Foreword and Introduction:
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Introduction: TDR priority-setting: the strategic emphases matrix
Any organization funding R&D, no matter how large or small its budget, should have clear ideas and guiding principles on how to establish its priorities. During the 2001-2002 biennium, TDR developed a new approach to priority-setting, summarized in its “strategic emphases matrix”(Fig. 2), which addresses two dimensions:
- The disease: the ten diseases in the TDR portfolio were categorized into three groups according to epidemiological trend and appropriateness of existing interventions.
- The functional area of work: TDR R&D activities were distributed in four areas corresponding to the main stages of the R&D pipeline – knowledge generation, development, testing of new interventions, implementation of new interventions.
This disease-function matrix provided a platform for the priority-setting process. The published matrix was the result of analytical work carried out during the biennium and involving the TDR functional coordinators and disease research coordinators as focal points while tapping into the expertise of TDR scientific committees and disease control programmes.
The final version, approved by TDR’s Scientific and Technical Advisory Committee (STAC), lists the R&D priorities for each disease and stage of the R&D pipeline, and took into account, inter alia:
- The disease category: diseases of group I, which lack cost-effective interventions, require more emphasis on the upstream stages of the R&D pipeline; diseases of group III, on the contrary, require more attention on downstream R&D, e.g. how to make better use of the available tools.
- The scientific opportunities: scientific and technological advances have to be continuously monitored as they can lead to new interventions, e.g. the sequencing of the Plasmodium falciparum genome allowed Jomaa and collaborators to discover the antimalarial action of the herbicide fosmidomycin.
The matrix, which will be revised annually by STAC, should be seen and used as a roadmap or city plan that helps the decision-making process but does not impose one unique path or indicate one place to visit. Once the matrix is ready, additional elements have to be considered during the next steps of the prioritysetting process:
- Available resources: the budget level and availability of human resources are basic determinants of the projects that TDR can fund and manage.
- The disease burden: the TDR budget is shaped towards a direct relationship between level of R&D investment and burden of disease.
- TDR comparative advantage: TDR should concentrate its actions in areas where it can make a difference, where there are no other players, or where its leadership can mobilize the expertise needed for a given project.
- Product development time frame: the TDR product portfolio should be balanced and include projects of short,medium and longterm duration, a requirement for a healthy and sustainable R&D pipeline.
- Capacity building and institution strengthening opportunities: emphasis is given to projects that will “leave something behind” – which our trainees and principal investigators refer to as a characteristic of TDR action – in terms of human resources and institutions of disease endemic countries.
4 Remme JHF et al. Strategic emphases for tropical diseases research: a TDR perspective. Trends in Parasitology, 2002, 18(10):421-426.
5 Group I: African trypanosomiasis, dengue, leishmaniasis; Group II: malaria, schistosomiasis, tuberculosis; Group III: Chagas disease, lymphatic filariasis, leprosy, onchocerciasis (see Remme et al 2002).
6 Area A: New basic knowledge; Area B: New and improved tools; Area C: New and improved methods; Area D: New and improved strategies and policies.
7 Jomaa H et al. Inhibitors of the nonmevalonate pathway of isoprenoid biosynthesis as antimalarial drugs. Science, 1999, 285 (5433):1573-1576.
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Foreword and Introduction:
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