehand et al., 2018). (P1 = Ebola, P2 = Marburg, P3 = MERS, P4= SARS, P5=Lassa, P6= Nipah, P7 = Rift Valley Fever, P8 = Zika, P9= Crimean-Congo haemorrhagic fever, P10 = Severe Fever with Thrombocytopenia Syndrome, P11 = non-polio enteroviruses).

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