The top 10 biotechnologies for improving health in developing countries were identified in a study conducted by the University of Toronto in partnership with an international panel of scientists with expertise in biotechnology and global health issues (Daar et al. 2002). The Panel members were identified through literature searches and with recommendations from individuals at World Health Organization and Rockefeller Foundation. Thirty-nine scientists from both developing and developed countries were invited to take part in the study, 28 of whom completed the project. Approximately half of the panelists were employed in developing countries, and the rest were either originally from developing countries or had experience working in global health. Some of the key developing countries with activity in biotechnology (Brazil, China, Cuba, Egypt, India, South Africa, South Korea) were represented.
A structured process known as the Delphi method was used to bring the Panel to a consensus regarding the identification and ranking of the biotechnologies (Adler & Ziglio 1996). The study spanned three "rounds," which were completed over a period of five months via email, fax, telephone and personal interviews.
In Round 1, the panelists were invited to participate in the project and asked the open-ended question, "what do you think are the major biotechnologies that can help improve health in developing countries within the next 5 to 10 years?" Their answers were analyzed and organized into categories (e.g. diagnostics, drug development, delivery systems), generating a list of 51 technologies. Their descriptions and definitions of the technologies were followed as much as possible, rather than the study team's own preconceptions. As the list was being developed, it was reviewed and modified by three external scientists (not Panel members) to ensure the technologies were mutually exclusive and categorized appropriately.
In Round 2, the list of 51 biotechnologies was reviewed by the Panel for ranking the ten most promising technologies and to provide reasons for their choices, using criteria such as impact of the technology, appropriateness for developing countries, burden of disease addressed, feasibility, creation of new knowledge, and indirect benefits. These rankings were combined (1st = 10 points, 2nd = 9 pts, etc.) to produce a total point score for each technology.
In the final consensus-building round a list of the top 12 technologies, based upon the Round 2 rankings, was sent to the panelists along with a summary of the reasons they had provided. They were given the opportunity to revise their rankings in light of this input. Twenty-eight panelists completed Round 3. The results of Round 3 represent the top 10 biotechnologies for improving health in developing countries in the next five to ten years. The top three technologies showed a high degree of consensus: all but one of the panelists included at least one of these among their personal top three choices. The final ranking of the technologies reflects the consensus of the Panel.
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