Post00330 GAVI - WHICH NEW TECHNOLOGIES?

Post00330 GAVI - WHICH NEW TECHNOLOGIES? 26 March 2001 CONTENTS 1. GAVI - WHICH NEW TECHNOLOGIES 2. QUESTIONNAIRE 1. GAVI - WHICH NEW TECHNOLOGIES "At the last GAVI Board Meeting it was proposed that the Task Force on R&D should seek out and evaluate new technologies and research that would improve the safety, access, effectiveness, utility, utilization or performance of immunization in developing countries. It was proposed that GAVI should consider supporting up to 3 such new technologies or research." Peter Wilson, PRB Consulting, on behalf of the GAVI Board, is seeking the views of Technet members. Improve the future! * Replies to Peter at: Peter Wilson or Fax: (44)-1932-874501 Opinion, comments and suggestions please: [[email protected]][email protected][/email] or use your reply button ___________________________________________________________________________ Date: Tue, 20 Mar 2001 04:11:10 -0500 From: Peter Wilson Subject: GAVI - Which New Technologies To: [[email protected]][email protected][/email] Allan We would be pleased to have responses from the Technet community, but we would like to have them within the next couple of weeks. Thanks for your help Peter ___________________________________________________________________________ From: Peter Wilson, Date: 15/03/101 21:57 PM GAVI - Which New Technologies Dear All PLEASE RESPOND TO THE ATTACHED QUESTIONNAIRE BY RETURN OR AT YOUR EARLIEST CONVENIENCE. At the last GAVI Board Meeting it was proposed that the Task Force on R&D should seek out and evaluate new technologies and research that would improve the safety, access, effectiveness, utility, utilization or performance of immunization in developing countries. It was proposed that GAVI should consider supporting up to 3 such new technologies or research. Attached is a questionnaire which seeks your views on technologies or research which should be considered, and how we should evaluate these technologies. The scope of opportunities is wide, and the questionnaire is a first attempt to narrow the focus and establish criteria for evaluating the options. A meeting of experts in these fields will be held in mid April to consider the output of the questionnaire, exchange knowledge on some of the proposed options and try to establish a preferred short list of technologies or research for further evaluation. The questionnaire is a key input to this decision making process. It is vital to helping us ascertain what the wider community of immunization specialists consider to be the priority areas to focus our attention to achieve the goals set out above. Please could you spend a few minutes (probably 10 minutes) to give your views on the 4 questions - your views are extremely important to establishing the agenda for this initiative. Please send the completed questionnaire back to me BY RETURN, if possible, and by the 31 March at the absolute latest: Preferably by e-mail to: [[email protected]][email protected][/email] or fax: (44)-1932-874501 Thank you very much for your cooperation. Peter Wilson PRB Consulting UK Phone: (44)-1932-872358 ___________________________________________________________________________ GAVI Task Force on Research & Development Questionnaire on "New Technologies" Background At the last GAVI Board Meeting it was proposed that the Task Force on R&D should seek out and evaluate new technologies and research that would improve safety, access, effectiveness, utility, utilization or performance of immunization in developing countries. It was proposed that GAVI should consider supporting up to 3 such new technologies or research. This would be in addition to research in the three disease areas agreed at the last Board Meeting This questionnaire seeks your views on technologies which could be considered, and how we should evaluate these technologies. The technologies and research should support the attainment of GAVI's overall objectives, namely to: * Improve access to sustainable immunization services * Expand the use of all existing, safe and cost-effective vaccines where they address a public health problem * Accelerate the development and introduction of new vaccines and technologies * Accelerate R&D efforts for vaccines needed primarily in developing countries * Make immunization coverage a centrepiece in international development efforts ____________________________________*______________________________________ 2. QUESTIONNAIRE The questionnaire has been reformatted to plain ASCII text. ____________________________________________________________________________ NAME: INSTITUTION OR COMPANY: COUNTRY: ___________________________________________________________________________ QUESTION 1: What are the most important roles new or improved technologies or non- disease specific research can play in meeting GAVI's objectives? Please add your own views to the list in the table below, and then rank from 3 to 1, what you consider to be the 3 most important roles the technologies or research should play - with 3 being the most important, and 1 the 3rd most important role: ROLE Increase Access to & Coverage of immunization services RANK [ ] Increase Access to & Utilization of immunization services RANK [ ] Make immunization Safer RANK [ ] Make immunization Simpler, more Practical and Easier to Implement RANK [ ] Make immunization more Effective and Successful RANK [ ] Increase Immmunogenicity and Optimise the limited access available RANK [ ] Reduce Vaccine Wastage RANK [ ] Increase the Efficiency of the Immunization System/Service RANK [ ] Increase our Understanding of the performance & effectiveness of immunization services RANK [ ] QUESTION 2: The following criteria have been proposed for selecting the technologies and research which will be proposed to the GAVI Board a. Please add any additional criteria you consider important b. Please suggest modifications to the existing criteria if you believe they should be expressed in a different manner (cross out the existing wording, and insert new wording under Other at the bottom of the Table) c. Rank the Criteria as follows: i. Mark the single most important criteria "1" ii. Mark with an "X" the 2 criteria you consider to be the next most important iii. Mark with an "S" any other criteria you consider to be important in the evaluation iv. Leave blank any criteria which you think are not that important CRITERIA Potential impact upon access, safety, effectiveness, utility, utilization, etc (with preference as indicated in question 1 and defined as in 2 (ii) below) RANK [ ] Sustainability of the impact, and changing /improving the future system High Probability of technological success in the short to medium term (5 - 7 years maximum) RANK [ ] Need 1 - is this an area in which little support is being provided by other agencies? RANK [ ] Need 2 - are there alternative, easily adopted solutions to the problem Programmatic Feasibility - how easy will it be to implement the program in the field? RANK [ ] Cross-Cutting - degree of generic or cross-cutting applicability to all vaccines and regions RANK [ ] Cost of adoption RANK [ ] Research conducted in Developing Countries by Local experts RANK [ ] Other: RANK [ ] 2. (ii) How should one measure the "potential impact" upon safety, effectiveness, utility, access, etc.? Would it be that upon implementation of the new technology or research findings there is a potential to: [ ] * Reduce Mortality in children by x% [ ] * Reduce Mortality in the population by x% [ ] * Reduce Morbidity in children by x% [ ] * Reduce Morbidity in the population by x% [ ] * Increase Immunization coverage by y% [ ] * Reduce cost per successful immunization by z % [ ] * Reduce DTP dropout by x% [ ] * [ ] * Please indicate with an "X" which of the above definitions is most appropriate in evaluating which technology or research to choose, or add a more appropriate measurement of your own. QUESTION 3: Below are some Generic areas of non-disease specific Research which could potentially play an important role in meeting GAVI's objectives. Please add any other area of Research (under Other) which you believe could play an important role Which 3 Areas (including those you have added) are likely to have the greatest impact in improving safety, effectiveness, access, utilization, utility or performance of immunization in developing countries. Mark these 3 with an "X" in the TOP 3 column. RESEARCH AREA TOP 3 1. Technologies to maintain safe vaccines at High & Low Temperatures [ ] TOP 3 2. Technologies to reduce Dependency on the Cold Chain [ ] TOP 3 3. Improved Cold Chain Technology [ ] TOP 3 4. Technologies to prevent Contamination [ ] TOP 3 5. Technologies to eliminate the Dangers of Non-Sterile Injections [ ] TOP 3 6. Technologies to prevent Collateral Sharps Injury [ ] TOP 3 7. Self-contained Unit-Dose Delivery Systems [ ] TOP 3 8. Technologies to reduce Vaccine Wastage [ ] TOP 3 9. Technologies to Reduce the number of Immunization Patient Interactions, e.g. fewer number of doses required, greater immunogenicity, etc [ ] TOP 3 10. Technologies to improve the Accessibility of Vaccines [ ] TOP 3 11. Technologies to improve the Management & Efficiency of Immunization Systems [ ] TOP 3 12. Systems & technologies to Assess the Effectiveness of Immunization Services [ ] TOP 3 13. Operational Research on how to "reach the unreached" - how to increase access to sustainable immunization services Other Research Areas : [ ] TOP 3 14. [ ] TOP 3 15. [ ] TOP 3 16. [ ] TOP 3 17. [ ] TOP 3 18. [ ] TOP 3 19. [ ] TOP 3 20. [ ] TOP 3 QUESTION 4: Listed below are some specific technologies or research areas under the categories used above. We need to expand our knowledge of what could be done under these categories, as well as obtain some initial views on the specific technologies/research which should be supported: PLEASE: 1. Add specific Technologies or Research Areas (not currently listed) you believe could make a short list for evaluation 2. Using the criteria you have chosen in Question 2, rank your top 4 specific technical/research areas (4 being top choice, 1 being 4th choice) which could have an impact in the next 5 years in the "Rank Shorter Term" column. 3. In the "Rank Longer Term" column rank your top 4 specific technical/research areas (4 being top choice, 1 being 4th choice) which could have an impact in the longer term (beyond 5 years) ____________________________________________________________________________ Note: Rank the bulleted items, not the Category headings Note: Some specific technologies may be listed under more than one category. ____________________________________________________________________________ TECHNOLOGY OR RESEARCH AREA 1. Technologies to maintain safe vaccines at High & Low Temperatures * Vaccine Vial Monitors RANK Shorter Term [ ] RANK Longer Term [ ] * Fail-safe Refrigeration RANK Shorter Term [ ] RANK Longer Term [ ] * Freeze Indicators RANK Shorter Term [ ] RANK Longer Term [ ] * Improved Vaccine Stability RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term RANK Longer Term 2. Technologies to reduce Dependency on the Cold Chain * Vaccines Stable at Ambient Temperature RANK Shorter Term [ ] RANK Longer Term [ ] - Sugar Glass Formulations RANK Shorter Term [ ] RANK Longer Term [ ] - Trehalose RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 3. Improved Cold Chain Technology * High Efficiency Solar Refrigerators RANK Shorter Term [ ] RANK Longer Term [ ] * Ice-free Cooling Systems RANK Shorter Term [ ] RANK Longer Term [ ] * Low/no Maintenance Systems RANK Shorter Term [ ] RANK Longer Term [ ] * Smaller, lighter vaccine Coolers that will maintain temperature longer RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 4. Technologies to prevent contamination * Auto-disable reconstitution syringes RANK Shorter Term [ ] RANK Longer Term [ ] * Monodose RANK Shorter Term [ ] RANK Longer Term [ ] * Auto-reconstitution RANK Shorter Term [ ] RANK Longer Term [ ] * Safe multi-dose jet injector RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 5. Technologies to eliminate the dangers of non-sterile injections * Needle-free parenteral inoculation devices RANK Shorter Term [ ] RANK Longer Term [ ] * Auto-disable syringes RANK Shorter Term [ ] RANK Longer Term [ ] * Uniject-type devices RANK Shorter Term [ ] RANK Longer Term [ ] * Non-parenteral vaccination Administration of vaccines via mucosal surfaces RANK Shorter Term [ ] RANK Longer Term [ ] - Transcutaneous administration of vaccines RANK Shorter Term [ ] RANK Longer Term [ ] - Edible vaccines RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 6. Technologies to prevent Collateral Sharps In jury * Point of use needle containers RANK Shorter Term [ ] RANK Longer Term [ ] * Low capacity waste destruction systems RANK Shorter Term [ ] RANK Longer Term [ ] * Anti-stick devices RANK Shorter Term [ ] RANK Longer Term [ ] * Waste collection infrastructure RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 7. Self-contained Unit-Dose Delivery Systems * Pre-filled Injection devices RANK Shorter Term [ ] RANK Longer Term [ ] * Oral Vaccines RANK Shorter Term [ ] RANK Longer Term [ ] * Transcutaneous Patches RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 8. Technologies to reduce Vaccine Wastage * Monodose Vaccines RANK Shorter Term [ ] RANK Longer Term [ ] * Vaccine Vial Monitors RANK Shorter Term [ ] RANK Longer Term [ ] * Auto-reconstitution RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 9. Technologies to Reduce the number of Immunization Patient Interactions * Adjuvants to increase the immunogenicity of existing & new vaccines RANK Shorter Term [ ] RANK Longer Term [ ] * Improved (more immunogenic) vaccines that require only 1 or 2 doses RANK Shorter Term [ ] RANK Longer Term [ ] * Modified immunization regimens (e.g. spacing of doses) to achieve comparable immunogenicity with fewer doses RANK Shorter Term [ ] RANK Longer Term [ ] * Antigen delivery systems to stimulate protective immune responses with fewer doses RANK Shorter Term [ ] RANK Longer Term [ ] - Non-living systems (e.g. proteosomes, liposomes, cochleates) RANK Shorter Term [ ] RANK Longer Term [ ] - Live bacterial vectors RANK Shorter Term [ ] RANK Longer Term [ ] - Live viral vectors RANK Shorter Term [ ] RANK Longer Term [ ] - Edible (transgenic plant) vaccines RANK Shorter Term [ ] RANK Longer Term [ ] * Multi-Valent Vaccines RANK Shorter Term [ ] RANK Longer Term [ ] * Multi-Vaccine Administration RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 10. Technologies to improve the Accessibility of accines * Adapted low maintenance vehicles - motorcycles, boats, all terrain vehicles, etc RANK Shorter Term [ ] RANK Longer Term [ ] * Bundling of indispensable commodities RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 11. Technologies to improve the Management & Efficiency of Immunization Systems * Logistics Management Information Systems RANK Shorter Term [ ] RANK Longer Term [ ] - Communications Technologies RANK Shorter Term [ ] RANK Longer Term [ ] - Freight Tracking Technologies RANK Shorter Term [ ] RANK Longer Term [ ] * Tracking of Infants RANK Shorter Term [ ] RANK Longer Term [ ] * Immunization Registries RANK Shorter Term [ ] RANK Longer Term [ ] * Disease Surveillance systems RANK Shorter Term [ ] RANK Longer Term [ ] * IT and Systems Infrastructures RANK Shorter Term [ ] RANK Longer Term [ ] * A Process of local active Monitoring of immunization Performance RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] 12. Systems & technologies to Assess the Effectiveness of Immunization Services * Improved methods of performing surveys to estimate immunization coverage RANK Shorter Term [ ] RANK Longer Term [ ] * Simplified methods of performing serosurveys to document the prevalence of immunoprotection RANK Shorter Term [ ] RANK Longer Term [ ] - Utilizing finger stick blood RANK Shorter Term [ ] RANK Longer Term [ ] - Utilizing crevicular fluid (serum transudate collected at the gum line) RANK Shorter Term [ ] RANK Longer Term [ ] - Utilizing "oral fluid" (saliva/crevicular fluid admixture) RANK Shorter Term [ ] RANK Longer Term [ ] * Simplified methods for specific surveillance of some sentinel diseases RANK Shorter Term [ ] RANK Longer Term [ ] - Measles RANK Shorter Term [ ] RANK Longer Term [ ] - Whooping cough RANK Shorter Term [ ] RANK Longer Term [ ] - Other RANK Shorter Term [ ] RANK Longer Term [ ] 13. Operational Research on how to "reach the unreached" * How to better deploy and utilize fixed facility immunization services RANK Shorter Term [ ] RANK Longer Term [ ] * How to staff, mobilize and design mobile immunization units suitable for different local conditions RANK Shorter Term [ ] RANK Longer Term [ ] * Best practice in promotion, education and implementation of immunization services RANK Shorter Term [ ] RANK Longer Term [ ] * Assessment of Impact of Immunization Programmes RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] Other RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] * RANK Shorter Term [ ] RANK Longer Term [ ] ___________________________________________________________________________ Please return the completed questionnaire by 31st March at the absolute latest to: Peter Wilson e-mail : [[email protected]][email protected][/email] or Fax: (44)-1932-874501