OS20 Online 10 December

1. 1EuFMD | Open Session special edition | #OS20se
1 Veterinary Office of Bosnia and Herzegovina, Animal Health and Welfare Department, 71000 Sarajevo, Bosnia and Herzegovina,
dzeno.hadzovic@vet.gov.ba
2 Veterinary Faculty of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
3 Wageningen Economic Research, Wageningen University and Research, NL-6706KN, Wageningen, the Netherlands
Dženo Hadžović¹
Nihad Fejzić²
Sabina Šerić-Haračić²
Marcel van Asseldonk³
Ron Bergevoet³

2. 2EuFMD | Open Session special edition | #OS20se
Abstract
Brucella melitensis (B.melitensis) in ruminants was first detected in Bosnia and Herzegovina in 1985 in Konjic after which it threatened
to become a serious human health issue. Until 2009, in addition to passive surveillance, a test and slaughter strategy was implemented
in ruminants, which did not bring the expected results. Then, from 2009 onwards, a more rigorous mass vaccination strategy was
implemented. It was foreseen to revert to a test and slaughter strategy after 2021 if prevalence would drop below 1% at herd level.
The aim of this research is to evaluate the costs and benefits related to animal and human health of B. melitensis control strategies in
small ruminants in Bosnia and Herzegovina. The applied vaccination program was compared with a test and slaughter strategy using an
epidemiological (SIR) and economic model. The outcome of the cost-benefit analysis, for both of the evaluated strategies during the 8
year programme implementation, focussed on the total discounted costs and benefits, net present value (NPV), benefit-cost ratio (BCR),
and the internal rate of return (IRR).

3. 3EuFMD | Open Session special edition | #OS20se
Total discounted benefits from the eight-year vaccination
programme implementation period amount EUR 23.822.163
for animals, and EUR 17.857.127 for humans, while the
avoided costs from the previous control amounted EUR
6.586.784. To sum up, the total benefit of the vaccination
programme amounts EUR 48.266.073 without a discount, or
EUR 33.928.344 with a discount rate.
Compared to a vaccination strategy, this Chart is showing that
the total benefits from the eight-year T&S programme
implementation period amount EUR 69.503.490 for animals,
EUR 17.857.127 for humans, and EUR 6.586.784 for the
avoided costs from the previous control. To sum up, the total
benefit of the “test and slaughter” programme amounts EUR
93.947.401 without a discount, or EUR 65.685.189 with a
discount factor.
Total discounted benefits over time in case of a vaccination strategy Total discounted benefits over time in case of a test and slaughter strategy

4. 4EuFMD | Open Session special edition | #OS20se
Economic indicator
Strategy and input 1
Cost
(million
Euro)
Benefits
(million
Euro)
NPV
(million
Euro)
BCR
(factor)
IRR
(%)
Vaccination
V1 +10% with 1-V1 +10% 0.15 1.34 30.00 0.05 13
V1 -10% with 1-V1 -10% -0.15 -1.96 -26.46 -0.19 -10
Dvacc +5% 1.40 1.12 1.92 51
Dvacc -5% -1.12 -1.40 -1.47 -42
Spreading +5% 3.70 3.70 0.73 10
Spreading -5% -3.10 -3.10 -0.62 -9
Test and slaughter
Dt&s +10% 2.82 10.18 9.87 0.45 7
Dt&s -10% -2.82 -8.50 -8.49 -0.42 -7
Spreading +5% 0.30 1.00 0.23 0.35 4
Spreading -5% 0 -3.08 -1.81 -0.36 -10
1 1
Percentage of the population covered by vaccination (V1±10%), reduction of prevalence rate when the vaccination programme is1
implemented ((1-V1) ±10%), percentage of diagnostically tested population of those included in the vaccination programme (Dvacc±5%),2
percentage of diagnostically tested population of those included in the test and slaughter strategy (Dt&s±10%), and annual rate of spreading3
of B. melitensis when vaccination is not implemented (Spreading ±5%).4
Sensitivity analysis in terms of ranking most important inputs
per control strategy and economic indicator
Economic indicator
Strategy
Cost
(million Euro)
Benefits
(million Euro)
NPV
(million Euro)
BCR
(factor)
IRR
(%)
Vaccination 5.05 33.93 28.87 6,72 198
Test and slaughter 20.15 65.69 45.53 3,26 78
Difference (%) 75 48 37 49 120
1
Comparative review of the control strategies per economic indicator
The analysis of costs and benefits for two alternative programmes of control of
Brucellosis in the small ruminant population in Bosnia and Herzegovina enabled
the simulation of the necessary investments (costs) and returns (benefits), arising
from avoided costs related to the disease outbreak during the planned period of
the programme implementation, including the estimation of the realistic
(discounted) costs for both categories. Furthermore, the obtained results are
quantitative and self-explanatory, comparable and scientifically proved, not only for
the veterinary service, but for further decision processes as well.
Under vaccination, the largest influence on costs are input parameters related to
the percentage of the simultaneously tested and vaccinated population.
The largest influence on benefits of the vaccination programme are related to the
rate of the disease spreading in non-vaccinated population and the rate of
population covered by vaccination. In the sensitivity analysis of all other economic
indicators derived from costs and benefits (NPV, BCR and IRR) it is clear that the
percentage of tested and vaccinated population is the key input assumption, while
the second most important is the spreading of B. melitensis without vaccination.

5. 5EuFMD | Open Session special edition | #OS20se
Conclusions
• The evaluation revealed that the vaccination strategy requires 75% less funds to control B. melitensis, and is the best option in terms
of the estimated BCR and IRR.
• The test and slaughter strategy outperforms a vaccination strategy, in terms of faster reduction of prevalence, as well as in terms of
the total benefits and NPV.
• Based on the outcomes of this analysis it can be concluded that implementing a vaccination strategy to control B. melitensis in sheep
and goat was from a veterinary, economic human health perspective the optimal decision compared to alternative strategies as a test
and slaughter strategy.
• If the costs of the intervention were shared between the sectors in proportion to the benefit to each, the public health sector would
contribute 37%, which gives a cost-effectiveness of 328 Euro per DALY averted.
• However, with a vaccination strategy it is not feasible to reduce the prevalence below 1% at herd level.
• More financial resources to enhance veterinary services are required to totally eradicate B. melitensis by means of a test and
slaughter strategy.
• The study showed that ex ante and ex post evaluation of implemented strategies using epidemiological and economic decision
support models can contribute to improve policy decision making.

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