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 -- INTERPRETATION OF RESULTS -- GUIDELINES -- Step 1 -- Step 2 -- SUMMARY -- REFERENCE -- 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 -- REFERENCES -- 5 Predictions on Vaccine Development -- THE NEED FOR PREDICTIONS -- SELECTION OF CANDIDATES -- 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 -- REFERENCE -- 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 -- SUMMARY -- REFERENCES -- 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 -- Adverse Reactions -- The Times for Occurrence of Vaccine-Associated Health Benefits and Cost Savings -- Time to Licensure -- Time to Adoption and Steady-State Yield of Benefits -- Costs -- THE TREATMENT OF VACCINE IMPROVEMENT PROJECTS -- RESULTS -- Health Benefits -- An Illustration of the Process -- Costs -- REFERENCES -- 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 -- REFERENCES -- 9 Findings, Conclusions, and Recommendations -- The Central Analysis -- FINDINGS -- 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 -- CONCLUSIONS -- DISCUSSION -- RECOMMENDATIONS -- REFERENCE -- 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 -- REFERENCE -- Appendix B The Burden of Disease Resulting from Acute Respiratory Illness -- UNCERTAINTY IN THE DISEASE BURDEN ESTIMATES -- REFERENCES -- Appendix C The Burden of Disease Resulting from Diarrhea -- MODIFICATION OF DISEASE BURDENS BY APPLICATION OF CURRENTLY AVAILABLE REMEDIES -- SECOND-ORDER EFFECTS OF DISEASES -- UNCERTAINTY IN THE DISEASE BURDEN ESTIMATES -- REFERENCES -- 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 -- Disease Burden Estimates -- PROBABLE VACCINE TARGET POPULATION -- Vaccine Preventable Illness* -- SUITABILITY FOR VACCINE CONTROL -- Alternative Control Measures and Treatments -- PROSPECTS FOR VACCINE DEVELOPMENT -- REFERENCES -- Appendix D-2 The Prospects for Immunizing Against Escherichia coli -- DISEASE DESCRIPTION -- PATHOGEN DESCRIPTION -- HOST IMMUNE RESPONSE -- DISTRIBUTION OF DISEASE -- Geographic Distribution of Disease -- Disease Burden Estimates -- PROBABLE VACCINE TARGET POPULATION -- Vaccine Preventable Illness* -- SUITABILITY FOR VACCINE CONTROL -- Alternative Control Measures and Treatments -- PROSPECTS FOR VACCINE DEVELOPMENT -- REFERENCES -- Appendix D-3 The Prospects for Immunizing Against Hemophilus influenzae Type b -- DISEASE DESCRIPTION -- PATHOGEN DESCRIPTION -- HOST IMMUNE RESPONSE -- DISTRIBUTION OF DISEASE -- Geographic Distribution -- Disease Burden Estimates -- PROBABLE VACCINE TARGET POPULATION -- Vaccine Preventable Illness* -- SUITABILITY FOR VACCINE CONTROL -- Alternative Control Measures and Treatments -- PROSPECTS FOR VACCINE DEVELOPMENT -- REFERENCES -- Appendix D-4 The Prospects for Immunizing Against Hepatitis A Virus -- DISEASE DESCRIPTION -- PATHOGEN DESCRIPTION -- HOST IMMUNE RESPONSE -- DISTRIBUTION OF DISEASE -- Geographic Distribution -- Disease Burden Estimates -- PROBABLE VACCINE TARGET POPULATION -- Vaccine Preventable Illness* -- SUITABILITY FOR VACCINE CONTROL -- Alternative Control Measures and Treatments -- PROSPECTS FOR VACCINE DEVELOPMENT -- REFERENCES -- Appendix D-5 The Prospects for Immunizing Against Hepatitis B Virus -- DISEASE DESCRIPTION -- PATHOGEN DESCRIPTION -- HOST IMMUNE RESPONSE -- DISTRIBUTION OF DISEASE -- Geographic Distribution -- Disease Burden Estimates -- Acute Hepatitis B -- Primary Hepatocellular Carcinoma -- Cirrhosis.

PROBABLE VACCINE TARGET POPULATION -- Vaccine Preventable Illness* -- SUITABILITY FOR VACCINE CONTROL -- Alternative Control Measures and Treatment -- PROSPECTS FOR VACCINE DEVELOPMENT -- REFERENCES -- Appendix D-6 The Prospects for Immunizing Against Japanese Encephalitis Virus -- DISEASE DESCRIPTION -- Existing Vaccines and Limitations -- PATHOGEN DESCRIPTION -- HOST IMMUNE RESPONSE -- DISTRIBUTION OF DISEASE -- Geographic Distribution -- Disease Burden Estimates -- PROBABLE VACCINE TARGET POPULATION -- Vaccine Preventable Illness* -- SUITABILITY FOR VACCINE CONTROL -- Alternative Control Measures and Treatments -- PROSPECTS FOR VACCINE DEVELOPMENT -- Status of Existing Vaccines -- Formalin-Inactivated Mouse Brain Vaccine -- Formalin-Inactivated Cell Culture Vaccine -- Live Attenuated Vaccine -- Potential for New Vaccines -- REFERENCES -- Appendix D-7 The Prospects for Immunizing Against Mycobacterium leprae -- DISEASE DESCRIPTION -- PATHOGEN DESCRIPTION -- HOST IMMUNE RESPONSE -- DISTRIBUTION OF DISEASE -- Geographic Distribution -- Disease Burden Estimates -- PROBABLE VACCINE TARGET POPULATION -- Vaccine Preventable Illness* -- SUITABILITY FOR VACCINE CONTROL -- Alternative Control Measures and Treatments -- PROSPECTS FOR VACCINE DEVELOPMENT -- Problems to be Overcome -- REFERENCES -- Appendix D-8 The Prospects for Immunizing Against Neisseria meningitidis -- DISEASE DESCRIPTION -- Previous Efforts at Vaccination -- PATHOGEN DESCRIPTION -- HOST IMMUNE RESPONSE -- DISTRIBUTION OF DISEASE -- Geographic Distribution -- Disease Burden Estimates -- Epidemic Meningococcal Meningitis -- Endemic Meningococcal Meningitis -- Uncertainty in the Disease Burden Estimates -- PROBABLE VACCINE TARGET POPULATION -- Vaccine Preventable Illness* -- SUITABILITY FOR VACCINE CONTROL -- Alternative Control Measures and Treatments -- PROSPECTS FOR VACCINE DEVELOPMENT.

Potential New Vaccines.