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.Outliningappropriateregulatory&ethicalpathways

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