An Open Access Collaborative Global Virtual Biorepository System (VBS): A Delphi Consensus

BackgroundThe re-emergence of Zika virus, the novel coronavirus, and new influenza strains highlighted the urgent need for an organized forum to access specimens for advancing research, diagnostics and vaccine development. A Virtual Biorepository System (VBS) was proposed to connect communities and samples, addressing specimen-sharing challenges while promoting inclusion and equity. Aim and ObjectivesTo enable equitable contribution, sharing, and access to specimens while addressing the complexities involved. The objective is to build stakeholder consensus on prioritized actions, tools, and responsibilities to establish a functional and practical VBS. MethodsA Delphi process was conducted online to gather stakeholder input and develop a prioritized action plan for the VBS. Respondents were recruited using snowball sampling, and questions were informed by participatory workshops, feedback, outreach efforts, and discussions to identify gaps and best practices. The Delphi process consisted of two rounds: an initial ranking informed by stakeholder inputs and a second round of refining priorities based on panel feedback. Consensus threshold was defined as [&ge;]70% of responses rating an item [&ge;]4 and excluded if an item had [&le;]15% response or was rated <2 on a 1-5 Likert scale. Advisory board discussions supplemented the virtual process to capture nuances, while qualitative data were analyzed using participatory action research methods. FindingsThe Delphi process identified critical gaps and priorities in biorepository systems. Consensus was reached for 22 out of 30 items. Items 20 of 26 in Round-1, with 2 of 4 additional items in Round-2 where consensus was reached on 2 items addressing benefit-sharing challenges (73%) and prioritizing whole blood, plasma, and serum samples (95%). Respondents overwhelmingly supported a hybrid VBS model combining federated and centralized systems (83%) cost recovery for services (100%) Some respondents suggested an equitable fee structure using a sliding scale to subsidize capacity building in low-and middle-income countries (95%). ConclusionsRespondents strongly supported a VBS to enable equitable access to specimens, services, and benefits. They emphasized the need for clarity on benefit-sharing, regulatory, and ethical frameworks to ensure effective implementation and global inclusivity. A fair and equivalent system to enhance participation and operational continuity is being discussed.