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Tue 28 Jun 2011
Posted by Susan MacMillan under Africa, Animal Diseases, Asia, Biotech, Biotechnology, Caribbean, Cattle, Disease Control, Event, ILRI, Kenya, Latin America, PA, Somalia, Spotlight, Staff, Vaccines
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At the 79th General Session of the United Nations World Organisation for Animal Health (OIE), in Paris in May 2011, ILRI’s Jeff Mariner (second from right) stands among a group of distinguished people heading work responsible for the eradication of rinderpest, a status officially declared at this meeting (image credit: OIE).
Several world bodies are celebrating what is being described as ‘the greatest achievement in veterinary medicine’: the eradication of only the second disease from the face of the earth.
The disease is rinderpest, which means ‘cattle plague’ in German. It kills animals by a virus—and people by starving them through massive losses of their livestock.
‘In the nineteenth and twentieth centuries,’ reports the United Nations Food and Agriculture Organization (FAO), ‘the disease devastated parts of Africa, triggering extensive famines. . . . After decades of efforts to stamp out a disease that kept crossing national borders, countries and institutions agreed they needed to coordinate their efforts under a single, cohesive programme. In 1994, the Global Rinderpest Eradication Programme (GREP) was established at the UN Food and Agriculture Organization (FAO), in close association with the World Organization for Animal Health (OIE).
‘Excellent science, a massive vaccination effort, close international coordination and the commitment of people at all levels have helped make rinderpest eradication possible.
‘On June 28, 2011, FAO’s governing Conference will adopt a resolution officially declaring that rinderpest has been eradicated from animals worldwide. The successful fight against rinderpest underscores what can be achieved when communities, countries and institutions work together.’
Australian Peter Doherty, 1996 winner of the Nobel Prize for Medicine who served on the board of trustees of the International Laboratory for Research on Animal Diseases (ILRAD), a predecessor of ILRI (photo credit: published on the Advance website).
Australian Peter Doherty, an immunologist who is the only veterinarian to win the Nobel Prize, for Physiology or Medicine, in 1996, and who served as chair of the board of trustees research program of the International Laboratory for Research on Animal Diseases (ILRAD), a predecessor of the International Livestock Research Institute (ILRI), is attending the FAO ceremonies this week. In an interview with FAO, he said:
Vaccine research is currently a very dynamic area of investigation and with sufficient investment and the enthusiastic participation of industry partners at the “downstream” end, we can achieve even better vaccines against many veterinary and human diseases.
The Washington Post in May reported that ‘the World Organization for Animal Health, at its annual meeting in Paris on Wednesday, accepted documentation from the last 14 countries that they were now free of rinderpest. The organization, which goes by its French acronym, OIE, was started in 1924 in response to a rinderpest importation in Europe.
‘The most recent recorded outbreak occurred in Kenya in 2001. Much of the past decade has been spent looking for new cases, in domesticated animals and in the wild, wandering herds of ungulates, or hoofed animals, in East Africa. The last place of especially intense surveillance was Somalia, where the final outbreak of smallpox occurred in 1977.
‘“There are a huge number of unsung heroes in lots of countries that made this possible,” said Michael Baron, a rinderpest virologist at the Institute for Animal Health in Surrey, England. “In most places, they were ordinary veterinary workers who were doing the vaccination, the surveillance, the teaching.”
‘Three things made rinderpest eradicable. Animals that survived infection became immune for life. A vaccine developed in the 1960s by Walter Plowright, an English scientist who died last year at 86, provided equally good immunity. And even though the virus could infect wild animals, it did not have a reservoir of host animals capable of carrying it for prolonged periods without becoming ill.
‘In 1994, the FAO launched an eradication program that was largely financed by European countries, although the United States, which never had rinderpest, also contributed money. The effort consisted of massive vaccination campaigns, which were made more practicable when two American researchers made a version of the Plowright vaccine that required no refrigeration. . . .’
One of those researchers was Jeffrey Mariner, now working at ILRI, in Nairobi, Kenya. Mariner also helped in surveillance work ‘with a technique called “participatory epidemiology” in which outside surveyors meet with herdsmen and ask open-ended questions about the health of their animals and when they last noticed certain symptoms.
‘“It was local knowledge that really helped us trace back the last places where transmission occurred—sitting down underneath a tree in the shade, listening to storytelling,” said Lubroth, of the FAO. . . .’
Read the whole article in the Washington Post, Rinderpest, or ‘cattle plague,’ becomes only second disease to be eradicated, 27 May 2011.
Read FAO’s interview of Peter Doherty: Healthier animals, healthier people, June 2011.
Thu 28 Oct 2010
Tom Olaka, a community animal health worker in Karamajong, northern Uganda, was part of a vaccination campaign in remote areas of the Horn of Africa that drove the cattle plague rinderpest to extinction in 2010 (photo credit: Christine Jost).
A superb example of why technical breakthroughs matter is reported in the current issue (22 October 2010) of the leading science journal, Science.
The eradication of rinderpest from the face of the earth, probably the most remarkable achievement in the history of veterinary science, is a milestone expected to be announced in mid-2011 pending a review of final official disease status reports from a handful of countries to the World Organisation for Animal Health.
A plague of cattle and wild ungulates, rinderpest would not have been eradicated without such a technical breakthrough. This was the development of an improved vaccine that did not require a 'cold chain' and thus could be administered in some of the most inhospitable regions in the Horn of Africa, where the virus was able to persist due to lack of vaccination campaigns in these hotspots.
Rinderpest is a viral livestock disease that has afflicted Europe, Asia and Africa for centuries. It killed more than 90 per cent of the domesticated animals, as well as untold numbers of people and plains game, in Africa at the turn of the 19th century, a devastation so complete that its impacts are still felt today, more than a century later. The last-known outbreak of rinderpest occurred in Kenya in 2001.
The key technical breakthrough in this effort involved development of an improved vaccine against rinderpest. The original vaccine was developed at the Kenya Agricultural Research Institute (KARI) laboratories. In 1990, Jeffrey Mariner, a veterinary epidemiologist who at that time was at the Tufts Cummings School of Veterinary Medicine and working with the Africa Union-Inter-African Bureau for Animal Resources (AU-IBAR), improved the vaccine by producing a thermostable version that did not require refrigeration up to the point of use. This allowed vets and technicians to backpack the vaccine into remote war-torn areas, where vet services had broken down and international agencies dared not send personnel. The AU-IBAR led the Pan-African Rinderpest Campaign, which coordinated the efforts that resulted in the eventual eradication of rinderpest from Africa.
Now working in the Nairobi laboratories of at the International Livestock Research Institute (ILRI), Mariner says that just as important as this technological advance was getting the development community to begin to address how people work together. Mariner and his colleagues at AU-IBAR themselves took three innovations as lessons from the rinderpest eradication campaign: (1) community-based vaccination programs, (2) participatory surveillance systems based on local knowledge, and (3) optimized control strategies that target high-risk communities through.
‘We must examine issues from the perspective of each group of stakeholders involved and visualize how proposed changes would affect them,’ says Mariner. ‘The power relationships of the groups also need to be considered. Advocates for change must then craft a new vision for how the various stakeholder groups will function that is sufficiently exciting to get people to risk change.’
Excerpts from the Science article, by Dennis Normille, follow.
'Rinderpest, an infectious disease that has decimated cattle and devastated their keepers for millennia, is gone. The United Nations Food and Agriculture Organization (FAO) announced on 14 October in Rome that a 16-year eradication effort has succeeded and fieldwork has ended.
'“This is the first time that an animal disease is being eradicated in the world and the second disease in human history after smallpox,” FAO Director-General Jacques Diouf said in his World Food Day address in Rome the next day.
'“It is probably the most remarkable achievement in the history of veterinary science,” says Peter Roeder, a British veterinarian involved with FAO’s Global Rinderpest Eradication Programme (GREP) from its launch in 1994 until he retired in 2007. For the veterinarians who participated in the effort, the achievement is particularly poignant. . . .
'One formality remains: The Paris-based World Organisation for Animal Health (OIE) still must complete the certification of a handful of countries as rinderpest free. OIE is likely to adopt an official declaration recognizing the demise of the disease at its May assembly. Meanwhile, animal-disease fighters have already been applying lessons learned from the rinderpest campaign and pondering which animal disease might be the next target for eradication.
'Although nearly forgotten in much of the West, as recently as the early 1900s, outbreaks of rinderpest—from the German for “cattle plague”—regularly ravaged cattle herds across Eurasia, often claiming one-third of the calves in any herd. The virus, a relative of those that cause canine distemper and human measles, spreads through exhaled droplets and feces of sick animals, causing fever, diarrhea, dehydration, and death in a matter of days. It primarily affects young animals; those that survive an infection are immune for life.
'When the virus hit previously unexposed herds, the impact was horrific. In less than a decade after the virus was inadvertently introduced to the horn of Africa in 1889, it spread throughout sub-Saharan Africa, killing 90% of the cattle and a large proportion of domestic oxen used for plowing and decimating wild buffalo, giraffe, and wildebeest populations. With herding, farming, and hunting devastated, famine claimed an estimated one-third of the population of Ethiopia and two-thirds of the Maasai people of Kenya and Tanzania. . . .
'In 1994, when rinderpest was entrenched in central Africa, the Arabian Peninsula, and a swath stretching from Turkey through India and to Sri Lanka, FAO brought together three regional rinderpest-control programs into GREP and set the goal of eliminating the disease by 2010. . . .
'The key technical breakthrough was the recognition that the virus was re-emerging from just a handful of reservoirs that could be the targets of intensive surveillance and vaccination campaigns. In 1990, Jeffrey Mariner, then at Tufts University School of Veterinary Medicine (now the Cummings School of Veterinary Medicine), had developed an improved vaccine that did not require refrigeration up to the point of use. This allowed vets and technicians to backpack vaccine into remote areas. One of the reservoirs was in the heart of war-torn eastern Africa, where vet services had broken down and international agencies dared not send personnel. GREP relied on local pastoralists to track the disease and on trained community animal health workers to administer the vaccine to quell outbreaks.
'. . . The virus was last detected in 2001 in wild buffaloes in Meru National Park in Kenya, on the edge of the Somali ecosystem.
'What comes next? Some veterinary experts question whether the international community is ready to take on another massive eradication campaign, but one disease mentioned as a possible eradication target is peste des petites ruminants (PPR), which is highly contagious and lethal among sheep and goats. Related to the rinderpest virus, the PPR virus has long circulated in central Africa, the Middle East, and the Indian subcontinent and has recently spread to Morocco. . . .'
ILRI's Jeff Mariner is now working on an improved vaccine for this disease.
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Read the whole article at Science (registration needed to read the full article): Rinderpest, deadly for cattle, joins smallpox as a vanquished disease, 22 October 2010.
To find out what the eradication of rinderpest means for livestock farmers around the world, listen to the following interview featuring John McDermott, ILRI's deputy director general.
Fri 22 May 2009
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To get serious about controlling emerging human disease, we're going to have to get serious about understanding and controlling their origin in animal disease, often in developing countries |
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As the world's governments raced to deal with a looming flu pandemic starting some two weeks ago, in late April 2009, World Health Organisation (WHO) officials confirmed that the world is better prepared than ever before to deal with a pandemic, thanks largely to six years of research and preparations to battle bird flu and SARS. Nearly 150 countries are now known to have drawn up contingency plans covering everything from the response of health services to travel restrictions and international co-operation.
Although it contains animal genetic components, the current influenza A(H1N1) virus has not been diagnosed in animals before and has spread from person to person, threatening an influenza pandemic which, according to scientists, is inevitable, even though no one can predict the timing. Three serious influenza pandemics occurred in the 20th century, with each new virus eventually infecting up to a third of the world over the course of one to two years: the 1918 ‘Spanish flu’ responsible for more than 40 million deaths, followed by the 1957 ‘Asian’ and 1968 ‘Hong Kong flu’, which killed between 1 and 3 million people worldwide,
The history of flu epidemics and pandemics, which can be traced back with some accuracy for the past 300 years, tells us that outbreaks occur somewhere in the world in most years and pandemics, which are epidemics that spread worldwide, at 10- to 50-year intervals. Despite influenza and its causative organism being the most studied of viral diseases and pathogens until the advent of HIV/AIDS two decades ago, little has been done in the past century to change the pattern of influenza infections.
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2009 June 11 Swine flu update:
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WHO on 11 June raised the pandemic alert level from phase 5 to 6, indicating a global pandemic outbreak
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This will trigger drug makers to speed production of a swine flu vaccine and prompt governments to devote more money to containing the virus.
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Although appearing less deadly than seasonal flu, experts worry the virus could mutate into a more lethal strain during the Southern Hemisphere’s coming flu season.
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Experts also worry that poorer countries could be overwhelmed with cases they do not have the capacity to treat.
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The last pandemic, the Hong Kong flu of 1968, killed 700,000 people worldwide. Ordinary flu kills 250,000 to 500,000 people each year
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11 May 2009 brief from the World Health Organisation
For more information, we encourage our readers to read the WHO brief copied below and linked to here:
http://www.who.int/csr/disease/swineflu/assess/disease_swineflu_assess_20090511/en/index.html
This WHO brief of 11 May 2009 provides much useful background information for understanding expert concerns about the current new flu virus, particularly how it may affect the developing countries of the southern hemisphere, where the flu season is about to begin. These expert concerns include the following.
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The influenza A(H1N1) could mutate into a more lethal form in a subsequent wave of this pandemic, as the virus causing the 1918 pandemic flu did.
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Having not appeared in humans or animals before, scientists anticipate that pre-existing immunity to the virus will be low or non-existent, or largely confined to older population groups that have had flu vaccinations and therefore striking down more people of a younger age group, than viruses causing normal so-called 'seasonal flu'.
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This new flu virus, although as yet causing generally mild illness in the 29 countries outside Mexico where it has so far been confirmed, could cause severe illness in developing countries, particularly:
• people suffering malnutrition
• poor communities with inadequate health care
• the greatly increased numbers of people now afflicted with chronic conditions such as heart disease and diabetes, conditions that can greatly increase the severity of illness this flu causes (although these chronic conditions afflicted mostly affluent populations until a few decades ago, a full 85% of people suffering them today live in low- and middle-income countries)
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As this new influenza A(H1N1) virus spreads to the southern hemisphere with the start of the flu season here, it may meet the H5N1 bird flu virus that is widely circulating among the poultry populations of some developing countries; no one knows how, under pressure of the new A(H1N1) human-to-human transmitted flu virus, the H5N1 bird-to-bird transmitted flu virus might change, including whether the latter, more lethal, bird flu virus could be helped to mutate into a form transmitted easily among people. (The more lethal H5N1 bird flu virus, now endemic in many areas, has thankfully to date been transmitted only rarely directly from person to person; almost all the people infected have received the virus from handling infected poultry, which has helped keep the virus from spreading widely among human populations.)
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11 May 2009 Update
11 May 2009 Update As reported in Time Magazine this week (11 May 2009), ‘new research suggests that the WHO acted wisely in raising the pandemic alarm — and that the threat of H1N1 may not have passed. In a study released May 11 in the journal Science, researchers from Imperial College London, along with WHO staff and Mexican scientists, conclude that H1N1 is transmitted considerably easier than the regular seasonal flu and is about as deadly as the 1957 Asian flu, which killed about 2 million people worldwide. A World Bank study last year found that a pandemic of similar severity today might kill 14.2 million people around the world, and cut 2% from the global economy.’
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7 May 2009 Update
As of 7 May 2009, there were 2,371 confirmed cases of swine flu in 24 countries and 46 deaths from this infection, all but 2 of the deaths occurring in Mexico. Scientists described 11 cases of Americans who were infected before the current outbreak with swine flus that partly matched the new epidemic strain that emerged in Mexico in March 2009. The first case was in December 2005. In articles published online in The New England Journal of Medicine, virologists from the US Centers for Disease Control and Prevention (CDC) described those cases, most of them in young people in the Midwest who touched or were near pigs. All had a ‘triple reassortant’ virus that combined human, swine and avian flu genes. The H1N1 flu now spreading out from Mexico also has those genes, as well as genes from Eurasian swine. The CDC reports that the pandemic does not appear to be petering out, that we appear to be still on the upswing of the epidemic curve, and that only about 10% of those infected had a travel history to Mexico.
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The role of livestock scientists in the developing world
Livestock scientists have a vital role to play in helping to predict, prevent and control zoonotic diseases, which are all those transmitted between animals and people. Remarkably, zoonoses make up more than 60% of all human infectious diseases and more than 70% of all emerging infectious diseases. These diseases occur most frequently in Asia and Africa, where limited resources hinder both surveillance and response. The growing threat of emerging diseases such as Nipah and SARS, and re-emerging diseases such as Rift Valley Fever and avian influenza, has served as a wakeup call to animal health and public health services that their collaboration is necessary if these threats are to be minimized. There is increasing recognition that, for a number of zoonotic diseases, the most effective way to protect the health of the public is to control disease in the animal host.
The work of livestock scientists working in and for developing countries has special relevance in tackling these animal-human diseases, because within developing countries today, fast changes in food systems wrought by skyrocketing demand for, and production of, livestock foods is creating new niches and transmission pathways for pathogens, with unprecedented numbers of diseases emerging and re-emerging in recent decades. New tools and approaches for managing diseases in developing countries are urgently needed.
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The animal-human disease interface
Most pathogens (61%) that affect people also affect animals; such shared infecting organisms and infections are known as ‘zoonotic’. A full 71% of all the world’s emerging infectious diseases are zoonotic, or transmissible between people and animals. In addition to swine flu, bird flu and SARS, these diseases include such devastating plagues as BSE (mad cow disease), HIV/AIDS, ebola and Rift Valley fever. The bugs that cause these diseases are notorious for their ability to evolve. Flu viruses, for example, can change both from severe to mild and from mild to severe.
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Researchers at ILRI have been working at the livestock-human disease interface, supporting better integration of veterinary and public health surveillance programs, for three decades. ILRI’s particular interests are aspects of zoonotic diseases that impact the world’s poorest communities, where animal husbandry is a way of life and a central means of livelihood for more than half a billion people. ILRI and its partners, for example, make evidence-based assessments of the different impacts on the poor of employing different disease-control methods, thereby helping policymakers determine optimal pro-poor strategies for different regions and agricultural production systems of the developing world.
ILRI works with many research institutions within developing countries to better control zoonotic diseases at local, national and regional levels. It works with WHO and its international network of institutions to bolster disease surveillance. It works with the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO) on participatory epidemiology, a grassroots approach to disease surveillance and control that is being successfully applied in the battle against bird flu in Indonesia. And it works with regional agencies such as the Africa Union / Inter-African Bureau for Animal Resources to improve laboratory testing and diagnosis of bird flu and other infectious livestock diseases.
ILRI and its partners are also investigating risk-based approaches that focus on key hazards and maximize benefits with available resources. With case studies in Africa and Asia, and concepts derived from ‘one medicine’ and ‘one health’, ILRI scientists argue that a ‘risk-analysis framework’ both can and should be extended to integrate risks to animal, human and environmental health.
The role of policy
ILRI also works with the International Food Policy Research Institute (IFPRI) and other institutions on providing evidenced-based policy support so that we don’t fall into the trap of doing more harm than good in our efforts to control infections, particularly in poor countries which can least afford such mistakes.
Some of the most profound consequences of disease threats are economic rather than medical, with inappropriate policies devastating local and national economies. Egypt’s on-going culling of its entire population of some 300,000 pigs, for example, is reported to be reigniting religious and economic tensions, and may end up doing more harm than good. The pigs are kept not by Egypt’s majority Muslim population, which views the animals as unclean, but by Egypt’s Coptic Christians, many of whom maintain pigs on the rubbish heaps of shantytowns, where entire families pick out organic waste to feed their pigs. On the other hand, Egyptian authorities may be trying to prevent a repeat of events two years ago, when they were criticized for not responding swiftly enough to an outbreak of bird flu, which killed 26 people in the country, three in just the last month.
‘Misconceptions and inappropriate responses can spread quickly during the early stages of a new disease outbreak,’ says John McDermott, a veterinary epidemiologist and ILRI’s director of research. ‘This “swine flu” is spread by people, not by pigs,’ he said. ‘So most authorities are appropriately focusing their current attention on stopping the spread of swine flu among people.’ (Bird flu, in contrast, is spread by birds, so authorities focus on controlling that disease within poultry rather than human populations.) This new swine flu virus, and our reactions to it, like the more lethal bird flu and SARS before it, should provide us with many lessons for the future.
Research gaps
We still know little about the nature of this new influenza virus strain, other than its genetic makeup is a ‘mashup’ of human, bird and pig elements (making the name ‘swine flu’ something of a misnomer we shall probably have to live with; ‘Spanish flu’ didn’t originate in Spain, but the name stuck anyhow). We don’t know yet when it first made the jump from pig to person, why it has been so deadly in Mexico but not elsewhere, or how virulent it will eventually prove to be. The pathogenicity of a virus can become milder or more severe over time. Until now, the influenza A(H1N1) virus thankfully has proven relatively mild, with most of those infected responding well to usual flu treatments and recovering.
Our ignorance of this new strain of swine flu virus is partly due to our neglect of animal health matters. In rich as well as poor countries, veterinary health care and research remains chronically under-funded. And there is increasing need for disease control policymakers, agents and researchers to collaborate at the interface of the human-and-animal-health sectors, exchanging up-to-date information on disease outbreaks and transmission.
Controlling emerging infectious diseases
‘To get serious about preventing new zoonotic infections from spreading,’ says Carlos Seré, director general of the Africa-based International Livestock Research Institute (ILRI), ‘we need to get serious about veterinary resources. We need new ways to look for new pathogens infecting animals, new ways to assess those which may be most dangerous, and new ways to determine how they may be transmitted to people. We have just had a demonstration as to the danger of waiting for a new flu to emerge and begin spreading among people before trying to contain it.’
The influenza A(H1N1) virus is spreading rapidly because in our ever-shrinking, ever-globalizing world, pathogens are crossing species and borders with increasing ease. In such a world, says Seré, ‘we ignore veterinary health problems in developing countries at our peril.’ With high-quality collaboration among countries (rich and poor alike), scientific disciplines (e.g. socio-economics as well as genetics), and sectors (e.g. medical, veterinary, agricultural, environmental, wildlife), Seré argues, we can manage today’s emerging disease threats.
Because animals are the origin of most emerging diseases, they could play the same role that canaries did in the mines, in that case, alerting the coal workers to the presence of noxious gases or too little oxygen.
‘We should be spotting many infectious disease threats not in people, as we did in the case of this new flu virus,’ says Seré, ‘but rather in animal populations.’ That should give authorities more time to design and implement interventions to protect people from becoming infected. ‘But as we’ve seen in recent outbreaks of bird flu and Rift Valley fever, all too often it is people rather than animals that serve as our sentinels, sickening and dying after the disease has begun circulating in local livestock populations.’ That’s largely because in poor countries, livestock diseases tend to go unreported (it’s hard to tell one livestock disease from another in countries with spotty veterinary coverage) and/or underappreciated (people facing serious human health problems have little time to spare worrying about animal diseases), and/or ignored (it may be considered political suicide to report a disease outbreak that might have large economic consequences).
‘To find better ways of controlling human diseases,’ Seré concludes, ‘we’re going to have to find better ways of understanding and controlling diseases in both domesticated and wild animal populations. And we’re all going to have to work together, breaking down traditional barriers between organizations and scientific disciplines in the process. We need new thinking to tackle these new threats. And bringing diverse expertise together is the best way of staying on top of fast-evolving situations that threaten our global public health—as well as the well being of the world’s poorer livestock keeping communities.’
For more information contact
John Mc Dermott
Deputy Director General-ILRI
Nairobi, Kenya
Email: j.mcdermott@cgiar.org
Telephone: +254 20 422 3207
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Tue 26 Feb 2008
The Scientific and Technical Review features ‘participatory epidemiology’ – a customer-oriented approach to disease control and surveillance that is being successfully applied in the battle against bird flu in Indonesia.
The latest issue of the World Animal Health Organization’s (OIE) Scientific and Technical Review contains 21 articles submitted by experts from all over the world describing different animal disease surveillance, control and elimination strategies, including an article on ‘participatory epidemiology’ for the control of deadly animal diseases.
Participatory epidemiologists rely on local knowledge to gather data on how disease is spreading, kept in circulation, and which diseases have most impact on livelihoods, from the perspectives of those affected. This ‘customer-oriented’ approach is throwing up surprises and proving to be working well for a variety of diseases that have big implications for animal health and veterinary public health worldwide.
The authors of the paper, ‘Participatory epidemiology in disease surveillance and research’, from the International Livestock Research Institute (ILRI), Food and Agriculture Organization of the United Nations (FAO), Ministry of Agriculture, Jakarta and United States Agency for International Development (USAID), summarise current field applications of participatory epidemiology and highlight lessons learned, future challenges and possible new areas for research. They argue that with the increasing international focus on emerging and re-emerging zoonotic diseases (animal to human transmitted), there is an urgent need for better integration of veterinary and public health surveillance programmes.
New approaches to new and old diseases
Traditionally, veterinary authorities and scientists approach disease outbreaks by making expert diagnoses and devising control solutions, with little involvement or consultation with the farmers affected. Participatory epidemiologists work differently and livestock keepers play a central role as key informants.
ILRI’s participatory epidemiologist, Christine Jost explains, ‘Participatory epidemiologists understand the importance of tapping into local knowledge and encouraging the participation of people affected. By involving local livestock keepers, we can gather valuable data on how disease is spreading and kept in circulation.
‘In poor countries there is often a lack of detailed information on disease outbreaks and prevalence. This is largely due to a lack of veterinary infrastructure, and also because there are typically many remote and isolated communities that are hard to reach. Even when there is some infrastructure in place, many authorities assume that farmers will come to their offices to report diseases. However, farmers would have to travel long distances to reach veterinary posts and incur significant costs when reporting disease problems. Thus it is very difficult to assess the real disease situation and the impacts of animal diseases on livelihoods.’
‘We go out into local communities and we talk to villagers. Local livestock keepers are critical in helping us establish livestock disease prevalence, symptoms, recent outbreaks, and also the impacts of different animal diseases from their perspectives. This approach is very much community centred and ‘customer-oriented’, says Jost.
Country experiences
This customer-oriented approach has thrown up some surprises which and reinforced the importance of actively involving local livestock keepers in disease control and surveillance plans and assessing disease priorities.
In Pakistan, authorities had previously thought that Foot and Mouth disease had the most important economic impact on farmers. However, participatory epidemiologists found that most farmers could cope with production losses from Foot and Mouth disease, but they could not cope with the impact of haemorrhagic septicaemia. These farmers took a more holistic view and considered risks and coping mechanisms, alongside economic impacts, when they prioritised diseases. This resulted in a rethinking of how diseases were prioritised by authorities.
In Indonesia, participatory epidemiologists, highlighted the true extent of bird flu. The avian influenza programme was first implemented in Indonesia in 2006 as a pilot programme and this has been rapidly expanded. When the programme was initiated, the extent of bird flu infection was not known. However, participatory epidemiologists found that bird flu was circulating unimpeded in backyard poultry, and within the first 12 months of operation, 800 disease events were detected. The large number of outbreaks detected overwhelmed the response capacity of the district animal health infrastructure, and led to recognition of the need to re-evaluate the national control strategy.
In Kenya, ILRI participatory epidemiologist, Jeff Mariner, led a multi-disciplinary team of participatory epidemiologists, economists and social scientists who assessed the impacts of the recent Rift Valley fever outbreak (a total of 684 human cases including 155 deaths of RVF were reported in Kenya between November 2006 and March 2007). This United States Agency for International Development (USAID) funded project generated some surprising results. One of the key findings was the importance of monitoring livestock owners’ local observations in early warning systems for preventing future outbreaks of the disease. The team is now about to start a follow-on project, contracted by FAO with USAID funds, to apply those lessons to Tanzania, and to develop guidelines for government decision-makers in Kenya and Tanzania so that they can have policies that more effectively take into consideration livestock owners’ knowledge for Rift Valley Fever prevention and control.
The future
While veterinary participatory epidemiology approaches are proving to be working well for various diseases, the authors of the Review paper argue that with the increasing international focus on emerging and re-emerging zoonoses, there is a need for better integration of animal health and public health surveillance programmes.
Traditionally, there is little collaboration or sharing of information between the veterinary and public health sectors. However, in Indonesia, the two sectors are now working together and applying participatory approaches in the fight against bird flu. Veterinary participatory disease surveillance is being used to target participatory public health surveillance to the most at-risk human populations – those whose poultry are experiencing outbreaks of active disease.
ILRI is also involved in another project in Indonesia, which commenced in August 2007. This is being funded by USAID.
According to Jeff Mariner, ‘This project focuses on different applications of participatory epidemiology methods in research.
‘We are testing the impact of alternative avian influenza disease control strategies on disease incidence, as well as testing the feasibility of various control options from an operational and livelihoods viewpoint’ says Mariner.
Mariner, Jost and colleagues are also involved in a pan-African project – Participatory Approaches to Disease Surveillance in Africa (PADSA) – which began in October 2007. The project, scheduled to be completed in two years, involves research to evaluate and apply participatory risk-based approaches to bird flu surveillance and to document lessons learned.
Need for veterinary and public health to work more closely together
The authors of the Review paper argue for the need for veterinary and public health to work more closely together and to apply participatory approaches. They make the following recommendations:
- Expand the field of participatory public health through active research to identify public health surveillance and response gaps that can be filled using participatory methods.
- Provide advocacy for policies that recognise veterinary services as integral to public health.
- Devise innovative ways to integrate participatory disease surveillance workers and participatory public health practitioners in the field; and
- Create effective models for integrating public health and veterinary surveillance, including the development of unified ‘public health’ databases.
One step forward has been the establishment of the Participatory Epidemiology Network for Animal and Public Health. Its purpose is to advance the science of participatory epidemiology through targeted research, capacity building, policy enhancement and practitioner education. The network is coordinated by ILRI and includes FAO, OIE, AU-IBAR, and nongovernmental organisations experienced in participatory epidemiology methods.
Article citation
Article reference: CC Jost, JC Mariner, PL Roeder, E Sawitri and GJ Macgregor-Skinner (2007). Participatory epidemiology in disease surveillance and research. Scientific and Technical Review. Volume 26 No 3. The Office International des Epizooties (OIE). pp 537-547. http://www.oie.int/doc/ged/D4693.PDF
Linked articles
Controlling bird flu in Indonesia through local knowledge ILRI news April 2007: http://www.ilri.org/ilrinews/index.php/archives/494
Further information:
Christine Jost
Veterinary Epidermiologist
International Livestock Research Institute (ILRI)
Nairobi, Kenya
Email: c.jost@cgiar.org
Telephone: +254 (20) 422 3435
OR
Jeff Mariner
Veterinary Epidemiologist
International Livestock Research Institute (ILRI)
Nairobi, Kenya
Email@ j.mariner@cgiar.org
Telephone: +254 (20) 422 3432
Tue 17 Apr 2007
| A major new report launched today charts a pathway towards the effective control of foot-and-mouth disease (FMD) in developing countries where the disease is a serious and growing threat. |
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| The report, ‘Global Road Map for Improving the Tools to Control Foot-and-Mouth Disease in Endemic Settings’, launched today (17 April 2007) at the headquarters of the United Nations Food and Agriculture Organization (FAO), in Rome, envisions ‘a world in which livestock-based livelihoods, enterprises and trade can flourish unimpeded by FMD’. The road map focuses on the outputs of a workshop held in Agra, India, in December 2006.
Efficacious vaccines, strategically deployed, have revolutionized control of many infectious human and animal diseases. For FMD, which severely constrains the welfare of millions of small-scale livestock farmers in the developing world, currently available vaccines do not meet many of the basic requirements necessary for sustainable control. FMD continues to be a persistent constraint to livestock production throughout the developing world. It can significantly reduce production of milk and meat and limits the ability of draft animals to work.
| Foot-and-Mouth Disease (FMD): Quick Facts
Foot-and-mouth disease (FMD) affects cloven-hoofed animals and is one of the most contagious diseases of mammals, with great potential for causing severe economic loss. FMD is endemic in parts of Asia, Africa, the Middle East and South America.
Hosts: Principally cattle, domestic buffaloes, yaks, sheep, goats, domestic and wild pigs and wild ruminants.
Transmission: Direct or indirect contact; animate vectors (humans, etc.); inanimate vectors (vehicles, implements); airborne, especially in temperate zones (up to 60 km overland and 300 km by sea).
Sources: Incubating and clinically affected animals; breath, saliva, faeces, and urine; milk and semen; meat and by-products and carriers, particularly cattle and water buffalo; convalescent animals and exposed vaccinates (virus can persist for up to 30 months in cattle or longer in buffalo, 9 months in sheep).
Source: Excerpted from World Organisation for Animal Health (OIE) Animal Diseases Data www.oie.int
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According to John McDermott, deputy director general for research at the International Livestock Research Institute (ILRI), ‘FMD is a major obstacle to productivity and market access in many of ILRI’s target regions, particularly South Asia, the Horn of Africa and southern Africa. It severely limits market opportunities for poor farmers and nations wishing to access more lucrative markets, both regionally and internationally.
‘FMD also can increase the vulnerability of small-scale farmers in mixed cropping systems where animal traction is important. For example, in Southeast Asia where rice is a staple, people are heavily reliant on water buffalo for ploughing. A FMD outbreak leaves the buffalo open to secondary infections, putting these highly valued animals out of action for a very long time.’
Brian Perry, who recently retired as senior scientist at ILRI and is now collaborating with ILRI on this and other projects, says, ‘There is an urgent and long overdue need to address the special research needs of poor people in endemic FMD settings. Current research on vaccines and associated tools for the control of FMD is driven more by the needs of relatively rich FMD-free countries which are dealing with and eliminating incursions of the disease, rather than by the needs of relatively poor FMD-endemic countries which are interested in longer-term management and control of the disease.’
In early 2006, Perry, ‘navigator’ of the FMD ‘Roadmap’ process, approached the Wellcome Trust (UK) to seek support for an initiative to tackle this need. Following submission of a joint proposal from ILRI and the UK’s Institute for Animal Health (IAH), the Wellcome Trust (UK) agreed to provide partial funding and, with the support of additional donors—notably the European Union—planning was begun to organize the meeting that became the launch pad of the ‘Global Road Map for Improving the Tools to Control Foot and Mouth Disease in Endemic Settings’.
‘We decided at an early stage that the road map workshop should be held in an FMD-endemic country’, says Keith Sones, workshop facilitator and co-editor of the report. ‘India, with its impressive and ambitious ongoing program to control FMD, was an obvious choice. The Indian Council of Agricultural Research (ICAR) was very supportive and agreed to host the workshop in Agra.’
According to VK Taneja, deputy director general of animal scrence at ICAR, ‘Livestock production in India is growing faster than arable agriculture. The value of output from the livestock sector has risen over the years and is now 26% of the total value of output from agriculture. It is predicted that livestock will contribute more than half of the total agricultural output in the next 25–30 years.’
‘One of the biggest impediments to growth of the livestock sector is the large-scale prevalence of FMD’, says Taneja. ‘In most Asian countries, FMD is endemic and severely limits the region’s ability to participate in international trade. Developmental strategies for control and eradication of FMD—including improving existing conventional vaccines and diagnostics for their quality and efficacy—will pave the way for the improved growth and productivity of livestock, especially in small-farm production systems, and for ensuring their participation and access to global markets.’
While the economic losses associated with major outbreaks of FMD in industrial countries, notably in Europe in 2001, grabbed world headlines, the disease continues to cause enormous, recurrent losses across large swathes of Asia, Africa, the Middle East and South America.
‘The direct losses alone due to FMD in India are estimated to be more than USD4.5 billion per year; indirect production losses could be much more’, says Dr R Venkataramanan, principal scientist at the Indian Veterinary Research Institute, in Bangalore.
‘The Roadmap report recognizes that vaccines currently available for the control of FMD are not ideal for use in many developing countries’, says Perry. ‘To remain effective they must be kept under constant refrigeration, so the protection they offer is better suited to the needs of FMD-free countries rather than countries where the disease is a constant and daily threat. We realize that it will take considerable time to develop and make available new improved vaccines suitable for developing- country conditions. But in the meantime much can be done with current vaccines and diagnostics, especially if their use is complemented with sound epidemiological and economic decision-support tools to guide and facilitate their effective use.’
Alexander Müller, FAO Assistant Director-General, declares that ‘FAO is ready to support this important initiative, which is expected to provide some of the breakthroughs needed for use in the most affected areas, and which will support the efforts of FAO with the World Organisation for Animal Health (OIE) to reduce FMD risk by promoting progressive control of FMD at all levels. The initiative from the research community is strongly needed and we are happy to play our role in launching this initiative and facilitating transfer of effective new approaches.’
Work undertaken after the Agra workshop ensured that research proposals were developed for funding high-priority areas identified during the workshop. Lead writers facilitated development of concept notes to be submitted to donor agencies in the fields of immunology, vaccine design and epidemiological and economic tools. In addition, some regional concept notes were developed focussing on southern Africa, South and Southeast Asia and South America. These draft concept notes are included in the road map report and provide guidance on further development of the tools for FMD control. Using the products of the road map process, ILRI and partners are now developing a project proposal that, once funded, will move the world closer to the vision of ‘a world in which livestock-based livelihoods, enterprises and trade can flourish unimpeded by FMD’
Participants of the Global Road Map for Improving the Tools to Control Foot-and-Mouth Disease in
Endemic Settings workshop held at Agra, India, 29 November – 1 December 2006
Download the FMD Road Map report
Citation: Perry BD and Sones KR (eds). 2007. Global road map for improving the tools to control foot-and-mouth disease in endemic settings. Report of a workshop held at Agra, India, 29 November–1 December 2006, and subsequent road map outputs. ILRI (International Livestock Research Institute), Nairobi, Kenya. pp. 88 |
