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 20152
Survey Content
1 DISEASE PRIORITIES
4 TRENDS, DRIVERS AND CHANGE
5 COSTS
3 DISEASE PREVALENCE AND CONTROL
6 OPPORTUNITIES
2 MULTIPLEIMPACTS
1. Disease priorities
Pareto principle: the vital few & trivial many
5
0
200000
400000
600000
800000
1000000
1200000
1400000
1600000
1800000
2000000
Top 13zoonoses
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 13zoonoses
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 Mongolia
Distribution 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
24
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%
Res
po
nd
en
ts o
pio
n o
n A
MR
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
Millio
n U
SD
37
0
200
400
600
800
1,000
1,200
1,400
US
D M
ILL
ION
LO
ST
AN
NU
AL
LY
Losses from cattle disease
38
Losses from sheep & goat disease
0
100
200
300
400
500
600
700
800
900
US
D M
ILL
ION
LO
ST
AN
NU
AL
LY
39
Losses from poultry disease
0
50
100
150
200
250
300
350
400
450
Newcastle Gumboro Coccidiosis Ectoparasites GIT Aflatoxicosis
US
D M
ILL
ION
LO
ST
AN
NU
AL
LY
40
Losses from pig disease
0
20
40
60
80
100
120
140
160
ASF GIT parasites Ectoparasites FMD Erysipelas Cysticercosis
US
D M
ILL
ION
LO
ST
AN
NU
AL
LY
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
4570 75 80 85 90 95 100
Affordable, pen side diagnostics
Increased engagement of private vets in diseasecontrol programmes
Investment in information and communicationstechnology
Capacity building in epidemiology
Better links between central and district, local,field veterinary services
Improved information flow between farmers andveterinary services
Increased engagement of farmers in diseasecontrol programmes
Increasing resources for veterinary services
How OIE can help reduce disease impact
4640 45 50 55 60 65 70 75 80 85
Making WAHIS more user friendly
Ensuring OIE focal points have more time for OIEresponsiblities
Improving temporal stability of OIE focal points
Improving synergy between OIE focal points andothers
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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given to ILRI.
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