3. Methods and process for developing the guidelines
Consolidated ARV guidelines, June 2013
3.3 External participation
3.3.1 Guideline Development Groups and peer review process
The process was supported by four, separate, external Guideline Development Groups (Adult; Maternal and Child Health; Operational and Service Delivery; and Programmatic, comprising 108 individuals) and an external peer review group of over 100 individuals. The acknowledgements list the members of these Groups. The composition of the Groups was in accordance with WHO procedures for developing guidelines (1) and included HIV experts, researchers, programme managers, guideline methodologists, epidemiologists, human rights experts, development agencies, United Nations partners, civil society representatives and representatives from networks of people living with HIV. Appropriate representation by geography and sex was considered. Community group members were selected following an open call for nominations. A full draft of the guidelines was circulated for comment to members of the Guideline Development Groups and the external peer review group.
3.3.2 Conflicts of interest
All members of the Guideline Development Groups and peer review group completed WHO declaration of interest forms (including participation in consulting and advisory panels, research support and financial investment). A total of 21 Guideline Development Group members and 12 peer reviewers declared membership of pharmaceutical industry or other advisory panels or receipt of consulting fees, and 23 Guideline Development Group members and 13 peer reviewers declared pharmaceutical industry financial support through grants for research.
The focus of the 2013 guidelines was on the development of new or updated recommendations on the use of ARV drugs in adults, adolescents, children and pregnant women. The WHO secretariat and co-chairs of each Guideline Development Group considered that important areas for potential conflict of interest would be evidence for exclusive engagement with one pharmaceutical company, or a major role within completed, ongoing or planned trials on either the timing of ART, or evaluation of specific ART regimens. The WHO Guideline Steering Group reviewed all declarations, and found no case where there was exclusive membership of an advisory group panel, receipt of consulting fees or financial support through research grants from only one pharmaceutical company. There was also a further declaration at the Guideline Development Group meeting of the involvement of members as investigators in key trials and studies. Overall, the WHO Guideline Steering Group and co-chairs of each Guideline Development Group were satisfied that there had been a transparent declaration of interests, and that no case necessitated exclusion from the deliberations. The broad range of constituencies represented on the different Guideline Development Group panels was also noted, and that the majority of members had no declared interests. All individuals with declared interests therefore proceeded to participate fully in the Guideline Development Group meetings or to act as peer reviewers.