How can infectious diseases be prioritized in public health?

Abstract

The prevention and control of infectious diseases involves dealing with numerous pathogens, each of which poses a specific threat to public health. In order to rationally allocate the limited resources for research, surveillance and other activities, it is necessary to prioritize infectious diseases; how to do this is the dilemma that public‐health experts face. The scientific literature abounds with examples in which the authors request that one specific disease or health issue be recognized as a priority for research, for surveillance or for funding, often accompanied by plausible arguments. Yet, few publications address the issue of prioritization in a comparative and transparent manner, and even those that do usually refer to research priorities in the fields of nursing, occupational health or public health in low‐income countries. This failure to prioritize effectively is due to many factors, including: an intrinsic difficulty in defining measurable criteria for the importance of disease in terms of public health; a lack of data—in part because of insufficient research in this field—for quantifying or measuring these criteria; a mixture of criteria by which to prioritize, some of which are driven by medical or social factors and others by political and cultural ones; and the difficulty of agreeing on a weighting scheme for those factors. In any case, any form of prioritization is only useful in the context in which it is conducted. Naturally, it is impractical to compare the relative priority of a wildlife research project with that of a project about bone‐marrow transplant. However, a non‐medical research group specializing in disease‐transmitting ticks might benefit from the prioritization of its research agenda, and would probably find transparent and comparable criteria in common with purely medical‐focused research. Yet, the benefit would be limited to this specific group and, in general, the larger the frame of prioritization, the …