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11–12 June 2019 | Geneva, Switzerland BETTER GLOBAL TOOLS FOR INFLUENZA Technical consultation on product research & innovation for influenza prevention, control & treatment Prevent. Control. Prepare. 11–12 June 2019 | Geneva, Switzerland BETTER GLOBAL TOOLS FOR INFLUENZA Technical consultation on product research & innovation for influenza prevention, control & treatment WHO/WHE/IHM/IPR/2019.1 © World Health Organization 2019 Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons. org/licenses/by-nc-sa/3.0/igo). Under the terms of this licence, you may copy, redistribute and adapt the work for non-commercial purposes, provided the work is appropriately cited, as indicated below. In any use of this work, there should be no suggestion that WHO endorses any specific organization, products or services. The use of the WHO logo is not permitted. If you adapt the work, then you must license your work under the same or equivalent Creative Commons licence. If you create a translation of this work, you should add the following disclaimer along with the suggested citation: “This translation was not created by the World Health Organization (WHO). WHO is not responsible for the content or accuracy of this translation. The original English edition shall be the binding and authentic edition”. Any mediation relating to disputes arising under the licence shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization. Suggested citation. Better global tools for influenza. Technical consultation on product research and innovation for influenza prevention, control and treatment, Geneva, Switzerland, 11-12 June 2019. Geneva: World Health Organization; 2019 (WHO/WHE/IHM/IPR/2019.1). Licence: CC BY-NC-SA 3.0 IGO. Cataloguing-in-Publication (CIP) data. CIP data are available at http://apps.who.int/iris. Sales, rights and licensing. To purchase WHO publications, see http://apps.who.int/bookorders. To submit requests for commercial use and queries on rights and licensing, see http://www.who.int/about/licensing. Third-party materials. If you wish to reuse material from this work that is attributed to a third party, such as tables, figures or images, it is your responsibility to determine whether permission is needed for that reuse and to obtain permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. General disclaimers. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use. This publication contains the report of the June 2019 Technical Consultation on Product Research and Innovation for Influenza Prevention, Control and Treatment and does not necessarily represent the decisions or policies of WHO. Written by Sian Lewis Design & layout by Vivian Lee CONTENTS Executive summary 4 PART I Introduction 5 Setting the scene WHO framework 6 PART II Innovating for influenza 7 The role of innovation Understanding virus characteristics and host factors 9 Building on lessons learnt 10 PART III Landscape overview 12 Towards better tools Diagnostics 13 Vaccines 14 Therapeutics 17 PART IV Scenario planning 21 Action planning Recommendations for action 22 Next steps 25 Annex I: Meeting agenda 26 Annex II: List of participants 28 Annex III: Individual suggestions 32 NOTE TO READER This report aims to capture key messages that emerged from the presentations and discussions rather than trying to provide a strictly chronological account of the meeting. The priorities for innovation and recommendations for action include suggestions made by all meeting participants (across all sessions), and do not necessarily imply consensus. Some priorities for innovation are repeated to reflect their emphasis by participants in different sessions and contexts. The presentations and background reading for the meeting are available at: https://www.who.int/influenza/global_influenza_ strategy_2019_2030/en/. Technical consultation on product research and innovation for influenza prevention, control and treatment | BETTER GLOBAL TOOLS FOR INFLUENZA | 1 ACRONYMS AND ABBREVIATIONS AMR antimicrobial resistance BARDA Biomedical Advanced Research and Development Authority CDC Centers for Disease Control CVV candidate vaccine virus DIA digital immunoassay FAO Food and Agriculture Organization of the United Nations FDA Food and Drug Administration GAP Global Action Plan for Influenza Vaccines GISRS Global Influenza Surveillance and Response System HA hemagglutinin HICs high-income countries IHR International Health Regulations (2005) LAIV live attenuated influenza vaccine LMICs low- and middle-income countries mAbs monoclonal antibodies NAAT nucleic acid amplification test NAI neuraminidase inhibitor NPI nonpharmaceutical intervention PAI polymerase inhibitor PCR polymerase chain reaction PIP Pandemic Influenza Preparedness R&D research and development RIDT rapid influenza diagnostic test RCT randomized control trial SDG Sustainable Development Goal WHE WHO Health Emergencies Programme WHO World Health Organization 2 | BETTER GLOBAL TOOLS FOR INFLUENZA | Technical consultation on product research and innovation for influenza prevention, control and treatment EXECUTIVE SUMMARY The 2019–2030 Global Influenza Strategy aims to protect all people Table 1. Sumtmary recommendations for delivering better global tools and communities from the threat of influenza by delivering better global to tackle influenza tools and stronger country capacities for tackling the virus and disease. Boost public understanding, confidence & uptake As a first step towards implementing the strategy, WHO convened • Find new ways to engage & inform the public a meeting of experts in June 2019 to explore the challenges and • Target messaging to key groups opportunities in research and innovation for developing new and improved products to prevent, treat, and potentially control influenza. Build political will • Turn global strategy into call for action • Make an effective case for investment Meeting participants reviewed the latest trends and current product • Leverage burden of disease studies pipelines in diagnostics, vaccines, and therapeutics. For each type of product, they identified knowledge gaps and barriers to development Secure funds and direct investors and utilization and put forward a selection of priorities for innovation. • Fundraise beyond the private sector These ranged from broad goals, for example to improve the way we • Coordinate donors • Direct investors towards high impact action collect and share data, to very specific suggestions such as conducting fixed and focused studies to better understand influenza transmission Work together to align efforts patterns in hospitals. • Build partnerships across research & clinical practice • Improve infrastructure for alignment & Key recommendations are highlighted throughout this report and collaboration summarized in Table 1. A common theme across product types was the • Harness new applications & methods for data need to focus on making tools as relevant and effective as possible. sharing This is not necessarily about only creating new tools or technologies, • Adopt a holistic view of production although participants agreed that developing a universal vaccine Strengthen the evidence base would be a significant leap forward. Rather, it is also about improving • Improve understanding of the virus and increasing the utilization of the currently available products and • Leverage existing or establish new clinical technologies through incremental innovations. networks • Harness existing evidence • Harmonize clinical trial methods Several speakers suggested that small technological innovations could make a big difference to efficiency and effectiveness, for example Support early detection & rapid data sharing by expanding breadth of protection for seasonal influenza vaccines. • Develop deployable diagnostics Incorporating public health outcomes in clinical trials or redesigning • Strengthen global surveillance clinical trials to focus on public health outcomes would help make Improve vaccine production efficiencies influenza products more relevant to health ministers and key decision • Speed up vaccine production makers. And tailoring existing diagnostics, vaccines, and therapeutics to • Streamline manufacturing processes resource-limited contexts would make them more appealing,
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