Improving accountability in vaccine decision-making

ABSTRACT

Introduction: Healthcare decisions, in particular those affecting entire populations, should be evidence-based and taken by decision-makers sharing broad alignment with affected stakeholders. However, criteria, priorities and procedures for decision-making are sometimes non-transparent, frequently vary considerably across equivalent decision-bodies, do not always consider the broader benefits of new health-measures, and therefore do not necessarily adequately represent the relevant stakeholder-spectrum.

Areas covered: To address these issues in the context of the evaluation of new vaccines, we have proposed a first baseline set of core evaluation criteria, primarily selected by members of the vaccine research community, and suggested their implementation in vaccine evaluation procedures. In this communication, we review the consequences and utility of stakeholder-centered core considerations to increase transparency in and accountability of decision-making procedures, in general, and of the benefits gained by their inclusion in Multi-Criteria-Decision-Analysis tools, exemplified by SMART Vaccines, specifically.

Expert commentary: To increase effectiveness and comparability of health decision outcomes, decision procedures should be properly standardized across equivalent (national) decision bodies. To this end, including stakeholder-centered criteria in decision procedures would significantly increase their transparency and accountability, support international capacity building to improve health, and reduce societal costs and inequity resulting from suboptimal health decision-making.

KEYWORDS:

• Vaccine evaluation
• vaccine policy
• core values
• public health policy
• Health Technology Assessment (HTA)
• MCDA
• SMART vaccines
• accountable decision-making
• transparency
• accountability for reasonableness

Acknowledgments

We would like to express our gratitude to Kenneth N. Timmis, Department of Microbiology, Technical University of Braunschweig, Germany, for his valuable comments whilst drafting this communication.

Declaration of interest

R Rappuoli is an employee of the GSK group of companies and S Black is a consultant for GSK vaccines. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Authors’ contributions

All authors participated in the design or implementation or analysis, and interpretation of the study results. All authors were involved in drafting the manuscript or revising it critically for important intellectual content. All authors had full access to the data and approved the manuscript before it was submitted by the corresponding author.

Additional information

Funding

The manuscript was funded by Novartis and GSK vaccines.