Topics - People & Health

WHO : Prioritising healthcare needs & gaps

How do you define what is and what is not a healthcare priority or a biomedical research priority? In its 2014 report on Priority Medicines for Europe and the WHO provides some important answers.

  • It starts by defining what global burden of diseases is – i.e. what are their costs to the patient and to society, beyond the cost of treatment, including: absenteeism [1], presenteeism [2], disability, impact on families, etc.
  • It also indicates what unmet needs are– i.e. where there is no treatment, where treatments lose their efficiency or are inadequate, or where the form of a treatment is not suitable for a special group or population (e.g. children or elderly).

The report also provides hints at the reasons for such gaps – whether scientific, regulatory, market or healthcare system failures (or combination of these).

Prioritising healthcare needs and gaps

The 2013 Report Priority Medicines for Europe and the World provides a public health based medicines development agenda, based on a systematic methodology for this priority setting. It is an update of the original 2004 Report Priority Medicines for Europe and the World and takes into account changes in global health and pharmaceutical innovation since 2004 - to better address current and future patient needs. 

This latest updated report analyses pharmaceutical innovation from a global public health perspective for Europe and the world, based on the principles of equity and efficiency. For this analysis, four inter-related criteria have been applied to determine priority disease areas of research: 

  • Criterion 1: The estimated European and global burdens of disease;
  • Criterion 2: The common risk factors amenable to pharmacological intervention that have an impact on many high-burden diseases;
  • Criterion 3: The prediction of disease burden trends, based on epidemiological and demographic changes in Europe and the world;
  • Criterion 4: The principle of “social solidarity” applied to diseases for which there are currently no market incentives to develop treatments.

Although a lot has been achieved in preventing or successfully treating certain diseases, with no surprise WHO prioritises conditions such as diabetes, cancer.

Pharmaceutical gaps vs. unmet needs

A gap exists for a disease or condition when: pharmaceutical treatments for that condition will soon become ineffective (e.g. due to resistance); the delivery mechanism or formulation is not appropriate for the target patient group; or when an effective medicine either does not exist or is not sufficiently effective (e.g. lack of basic scientific knowledge or lack of financial incentive due to market failure).

If there is sometimes a mismatch between priorities/unmet needs and what comes to the market, it doesn’t mean that companies are not working in these specific areas. The WHO report points at elements, which make these investments into new prevention and treatments more difficult and less successful today: 

  • The scientific challenges is increasingly complex and often cannot be addressed by the industry alone;
  • There are regulatory hurdles and market failures (with low or no return on investment) that need to be addressed through changes in the legal framework and providing adapted incentives. 

Implementing the recommendations

On the R&D side, EFPIA will use the WHO report as a starting point for the Innovative Medicines Initiative 2, the largest public private partnership in biomedical research.

EFPIA hopes that this report will be used as a starting point for governments to set their healthcare policy priorities, which will provide more long-term certainty for the new prevention and treatments to be used once they are developed.  


About the World Health Organization (WHO)

The World Health Organization (WHO) is the directing and coordinating authority on international health within the United Nations’ system; experts producing health guidelines and standards, helping countries to address public health issues. WHO also supports and promotes health research. Through the WHO, governments jointly tackle global health problems and improve people’s well-being through:

  • Promoting development
  • Fostering health security
  • Strengthening health systems
  • Harnessing research, information and evidence
  • Enhancing partnerships
  • Improving performance 


[1] Absenteeism is a habitual pattern of absence from a duty or obligation. Traditionally, absenteeism has been viewed as an indicator of poor individual performance, as well as a breach of an implicit contract between employee and employer; it was seen as a management problem, and framed in economic or quasi-economic terms. More recent scholarship seeks to understand absenteeism as an indicator of psychological, medical, or social adjustment to work.

[2] Presenteeism is the act of attending work while sick. A topic that is at times considered its opposite, absenteeism, has historically received extensive attention in the management sciences,