Diseases of importance in developing countries : establishing priorities / by the Committee on Issues and Priorities for New Vaccine Development, Division of Health Promotion and Disease Prevention, Institute of Medicine.

Format:

Book

Author/Creator:

Institute of Medicine (U.S.). Committee on Issues and Priorities for New Vaccine Development.

Series:

New vaccine development ; v.2

Language:

English

Subjects (All):

Vaccination--Developing countries.

Vaccination.

Vaccination--United States.

Vaccines--Research--Government policy.

Vaccines.

Physical Description:

1 online resource (xvi, 432 pages)

Edition:

1st ed.

Place of Publication:

Washington, D.C. : National Academy Press, 1986.

Language Note:

English

Summary:

Common diseases cost the developing world an enormous amount in terms of human life, health, and productivity, as well as lost economic potential. New and effective vaccines could not only improve the quality of life for millions of residents in developing countries, they could also contribute substantially to further economic development. Using data from the World Health Organization and other international agencies, this book analyzes disease burdens, pathogen descriptions, geographic distribution of diseases, probable vaccine target populations, alternative control measures and treatments, and future prospects for vaccine development. New Vaccine Development provides valuable insight into immunological and international health policy priorities.

Contents:

New Vaccine Development Establishing Priorities

Copyright

Acknowledgements

Preface

Abstract

Contents

Summary

SELECTION OF CANDIDATES

DETERMINATION OF HEALTH BENEFITS

Disease Burden Estimates

Infant Mortality Equivalence Values

Total Disease Burden Values

VACCINE CHARACTERISTICS

Predictions of Vaccine Development

Definition of Probable Vaccine Target Population

Treatment of Vaccine Utilization

Estimation of Time to Licensure, Time to Vaccine Adoption, and Delay of Vaccination Benefits: Discou...

Estimation of Vaccine Preventable Illness

Calculation of Potential Health Benefits for Each Vaccine

Cost Calculations

INTERPRETATION OF RESULTS

FINDINGS, CONCLUSIONS, RECOMMENDATIONS

REFERENCE

2 Priority Setting for Health-Related Investments: A Review of Methods

METHODS FOR PROJECT RANKING AND SELECTION

MULTIATTRIBUTE ACCOUNTING

MULTIATTRIBUTE SCORING

DECISION ANALYSIS WITH MULTIPLE OBJECTIVES

COST-EFFECTIVENESS AND COST-UTILITY ANALYSIS

BENEFIT-COST ANALYSIS

SELECTION OF AN APPROACH

ISSUES IN PROJECT RANKING METHODOLOGIES

Sources of Estimates

Sequential or "Lexicographic" Methods

Interdependence Among Projects

The "Portfolio" Question

SUMMARY

REFERENCES

3 Overview of the Analytic Approach

METHOD

Calculation Procedures

GUIDELINES

Step 1

Step 2

4 Comparison of Disease Burdens

ELEMENTS OF THE SYSTEM FOR COMPARING MORBIDITY AND MORTALITY BURDENS ARISING FROM VARIOUS DISEASES

Trade-Off Values

Expression of Morbidity and Mortality Burdens

Procedures Used in Deriving Disease Estimates

Limitations of the Current Estimates

VALUE JUDGMENTS IN QUANTIFYING MORBIDITY AND MORTALITY

IME Perspective Used in This Study

The Effect of Adopting Other IME Perspectives.

COMPARISON OF COSTS ASSOCIATED WITH DISEASES

Estimating Aggregate Direct Costs of Diseases in the Developing World

Estimating Costs for Diseases in Specific Countries or Regions

Indirect Costs

FINDINGS

LIMITATIONS OF THE PROPOSED SYSTEM

SUMMARY AND CONCLUSIONS

RECOMMENDATIONS

5 Predictions on Vaccine Development

THE NEED FOR PREDICTIONS

VACCINE CANDIDATES AND TARGET POPULATIONS

PREDICTIONS ON VACCINE DEVELOPMENT

Probability of Successful Development

Cost of Development

Time to Licensure

PREDICTIONS ON VACCINE CHARACTERISTICS

Efficacy

Adverse Reactions

Production Technology, Delivery Requirements, and Cost per Dose

Number of Doses and Route of Administration

CONCLUSIONS

6 Assessing the Likely Utilization of New Vaccines

VACCINE AVAILABILITY

VACCINE UTILIZATION

Prediction of Utilization in Defined Populations

Utilization of Vaccines in the Developing World

7 Calculation and Comparison of the Health Benefits and Differential Costs Associated with Candidat...

PROCEDURES

Vaccine Characteristics

Target Population

Vaccine Preventable Illness

Trends in Disease Burden and Population Numbers

The Times for Occurrence of Vaccine-Associated Health Benefits and Cost Savings

Time to Adoption and Steady-State Yield of Benefits

Costs

THE TREATMENT OF VACCINE IMPROVEMENT PROJECTS

RESULTS

Health Benefits

An Illustration of the Process

8 Additional Issues in the Selection of Priorities for Accelerated Vaccine Development

EQUITY CONSIDERATIONS IN CALCULATING DISEASE BURDENS AND VACCINE BENEFITS

Age-Related Weights

Effect of Infant Mortality on Fertility Control

Lives Versus Cases Versus Days.

The Aggregate Nature of the Disease Burden Calculations

The Portfolio Approach for Ranking Vaccines for Research and Development Support

INTERDEPENDENCE OF VACCINE DEVELOPMENT EFFORTS

INTERDEPENDENCE OF IMMUNIZATION EFFORTS

INDUSTRY INTEREST AND ACTIVITY: THE RESPECTIVE ROLES OF THE PUBLIC AND PRIVATE SECTORS

INTEREST IN OTHER COUNTRIES OR INTERNATIONAL ORGANIZATIONS

OTHER DIEASE CHARACTERSTICS RELEVANT TO ESTABLISHING PRIORITIES

Alternative Disease Control Measures

Epidemiologic and Clinical Features

Potential for Disease Eradication

Interaction with Other Diseases

FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

9 Findings, Conclusions, and Recommendations

The Central Analysis

Disease Burden Assumptions

Target Population and Assumptions on Vaccine Preventable Illness

Discount Rate

Alternative Development Scenario: Probability of Success

Assessing the Effect of Differential Utilization

DISCUSSION

Appendix A Selection of Vaccine Candidates for Accelerated Development

JUDGING THE FEASIBILITY OF ACCELERATED VACCINE DEVELOPMENT

ACCELERATED VACCINE DEVELOPMENT AND BASIC RESEARCH PRIORITIES

SELECTING CANDIDATES FOR ACCELERATED DEVELOPMENT

Appendix B The Burden of Disease Resulting from Acute Respiratory Illness

UNCERTAINTY IN THE DISEASE BURDEN ESTIMATES

Appendix C The Burden of Disease Resulting from Diarrhea

MODIFICATION OF DISEASE BURDENS BY APPLICATION OF CURRENTLY AVAILABLE REMEDIES

SECOND-ORDER EFFECTS OF DISEASES

Appendix D-1 The Prospects for Immunizing Against Dengue Virus

DISEASE DESCRIPTION

Limitations of Existing Vaccines

PATHOGEN DESCRIPTION

HOST IMMUNE RESPONSE

DISTRIBUTION OF DISEASE.

Geographic Distribution

PROBABLE VACCINE TARGET POPULATION

Vaccine Preventable Illness*

SUITABILITY FOR VACCINE CONTROL

Alternative Control Measures and Treatments

PROSPECTS FOR VACCINE DEVELOPMENT

Appendix D-2 The Prospects for Immunizing Against Escherichia coli

DISTRIBUTION OF DISEASE

Geographic Distribution of Disease

Appendix D-3 The Prospects for Immunizing Against Hemophilus influenzae Type b

Geographic Distribution

Appendix D-4 The Prospects for Immunizing Against Hepatitis A Virus

Appendix D-5 The Prospects for Immunizing Against Hepatitis B Virus

Acute Hepatitis B

Primary Hepatocellular Carcinoma

Cirrhosis.

PROBABLE VACCINE TARGET POPULATION

Alternative Control Measures and Treatment

Appendix D-6 The Prospects for Immunizing Against Japanese Encephalitis Virus

Existing Vaccines and Limitations

Status of Existing Vaccines

Formalin-Inactivated Mouse Brain Vaccine

Formalin-Inactivated Cell Culture Vaccine

Live Attenuated Vaccine

Potential for New Vaccines

Appendix D-7 The Prospects for Immunizing Against Mycobacterium leprae

Problems to be Overcome

Appendix D-8 The Prospects for Immunizing Against Neisseria meningitidis

Previous Efforts at Vaccination

Epidemic Meningococcal Meningitis

Endemic Meningococcal Meningitis

Uncertainty in the Disease Burden Estimates

PROSPECTS FOR VACCINE DEVELOPMENT.

Potential New Vaccines.

Notes:

Prepared for the National Institute of Allergy and Infectious Diseases.

Includes bibliographies and indexes.

ISBN:

9786610221769

9781280221767

1280221763

9780309568203

030956820X

OCLC:

726823260