Transboundary Diseases, Agriculture and Health: Policy Implications and Research Priorities

1. Transboundary Diseases, Agriculture and Health: Policy Implications and Research Priorities Presented at the Global Ministerial Forum on Research for Health Bamako, Mali 17-19 November 2008 Gabriel Rugalema and Giulia Muir Food and Agriculture Organization of the United Nations

2. What are Transboundary diseases? • diseases of significant economic, trade and/or food security importance for a considerable number of countries; • diseases which can easily spread between countries and reach epidemic proportions; • the environment in which these diseases are found and the human activities which facilitate their spread straddle common borders; • their control/management, including exclusion, requires co-operation between several countries.

3. Some examples of Transboundary diseases of agricultural importance

4. The Burden of Disease: a global snapshot

5. HIV and AIDS • Number of people living with HIV: 33 million people [30–36 million] • New infections in 2007: 2.7 million • Deaths due to AIDS in 2007: 2 million • Source: UNAIDS 2008 Report on the Global AIDS epidemic

6. Malaria • Percentage of the world’s population at risk = 40% • Cases of Clinical Malaria each year = 300 million • Malaria cases resulting in death each year = 1 million (some studies indicate • as many as 3 million) Source: http://www.theglobalfund.org/en/files/about/replenishment/disease_report_malaria_en.pdf

7. Tuberculosis • People carrying the bacterium that causes Tuberculosis globally = 2 billion • Deaths due to Tuberculosis each year = 1.6 million • Estimated number of people who will become sick from TB between 2000 and 2020 = 200 million Source: http://tballiance.org/why/tb-threat.php

8. H5N1 Avian Influenza

9. Severe Acute Respiratory Syndrome (SARS)

10. Cholera

11. Peste des Petits Ruminants (PPR) FAO, 2008

12. Factors making diseases “transboundary” :What we know 1. Ecological and Environmental changes 2. Human mobility and migration 3. Internal and International Trade 4. Unregulated movement of animals and plants 5. Interaction between humans and animals

13. Consequences of Transboundary Diseases • Direct health impact (illness, death, disability) • Costs related of prevention, treatment and care • Economic loss at household and national level • Disruption of trade and employment • Barriers to entry into international commodity markets • International trade and traffic may spread transboundary diseases • Potential for exacerbation of political tensions between countries

14. Macro-economic costs of diseases • According to recent macro-economic estimates, the growth rate per capita GDP in highly Malarious countries (0.25-1.3% points lower than non-endemic countries) can amount to almost half of the per capita GDP of poor countries over a period of 25 years. (Malaeny and Sachs, 2004) • During the two months after the first outbreaks in Nigeria (February 2006) about 440,000 birds were destroyed. Assuming the disease follows the same course for the remaining year, compensation for 2.64 million birds will have to be paid in the first year. The Nigerian government has announced a compensation rate of US$ 1.95 per culled chicken, which would result into a compensation bill of about US$ 5.15 million for one year. (Hinrichs, Sims and McLeod, 2006)

15. Research Priorities, Capacity, Conduct and Translation • Why is further research called for? • Extent of the problem not well known • Dynamic environment (including climate change) • Differentiated (social, geographical) cost of transboundary diseases not well known nor appreciated • Control measures not always evaluated for their efficiency and effectiveness • Etc

16. Research priorities—what we need to know • Identify factors and channels facilitating the establishment and spread of transboundary diseases in different areas • Epidemiological studies to examine and identify microbial types and sub-types, their prevalence and distribution in time and space; • Economic analyses of impact of diseases at micro, meso and macro economic levels; • Analysing existing disease surveillance systems, their strengths and weaknesses • Examine international disease control efforts, gaps and lessons learned over the years.

17. Research Capacity • Assess capacity building needs of institutions in areas considered as hotspots for disease outbreaks. • Assess effectiveness of disease-control infrastructure and identify weaknesses. • Assess the role and potential for use of modern technology in disease surveillance (mobile phones, PDA, computers).

18. Research Conduct • Who will conduct the research? International Organizations like the FAO; Local and international research institutions. • Collective, multi-sectoral efforts are necessary through coordination and joint planning. • Need for a common set of research tools and instruments. • Need for both bottom-up and top-down approaches.

19. Research Translation Translating research into ACTION: • Need for frequent dialogue between researchers and end users of research (policy makers, local communities). • Research should be policy orientated. • International collaboration in research, policy development and implementation. • Strong coordination of activities related to [human] health. • Stimulate culture of evidence-based policy formulation.

20. Future Scenarios: Transboundary diseases require Transboundary solutions • Given factors such as climate change, increased human mobility/travel and agricultural change, it is likely that Transboundary diseases will continue to pose a serious challenge. • Transboundary disease challenges respect no internal, national or international borders; they hence require global perspectives and responses, conceptually and geographically. • Human activities are the most potent factors driving disease emergence; our response or lack thereof will determine their persistence.