At the same time, given the unique obstacles to achieving global STI control for most existing interventions, innovative biomedical solutions are also critical. Validating new rapid diagnostic tests for curable STIs, evaluating new drug regimens for gonorrhea, and testing new microbicides against STIs will be extremely valuable, but these interventions may not fully solve long-term barriers to STI control. Thus, continued advancement

of STI vaccines is crucial for sustainable global STI prevention and control. We report no conflicts of interest. Drs. Newman and Broutet are staff members of the World Health Organization. The authors alone are responsible for the views expressed in this article and they do not necessarily represent the decisions or policies of the World Health Organization. The findings and conclusions

of this report are those of the authors and do not necessarily represent the official position Galunisertib in vitro of the Centers for Disease Control and Prevention. The authors wish to thank Janet Petitpierre for her assistance with the figures. “
“Cost effective vaccination against sexually transmitted infections (STI) is available today in the form of hepatitis B [1] and human papilloma virus vaccination [2] and [3], but whether future vaccines can also be as cost effective will depend on a range of different factors. These factors include: (1) the cost of the disease; (2) the price of the vaccine; (3) the efficacy or effectiveness of the vaccine; (4) the population requiring immunization;

(5) the organization required KU-57788 order to provide access to the vaccine; and (6) any alternative interventions against which vaccination has to be measured. STIs comprise very different organisms grouped according to their route of transmission, with great differences in clinical course and in distribution of infection and disease. These differences include the severity of disease, the duration of infection, the generation of naturally acquired immunity until and pattern of spread, all of which play a role in determining how cost effective an STI vaccine could be. In deciding about the use of resources cost effectiveness analyses allow us to compare the merits of alternative interventions [4]. Models which include the transmission of infection also allow us to explore the potential impact of STI vaccines in different epidemiological contexts and for different vaccine characteristics [5] and [6]. In this paper, insights from modeling the impact of STI vaccination are discussed as a guide to thinking about the future development and delivery of STI vaccines. The influence of infection and vaccine characteristics on this impact are explored along with the potential design of programs. Finally, illustrative cost-utility analyses are provided for HSV-2 vaccination in the US. A summary of the major STIs, the diseases they cause, available treatments and relative prevalence is provided in Table 1[7].