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This model was developed to assist the National Institute of Allergy and Infectious Diseases (NIAID) and the U.S. Agency for International Development (AID) in their decision making. The priorities identified by this model are not appropriate for all circumstances, but it is hoped that the model or some modification of it may be useful to other groups, both in the United States and elsewhere, that are faced with similar resource allocation problems.

The Central Analysis

The central analysis described below incorporates the following:

vaccine and development characteristics described in Chapter 5, including predictions on the target population, efficacy, and vaccine cost

  • estimates of the burden of each disease, derived as described in Appendixes B, C, and D-1 through D-19

  • the assumption that utilization rates would not differ among vaccine candidates (because delivery of vaccines would probably be through the World Health Organization Expanded Program on Immunization [WHO-EPI])

  • estimates of the number of new entrants to the respective target populations, as described in Appendixes D-1 through D-19 and summarized in Chapter 7, Table 7.1

  • times to licensure and adoption, delay of vaccination benefits presented in Chapter 7, Table 7.2

    calculations of each vaccine candidate’s potential health benefits and associated expenditures as described in Chapters 4 and 7

  • a 5 percent discount rate for future health benefits and costs

  • a perspective, for illustrative purposes only, on the undesirability of various morbidity conditions and mortality, derived from the median values of responses from a range of health professionals in developing countries

  • independent consideration of each disease and the development of each vaccine candidate (for each target population)

  • expression of health benefits in units considered equivalent in undesirability to the death of an infant (i.e., infant mortality equivalents, see Chapter 4)

FINDINGS

The results of the central analysis (Chapter 7) are shown in Tables 9.1 and 9.2.

The range of potential benefits from the various vaccine candidates, viewed as present-day investment options, is considerable,



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