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. 2020 Oct 6:6:100078.
doi: 10.1016/j.jvacx.2020.100078. eCollection 2020 Dec 11.

How can we evaluate the potential of innovative vaccine products and technologies in resource constrained settings? A total systems effectiveness (TSE) approach to decision-making

Siobhan Botwright  1 , Anna-Lea Kahn  1 , Raymond Hutubessy  1 , Patrick Lydon  1 , Joseph Biey  2 , Abdoul Karim Sidibe  3 , Ibrahima Diarra  4 , Mardiati Nadjib  5 , Auliya A Suwantika  6   7 , Ery Setiawan  5 , Rachel Archer  8 , Debra Kristensen  9 , Marion Menozzi-Arnaud  10 , Ado Mpia Bwaka  2 , Jason M Mwenda  11 , Birgitte K Giersing  1
Affiliations

How can we evaluate the potential of innovative vaccine products and technologies in resource constrained settings? A total systems effectiveness (TSE) approach to decision-making

Siobhan Botwright et al. Vaccine X. .

Abstract

Innovations in vaccine product attributes could play an important role in addressing coverage and equity (C&E) gaps, but there is currently a poor understanding of the full system impact and trade-offs associated with investing in such technologies, both from the perspective of national immunisation programmes (NIPs) and vaccine developers. Total Systems Effectiveness (TSE) was developed as an approach to evaluate vaccines with different product attributes from a systems perspective, in order to analyse and compare the value of innovative vaccine products in different settings. The TSE approach has been advanced over the years by various stakeholders including the Bill and Melinda Gates Foundation (BMGF), Gavi, PATH, UNICEF and WHO. WHO further developed the TSE approach to incorporate the country perspective into immunisation decision-making, in order for countries to evaluate innovative products for introduction and product switch decisions, and for vaccine development stakeholders to conduct their assessments of product value in line with country preferences. This paper describes the original TSE approach, development of the tool and processes for NIPs to apply the WHO TSE approach, and results from piloting in 12 countries across Africa, Asia and the Americas. The WHO TSE framework emerged from this piloting effort. The WHO TSE approach has been welcomed by NIP and vaccine development stakeholders as a useful tool to evaluate trade-offs between different products. It was emphasised that the concept of "total systems effectiveness" is likely to be context-specific and that TSE is valuable in facilitating a deliberative process to articulate NIP priorities, for decisions around product choice, and for prioritising the development of future vaccine innovations.

Keywords: Delivery technology; Immunisation; MCDA; Prioritisation; R&D; Vaccine.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
The concept of WHO Total Systems Effectiveness (TSE) is to improve the alignment of global R&D with the needs and preferences articulated by LMIC immunisation programmes, in order to accelerate development and uptake of vaccines.
Fig. 2
Fig. 2
Summary of the three iterations of the WHO TSE model for rotavirus product selection.
See this image and copyright information in PMC

References

    1. World Health Organization. WHO and UNICEF warn of a decline in vaccinations during COVID-19 [Internet]; 2020. Available from: https://www.who.int/news-room/detail/15-07-2020-who-and-unicef-warn-of-a...
    1. World Health Organization, PATH. Achieving the Global Vision for Future Immunization Supply and Logistics Systems: Action Plans [Internet]. Seattle: PATH; 2012 p. 8-9. Available from: https://www.who.int/immunization/programmes_systems/supply_chain/optimiz....
    1. BMGF, Gavi, UNICEF. Healthy Markets Framework. Public Overview. [Internet]. Available from: https://www.gavi.org/sites/default/files/document/healthy-markets-framew....
    1. Giersing B., Kahn A., Jarrahian C., Mvundura M., Rodriguez C., Okayasu H. Challenges of vaccine presentation and delivery: how can we design vaccines to have optimal programmatic impact? Vaccine. 2017;35(49):6793–6797. - PubMed
    1. Menozzi-Arnaud M, Giersing B. VIPS - Vaccine Innovation Prioritisation Strategy. Presentation presented at; 2019; PDVAC, Geneva.

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