Last updated: 2 September 2025

Terms of Reference

Terms of reference in PDF format

The Working Group will be requested to review the scientific evidence and relevant programmatic considerations to formulate recommendations on the use of Chikungunya vaccines. The Working group will develop draft recommendations to be submitted for consideration by SAGE to inform the global policy on Chikungunya vaccine use, and for subsequent issuance of the WHO Position Paper on Chikungunya vaccines.

Specifically, the Working Group will be asked to address the following areas in its review:

• the global burden of disease caused by chikungunya virus infection, including outbreaks;
• safety, efficacy, duration of protection, schedules, and co-administration of chikungunya vaccines that are now licensed in some countries;
• data on cost-effectiveness and cost-utility of chikungunya vaccination;
• programmatic feasibility of chikungunya introduction into routine immunization schedule and/or as an outbreak response;
• vaccine impact of routine immunization versus outbreak response (endemic use versus reactive use)
• acceptability and equity impacts of chikungunya vaccination.

The working group will provide options for policy and strategy development and describe the broader implications of those options; present the results of the evidence review as requested by WHO; highlight knowledge gaps and research questions from the review of evidence, including an assessment of vaccine products in the pipeline and needs for future products.

Composition

SAGE Members

• Professor Cristiana Toscano, Universidade Federal de Goiás, Brazil (Chair)
• Professor Punnee Pitisuttithum, Mahidol University, Thailand (Co-Chair)

Experts

• Ralph Huits, IRCCS Ospedale Sacro Cuore Don Calabria (Italy)
• George Warimwe KEMRI Wellcome Trust Research Program (Kenya)
• Andre Siqueira, Drugs for Neglected Diseases Initiative (DNDi) (Brazil)
• Koen Pouwels, Nuffield Department of Primary Care Health Sciences, University of Oxford (UK)
• Ernesto Marques, Graduate School of Public Health, University of Pittsburgh (USA)
• Susan Hills, US Centers for Disease Control and Prevention, Arboviral Diseases Branch, Division of Vector Borne Diseases (USA)
• David Freedman, University of Alabama Birmingham (UAB) (USA)
• Rafaella Fortini Grenfell e Queiroz, Fundação Oswaldo Cruz (Fiocruz) (Brazil)
• Kaja Abbas, Department of Infectious Disease Epidemiology & Dynamics, London School of Hygiene & Tropical Medicine  and Global Health Nagasaki University (UK & Japan)
• Hannah Clapham, Saw Swee Hock School of Public Health, National University of Singapore (Singapore)
• Celina Maria Turchi Martelli, Fundação Oswaldo Cruz (Fiocruz) (Brazil)
• Manuela Mura, European Medicines Agency (EMA) (The Netherlands)
• Eggi Arguni, Faculty of Medicine, Universitas Gadjah Mada (Indonesia)

WHO Secretariat

• Annelies Wilder-Smith
• Ana Belen Ibarz-Pavon (Consultant)

DECLARATION OF INTERESTS

All members completed a declaration of interest form. All interests were assessed not to constitute a conflict of interest. It was concluded that all members could take part in full in all of the discussions. The reported relevant interests are summarized below:

George Warimwe

• Serves as a member of the CEPI scientific advisory committee; currently leads the CEPI-funded ACHIEVE project to estimate the burden of Chikungunya in East Africa. This interest was perceived as non-personal, specific and financially significant*.

Andre Siqueirai

• Serves as a member of the CEPI scientific advisory committee; principal investigator on the REPLIK network with focus on acute and chronic musculoskeletal manifestations of Chikungunya infection. This interest was perceived as non-personal, specific and financially significant*.

Koen Pouwels

• Principal investigator on a CEPI-funded project evaluating cost-effectiveness of Chikungunya vaccines in 34 countries. This interest was perceived as non-personal, specific and financially significant*.

Ralph Huits

• Served as a member of the Chikungunya vaccine advisory board until 2024. Has received speaker fees from Valneva and Takeda within the past four years. This interest was perceived as non-personal, specific and financially significant*.

* According to WHO's Guidelines for Declaration of Interests (WHO expert), an interest is considered "personal" if it generates financial or non-financial gain to the expert, such as consulting income or a patent. "Specificity" states whether the declared interest is a subject matter of the meeting or work to be undertaken. An interest has "financial significance" if the honoraria, consultancy fee or other received funding, including those received by expert's organization, from any single vaccine manufacturer or other vaccine-related company exceeds 5,000 USD in a calendar year. Likewise, a shareholding in any one vaccine manufacturer or other vaccine-related company in excess of 1,000 USD would also constitute a “significant shareholding”.