Details of research question #1 “What is the optimal allocation of a limited resource to the control of MDR TB?”
The effective management of MDR-TB is a high priority for tuberculosis control, but how should limited funds be allocated so as to achieve the best possible outcome? The standard approach to resource allocation, namely cost-effectiveness analysis, does not solve the problem of how to distribute a finite resource among competing priorities — for instance, the balance of investment in treating drug sensitive and drug resistant TB to minimize MDR-TB. Results from this study would inform the rational use of both present and future drug regimens in preventing and reversing the spread of drug resistance.
Interventions on MDR TB control broadly separate into 1) preventing acquired TB through improving the existing diagnosis and treatment of drug sensitive TB cases, and 2) preventing transmission of MDR by more/earlier diagnosis and successful treatment of existing MDR TB cases, but could also include treatment of latent TB infection or alternative creative approaches. Successful applications will consider different combinations of interventions.
Specific consideration should be given to:
A. Model requirements
– The model should use currently available drugs and diagnostic tools
– The proposal should evaluate two or more contrasting and relevant epidemiological settings (by incidence, HIV or MDR prevalence).
– The model should consider both economical and epidemiological aspects
B. Applicants should clearly specify, and consider how the sensitivity of their results depends on:
– Epidemiological setting (TB incidence and mortality, initial prevalence of MDR and HIV)
– Choice of MDR-TB indicators to be optimized
– Current levels of TB control
– Scale of interventions
The aims are (1) to develop a mathematical framework for optimal allocation of resources to MDR-TB control, and (2) to present results for two or more epidemiological settings.
- To develop a mathematical framework for optimal allocation of resources to MDR-TB control
- To present results for two or more epidemiological settings
All applications will be reviewed by expert reviewers. All applications to this research question will be scored against the following criteria:
- Is the research question and plan well-described
- Is the research team qualified to conduct this research
- Is the budget and timeline appropriate for the proposed activity
- Is the proposal likely to meet the aim and objectives outlined in the RFA
- Is the dissemination and impact maximisation plan adequate
- Does the proposal explain how models and data will be shared for maximum public utility
- Show a clear understanding of the limitations of present analysis for resource allocation (cost-effectiveness etc), and propose an improved mathematical framework for analysis
- Show how the modelling will be tied to data, preferably for countries/settings where the management of MDR-TB is a high priority
- Explain how collaborations have been or will be developed to carry out the project and apply the results