Prioritization models for vaccine development against emerging infections

Abstract

Vaccine development is essential in efforts to avert and respond to emerging epidemics. The dissertation develops and applies a framework for prioritizing investments in vaccine development against emerging infectious diseases in global funding organizations. The Coalition for Epidemic Preparedness and Innovations (CEPI) is used as a case study. The purpose is to develop prioritization models that consistently link the organization's strategic goals with vaccine development investment decisions under uncertainty and stakeholder heterogeneity. The analysis uses a combination of stakeholder engagement and preference elicitation techniques to identify appropriate strategic objectives in the case organization. A simulation-optimization model is used to estimate the optimal level of investment required to develop vaccines against 11 priority diseases. Multi-criteria decision analysis and operations research methods are employed to support the optimal selection of vaccine development projects for investment against various emerging infectious diseases. There are three key findings in the dissertation. First, the dissertation provides new empirical evidence on emerging infectious disease vaccine development objectives, costs, risks and preferences for investment. Second, the dissertation demonstrates how prioritization models can be developed that are suitable for different investment decision contexts, but which at the same time remain consistent with the organization's overarching strategic goals. Third, the dissertation illustrates how this framework can be applied to support investment decisions in real-life settings, adapting models to practical limitations while maintaining consistency with theoretical foundations. These findings are important as new global governance structures for contingency and response, such as CEPI, are still in the making. For such organizations, the framework developed in this dissertation can contribute to better decisions for global health.