Impact of neglected diseases on animal productivity and public health in Africa

Impact of neglected diseases on animal productivity and public health in Africa
Impact of neglected diseases on animal productivity and public health in Africa 21st Conference of the OIE Regional commission for Africa, Rabat, Morocco, 16-20 February 2015 Delia Grace, Mwansa Songe, Theo Knight-Jones
Survey methodology Survey commissioned and supported by OIE Sent to 54 Member Countries – 34 responded in time for inclusion: • 63% response rate • Covers 87% of ruminant, 82% poultry, 64% pig population in Africa December 2014-January 2015 2
Survey Content 1 DISEASE PRIORITIES 4 TRENDS, DRIVERS AND CHANGE 5 COSTS 3 DISEASE PREVALENCE AND CONTROL 6 OPPORTUNITIES 2 MULTIPLE IMPACTS
1. Disease priorities
Pareto principle: the vital few & trivial many 5 0 200000 400000 600000 800000 1000000 1200000 1400000 1600000 1800000 2000000 Top 13 zoonoses Next 43 GBD: top 10 human disease cause 90% burden 1 10 5 Illnesses 8 6 3 4 9 2 7
Most commonly cited priority diseases 0 1 2 3 4 5 6 7 8 N=109 diseases
Pareto principle: the vital few & trivial many 13 0 200000 400000 600000 800000 1000000 1200000 1400000 1600000 1800000 2000000 Top 13 zoonoses Next 43 GBD: top 10 human disease cause 90% burden This survey: 20% of diseases got 78% of cites
14 2. Multiple impacts
Synoptic view of benefits and costs of animal brucellosis mass vaccination in MongoliaDistribution of benefits 0 5000000 10000000 15000000 20000000 25000000 30000000 Intervention cost Total Health Benefits Public health benefits Private health benefits Household income loss Agricultural Benefits Total Societal Benefits Sector US$ Roth et al. 2003, Bulletin WHO ‘Combining the total societal benefits, the intervention in the animal sector saves cost, provides the economic argument and thus opens new approaches for the control of zoonoses in developing countries through cost contributions from multiple sectors.’
16 Annual benefit Annual cost Confidence in investment Sharing resources 4 billion 1 billion ++ Controllable zoonoses 60 billion 20 billion +++ Timely response 6 billion 3.4 billion ++ Averting pandemics 30 billion + Bottom line 100 billion 25 billion +++ A business case for One Health
Disease impacts Disease impacts
Disease impacts Disease impacts
SVS considerations in deciding most important diseases 19
3. Prevalence and control
21
22
23
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Priority List Diseases FMD PPR ASF CBPP NCD Anthrax bTB RVF IMPORTANT DISEASES RVF FMD PPR bTB Anthrax Brucellosis CBPP Africa: Priority list well aligned with important diseases
PRIORITY DISEASES 1: Avian influenza 3: Leptospirosis IMPORTANT DISEASES 1: Vector-borne disease 2: Food borne disease SE Asia: Priority disease not aligned with important diseases
27 Vaccination for priority diseases
28 0 10 20 30 40 50 60 70 80 90 100 Countries with disease present % 0 10 20 30 40 50 60 70 Good control (as % of countries with disease)
4. Trends, drivers and change
30 0 2 4 6 8 10 12 14 16 18 20 Wildlife disease Emerging zoonotic Fish disease Emerging livestock Food-borne Endemic Vector-borne Epidemic Zoonotic Decreasing Static Increasing Most diseases are increasing or static
31 These trends have important drivers 0 20 40 60 80 100 120 Land purchase by foreigners Inequality In-migration Irrigation Wildlife conservation Poverty increase Conflict Land use change Biodiversity Habitat loss Wildlife areas incursion Food price Urbanisation Deforestation Economic growth Social change Wildlife reservoirs Intensifying livestock Human population growth Trade in livestock & products Climate change
Drug resistance an increasing threat 32 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% RespondentsopiononAMR Common Occasional Not present No information
Foodborne disease a public concern 33
5. Costs
Multiple burdens of animal disease 35 Burden of illness in people (DALY’s) Costs of treating disease in people ($) Losses in agri- food chains ($) Costs of Responding to disease in food chains($) Costs of preventing disease in people Costs of preventing disease in food chain Direct impact Treatment Prevention People Animals Losses due to ecosystem impacts (?) Ecosystem Shaw & Grace, 2014
Annual losses from animal mortality and costs of disease control in Africa 36 0 200 400 600 800 1000 1200 1400 1600 1800 2000 MillionUSD
37 0 200 400 600 800 1,000 1,200 1,400 USDMILLIONLOSTANNUALLY Losses from cattle disease
38 Losses from sheep & goat disease 0 100 200 300 400 500 600 700 800 900 USDMILLIONLOSTANNUALLY
39 Losses from poultry disease 0 50 100 150 200 250 300 350 400 450 Newcastle Gumboro Coccidiosis Ectoparasites GIT Aflatoxicosis USDMILLIONLOSTANNUALLY
40 Losses from pig disease 0 20 40 60 80 100 120 140 160 ASF GIT parasites Ectoparasites FMD Erysipelas Cysticercosis USDMILLIONLOSTANNUALLY
How does this compare to other estimates? Million USD Value sector WLDA $39 0.03% SVS estimate $9,000 6% Literature $30,000 21% BMGF $35,000 41 Million USD Value sector Australia 979 16% UK 1,178 8% 2/3 from death 1/3 production Only death or control Bennett RM, Ijpelaar J, 2005, Sackett D & Holmes P, 2006
42 Reporting common, non-pathognomonic disease a challenge Bovine brucellosis Predicted cases annual Bovine brucellosis Cases reported 2010 East Africa 21,104,976 12 West Africa 30,646,060 37 South Africa 8,492,555 6305 North Africa 7,952,853 1073 Bovine brucellosis reported 2008-2012 Bovine brucellosis according to 440 surveys Source: LRI report to DFID Mapping poverty and likely zoonosis hotspots
Diagnosis a challenge 43
6. Opportunities
How to improve disease reporting 45 70 75 80 85 90 95 100 Affordable, pen side diagnostics Increased engagement of private vets in disease control programmes Investment in information and communications technology Capacity building in epidemiology Better links between central and district, local, field veterinary services Improved information flow between farmers and veterinary services Increased engagement of farmers in disease control programmes Increasing resources for veterinary services
How OIE can help reduce disease impact 46 40 45 50 55 60 65 70 75 80 85 Making WAHIS more user friendly Ensuring OIE focal points have more time for OIE responsiblities Improving temporal stability of OIE focal points Improving synergy between OIE focal points and others ARIS and WAHIS inter-operability Training to focal points
Take homes  Unlimited wants in a world of limited resources  Vital few and trivial many: Pareto principle  The multiple burdens of animal disease  What cannot be measured, cannot be managed  Foreseen is forearmed
Ways Forward  An Africa list of “neglected animal diseases”?  More detailed disease impact studies?  Sharing & harmonisation of contingency plans?  Pilot novel ways to improve reporting?  A One Health system for monitoring animal use of antimicrobials?  Norms for informal food markets?
Conclusion  Good progress has been made on disease control, priority lists, contingency plans, and vaccination  SVS have broad-based, equitable, development-oriented approach to disease control  But diseases have multiple, heavy burdens and trends are upwards  While new and important threats emerge (climate sensitive disease, EIDs, FBD and AMR)  And limited quantification of impacts may chill investment in disease control Therefore improved reporting, more information, stronger engagement, and deeper co-operation, is needed to tackle neglected animal disease in Africa.
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