Table 9.

Overview of expectations of evidence that are likely to be required to support a global / regional / national policy recommendation or financing for gonococcal vaccines.

Parameter for policy/financing consideration	Assumptions/considerations
Vaccine safety and efficacy	Vaccines will need to be shown safe and efficacious in clinical trials [7].
Vaccine impact on antibiotic use and AMR	Demonstrating vaccine impact in reducing antibiotic prescribing and/or AMR-strains in post-introduction observational studies would facilitate policy and financing decisions [97,128,131].
Global, regional, and (where feasible) national gonorrhoea-associated disease burden data	Global and regional infection estimates exist; however, disease burden estimates will be important in influencing policy and financing discussions [1].
Global, regional, and (where feasible) national data on gonococcal AMR	Global AMR surveillance is ongoing but could be expanded to reach more countries, particularly LMICS. Increasing AMR could greatly influence policy decisions [67].
Favourable cost-effectiveness	Several modelling studies have demonstrated the potential impact of gonococcal vaccines. however, further work is needed on cost-effectiveness in different epidemiologic scenarios. Countries will be more likely to take up vaccines if cost-effectiveness analyses show favourable value for money [126,130].
Product price acceptable to Gavi investment case for use in Gavi-eligible countries	LMICs that are Gavi eligible will apply for the use of gonococcal vaccines only if Gavi support is available.