Abstract
In order to allocate rationally resources for research and surveillance of infectious diseases at the level of the German public health institute (RKI), we prioritised pathogens by public health criteria. After screening the relevant literature we developed a standardised methodology including a three-tiered scoring system for selected pathogens. The pathogens were rated in four categories containing a total of 12 criteria: burden of disease including incidence, severity, mortality; epidemiologic dynamic including outbreak potential, trend, emerging potential; information need including evidence on risk factors/groups, validity of epidemiologic information, evidence for pathogenesis; international duties and public attention; health gain opportunity including preventability, treatability. For each criterion a numerical score of +1, 0 or -1 was given and each criterion received a weight by which the numerical score of each criterion was to be multiplied. The total weighted scores ranged from +22.7 (influenza) to - 64.4 (cholera) with the median being -22.9 (rubella). Relevant changes were observed between weighted and unweighted scores. The chosen approach proved to be feasible and the result plausible. However, in order to further improve the methodology we invite experts to give feedback on the methodology via a structured web-based questionnaire at www.rki.de/EN > Prevention of infection > Infectious Disease Surveillance > Pathogen prioritization. Results of this survey will be included in a modification of the methodology. .
Highlights
One of the challenges of public health is that infectious disease control covers a wide range of pathogens requiring diverse methods for prevention and control
A list of pathogens was compiled based on one or more of the following criteria: notifiable according to German law [11], reportable within the European Union according to European regulations [12], listed as chapters in selected established manuals and textbooks on infectious diseases [13,14,15], causative agent in outbreaks reported to Robert Koch Institute (RKI) in the past 10 years, agent with potential for deliberate release [16]
The working group on prioritisation consisted of eleven senior epidemiologists and infectious disease specialists at the department for infectious disease epidemiology at RKI
Summary
One of the challenges of public health is that infectious disease control covers a wide range of pathogens requiring diverse methods for prevention and control. Resources for research, surveillance and other public health activities are limited; it is of major importance to allocate rationally these resources by using public health criteria. The agendas of institutions in the field of public health and infectious diseases, are fragmented and experts are increasingly specialised, making it difficult to find institutions or individuals who would be able to prioritise a broad range of infectious diseases without being biased by individual professional focus on one hand or lack of specific pathogen-related knowledge on the other. In 2004 the department for infectious disease epidemiology of the Robert Koch Institute (RKI), the national public health institute in the portfolio of the German federal ministry of health, initiated a prioritisation exercise to guide the research and surveillance strategies of the department [6]. Initial findings were presented at three international scientific conferences in 2006 and 2007 [7,8,9]
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