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New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries (1986)
Board on Population Health and Public Health Practice (BPH)

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. "1. Summary." New Vaccine Development: Establishing Priorities: Volume II, Diseases of Importance in Developing Countries. Washington, DC: The National Academies Press, 1986.

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New Vaccine Development: Establishing Priorities, Volume II, Diseases of Importance in Developing Countries

TABLE 1.4 Ranking of Diseases by Total Disease Burden Values

Disease

Total Disease Burden Value (IME units)a

Streptococcus pneumoniae

6,612,261

Hepatitis B virus

2,394,256

Plasmodium spp.

2,111,795

Salmonella typhi

1,308,121

Escherichia coli

978,248

Rotavirus

925,042

Shigella spp.

828,068

Streptococcus Group A

811,477

Mycobacterium leprae

657,349

(Escherichia coli)

(550,248)b

(Rotavirus)

(488,542)b

Hemophilus influenzae type b

471,336

Vibrio cholera

229,217

Respiratory syncytial virus

183,326

Parainfluenza virus

145,954

Neisseria meningitidis

68,252

Rabies virus

67,821

Dengue virus

34,365

Yellow fever virus

32,887

Hepatitis A virus

30,229

Japanese encephalitis virus

18,075

aInfant mortality equivalence units.

bValues represent the anticipated disease burden from certain diarrheal pathogens if a plausible increase in oral rehydration therapy is assumed (see Appendix C) .

categories if different, plausible assumptions are adopted, the assignments in Table 1.6 should not be regarded as definitive.

Most of the vaccines that consistently rank low (as compared with the other candidates in this assessment) would prevent diseases that, although often serious, are found in relatively small regions of the developing world. In such areas they may have considerable benefit relative to the more widespread diseases that rank higher when the developing world is considered as a whole.

Final decisions on the number of vaccines to be selected for accelerated development and on the ultimate choices should be addressed in a broader political/public policy forum, after consideration of the issues identified above and discussed in Chapters 8 and 9.

Scientific opinion differs on some of the judgments incorporated into the proposed method, and uncertainty surrounds certain data (e.g., on disease incidence) or the predictions (e.g., of efficacy). When data are unavailable, expert judgments are required. The attempt to be explicit about certain estimates should not be interpreted as indicating that a high degree of precision, unanimity, or certainty in

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Front Matter (R1-R16)
1. Summary (1-18)
2. Priority Setting for Health-Related Investments: A Review of Methods (19-29)
3. Overview of the Analytic Approach (30-43)
4. Comparison of Disease Burdens (44-62)
5. Predictions of Vaccine Development (63-75)
6. Assessing the Likely Utilization of New Vaccines (76-81)
7. Calculation and Comparison of the Health Benefits and Differential Costs Associated with Candidate Vaccines (82-105)
8. Additional Issues in the Selection of Priorities for Accelerated Vaccine Development (106-120)
9. Findings, Conclusions, and Recommendations (121-142)
Appendix A: Selection of Vaccine Candidates for Accelerated Development (143-148)
Appendix B: The Burden of Disease Resulting from Acute Respiratory Illness (149-158)
Appendix C: The Burden of Disease Resulting from Diarrhea (159-169)
Appendix D-1: The Prospects for Immunizing Against Dengue Virus (170-177)
Appendix D-2: The Prospects for Immunizing Against Escherichia coli (178-185)
Appendix D-3: The Prospects for Immunizing Against Hemophilus influenzae Type b (186-196)
Appendix D-4: The Prospects for Immunizing Against Hepatitis A Virus (197-207)
Appendix D-5: The Prospects for Immunizing Against Hepatitis B Virus (208-222)
Appendix D-6: The Prospects for Immunizing Against Japanese Encephalitis Virus (223-240)
Appendix D-7: The Prospects for Immunizing Against Mycobacterium leprae (241-250)
Appendix D-8: The Prospects for Immunizing Against Neisseria meningitidis (251-266)
Appendix D-9: The Prospects for Immunizing Against Parainfluenza Viruses (267-274)
Appendix D-10: The Prospects for Immunizing Against Plasmodium spp. (275-286)
Appendix D-11: The Prospects for Immunizing Against Rabies Virus (287-298)
Appendix D-12: The Prospects for Immunizing Against Respiratory Syncytial Virus (299-307)
Appendix D-13: The Prospects for Immunizing Against Rotavirus (308-318)
Appendix D-14: The Prospects for Immunizing Against Salmonella typhi (319-328)
Appendix D-15: The Prospects for Immunizing Against Shigella spp. (329-337)
Appendix D-16: The Prospects for Immunizing Against Streptococcus Group A (338-356)
Appendix D-17: The Prospects for Immunizing Against Streptococcus pneumoniae (357-375)
Appendix D-18: The Prospects for Immunizing Against Vibrio cholerae (376-389)
Appendix D-19: The Prospects for Immunizing Against Yellow Fever (390-402)
Appendix E: Questionnaire for Assessing Morbidity-Mortality Trade-Offs (403-411)
Appendix F: Technical Notes (412-412)
Appendix G: Biographical Notes on Committee Members (413-417)
Appendix H: Additional Sources of Advice to the Committee (418-419)
Appendix I: Contents of Supplement to Volume II (420-420)
Appendix J: Preface to Volume I (421-422)
Appendix K: Contents to Volume I (423-423)
Index (424-432)