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FAO-EuFMD-OIE Progressive Control Pathway for FMD

FAO-EuFMD-OIE Progressive Control Pathway for FMD. Presented by Keith Sumption – with acknowledgements to PCP team in FAO, EuFMD and OIE Regional Consultative Seminar on the preliminary work of the GF-TADS FMD Global Working Group on the FAO-OIE Global Strategy for the control of FMD

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FAO-EuFMD-OIE Progressive Control Pathway for FMD

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  1. FAO-EuFMD-OIEProgressive Control Pathway for FMD Presented by Keith Sumption – with acknowledgements to PCP team in FAO, EuFMD and OIE Regional Consultative Seminar on the preliminary work of the GF-TADS FMD Global Working Groupon the FAO-OIE Global Strategy for the control of FMD November 2 – 4 2011, OIE Headquarters in Paris, France

  2. The PCP for FMD • Background; the rationale • Development, application and refinement • Stage definitions and Criteria • Assessment • Acknowledgements • This is the work of MANY

  3. 3 2 4 7 1 5 6 Outlook of Southern Africa Regional Roadmap(FAO-OIE meeting in Gaborone, March 2011)

  4. Summary PCP-FMD : • In use since 2008 • Joint FAO-EuFMD-OIE Tool • 5 stages • Outcome oriented , evidence based • Strategy development • Gap analysis • Comparative • Work in progress: • Tools for assessment • linkages to PVS • IS: a tool to assist strategy development - in an area of potential policy conflicts

  5. Reference Laboratories and Collaborating Centres Background – FMDV distribution across 7 virus “”pools”” Reference Centres (UK, Belgium, Italy, South Africa, India, Russian Fed – at 3/09) Regional/National Reference Centres Pool 3 O, A, Asia 1 Pool 1 O, A, Asia 1 Pool 2 O, A, Asia 1 Pool 4 A, O, SAT 1, 2, 3 Pool 5 O, A, SAT 1, 2 Pool 7 O, A Pool 6 SAT 1, 2, 3 Endemic FMD - Free Free with vaccination Free. Virus present in game parks Intermediate, sporadic Countries with multiples zones Source: Annual OIE/FAO FMD Reference Laboratory Network Report, 2007

  6. Background – serotype distribution. But at animal level – what is the risk of infection?

  7. 41% 54% 2% 28% 7% Age class <1 year Background: the scale of infection: - FMD as a “”common childhood illness”” –newly recognised as serology becomes widely applied 2% • Turkey • Infection in first year of life (2007): • similar seen in other endemic countries Survey at animal markets in Turkey (2008) - for exposure to FMD (NSP +ve) FAO-EUFMD/EC/GDPC

  8. Background: public-private policy issues affecting progress • lack of incentives at national level • lack of incentives at producer level to invest in prevention • lack of opportunity to purchase vaccine (state controlled access, limited or no suppliers, cold-chain issue) • lack of technical advice to guide vaccine purchase • commonplace high risk situations: open borders/ classical transboundary rangeland issues, and wildlife-domestic interface • lack of confidence in the vaccination approach to area wide FMD control FMD is common and damaging disease – but who benefits and who should pay for control?

  9. Background : low reported use of FMD vaccination …and limited FMDV virus intelligence to select vaccines

  10. Background – the behaviourchallenge :FMD control –what’s in it for me?

  11. Background – the market chain challenge • “if I was vaccinated, I would be less risk when traded”

  12. Critical control points.......or already too late in the infection chain?

  13. Background – the scale of under-reportingWagging fingers does not change reporting behaviour

  14. Faced with such challenges…the PCP –FMD needed to be : • Simple – to communicate, and apply • Comprehensive – technically sound, critical factors for success are addressed • Credible – progress must be validated with evidence • Progressive – easy to enter, each stage a base for progress • Risk based – with focus on optimising impact of limited resources, avoid prescriptions • Rewarding – potential gains from every Stage • Objective – promoting and rewarding active monitoring and the use of evidence • Environmentally neutral – and part of the solution to develop integrated approaches involving wildlife

  15. 1 2 • PCP concepts -1 • Focus of control – changes with Stage 3 4 5 Identify risk and control options Implement risk-based control Implement Control strategy to eliminate circulation Maintain zero circulation and incursions • Maintain zero circulation; withdraw vaccination • Event based control • (and population level) • Population level control • Sector or herd level control FMDV Incidence Objective Assessment of Progress of PCP for FMD

  16. 1 2 • PCP Concept 2 • Monitoring (and at higher levels – Surveillance) - is a key principle of the PCP 3 4 5 Identify risk and control options Implement risk-based control Implement Control strategy to eliminate circulation Maintain zero circulation and incursions • Maintain zero circulation; withdraw vaccination • Confirm • FMD free • Early detection & • response to incursions • Monitor implementation & • impact of the control program • Monitor FMD epidemics – and • & risk as needed to develop risk-based control program Objective Assessment of Progress of PCP for FMD

  17. The Progressive Control Pathway (PCP) for FMD control • developed by FAO/EuFMD in 2008 • pathway leading from “”endemic”” towards “free status”” • applied in West Eurasia, and for developing Roadmap for subregions of Africa, South Asia ; • enables assessment of country progress • within a Region • between Regions • self-assessment at National level • Identifies gap and assists project formulation • provide progress indicators for donors/investment • Since 2011 a Joint FAO/EuFMD/OIE tool

  18. Country Stages - facilitate progress monitoring at national and regional level Global scale -across Regional Roadmaps and at every stage generates information for risk assessment PCP – stepwise along the road

  19. Areas where PCP-FMD has been used- in assessment, and longer term planning

  20. The Progressive Control Pathway for Foot and Mouth Disease (PCP-FMD) : definitions and criteria for progress • 5 stages that progressively increase the level of FMD control • Developed by FAO and EuFMD • Intended to assist FMD-endemic countries to progressively reduce the impact and burden of FMD

  21. PCP-FMD Tools used in PCP • Monitoring for impact - Repeated serological surveys • Reference laboratory services – vaccine matching • Socio-economic studies; identify options and approaches • Auditing interventions • Evidence based decision support • May be applied at national level ...OR targeted geographically&/or to specific husbandry system(s) • Each stage has well-defined outcomes ...which may be achieved through a variety of activities (NON-prescriptive approach) • Evidence based and transparent assessment of Stage of a country (or zone) Objective Assessment of Progress of PCP for FMD

  22. PCP Stage 1 Focus: “To gain an understanding of the epidemiology of FMD in the country and develop a risk-based approach to reduce the impact of FMD ” Comparable with Risk Assessment Objective Assessment of Progress of PCP for FMD

  23. Stage 1 of the PCP: 8 outcomes Husbandry systems.......are described and understood ....a ‘working hypothesis’ of how FMD virus circulates in the country has been developed Socio-economic impact .........has been estimated The most common circulating strains of FMDV identified 5. ........progress towards an enabling environment for control activities 6. ..... transparency and commitment to .....regional FMD control 7. Important risk hotspots for FMD transmission are identified

  24. AND TO PROGRESS TO STAGE 2: A strategic FMD control plan that has the aim of reducing the impact of FMD in at least one zone or husbandry sector is developed

  25. Stage 1 examples: Value chain analysis in Iran • Understanding animal movement patterns can be critical for planning effective FMD control Effective control HERE can prevent spread downstream Qom Objective Assessment of Progress of PCP for FMD

  26. Baseline serosurveys - Using NSP-ELISA to identify FMD prevalance Corrected for known risk factors Uncorrected • Can be useful to target control • Baseline for comparison after interventions introduced Objective Assessment of Progress of PCP for FMD

  27. PCP Stage 1 –developing national ownership of strategy

  28. PCP Stage 2 Focus: “To implement risk based control measures such that the impact of FMD is reduced in one or more livestock sectors and/or in one or more zones” Comparable with sector level Risk Management Objective Assessment of Progress of PCP for FMD

  29. Stage 2 of the PCP: 5 outcomes • Ongoing monitoring of circulating strains and risk in different husbandry systems • Risk-based control measures are implementedfor the sector or zone targeted, based on the FMD strategic control plan developed in Stage 1 • It is clearly established that the impact of FMD is being reduced by the control measures in at least some livestock sectors and/or zones • There is further development of an enabling environment for control activities AND TO PROGRESS TO STAGE 3: 5. A revised, more aggressive control strategy that has the aim of eliminating FMD from at least a zone of the country has been developed

  30. PCP Stage 2 - examples of national strategies • FMD as a private good: • Private sector (stakeholders) can purchase quality vaccines • Emphasis on private sector action to protect themselves • Public role is to monitor FMD risk in wider population, licensing vaccines, and communication (epidemics, encouragement to buy vaccination in risk situations) • Example: Kenya - most FMD vaccination is paid by stakeholders. Transition issues: mix of partial state supply and private purchases leaves many gaps.

  31. PCP Stage 2 : other examples • FMD as private and public good: • Define sectors that can pay for their vaccination (smallholder dairy?) • Define zones where public funded control is for public good: e.g along borders, around wildlife reservoirs • Reach stakeholder consensus, implement and monitor impact in each sector/zone • Examples: • State funded buffer zone vaccination, private sector vaccination elsewhere • FMD as a public good • State supported FMD control zones to protect the rest of the population (HIGH RISK areas)

  32. PCP Stage 2 have focus is on FMD risk management Or as stated by one CVO : “Surveillance activities in their own right do not reduce FMD impact. Thatneedsdecisions, actions and evaluation!”

  33. Risk management FMD control Knowledge about FMD transmission Legislation Stakeholder participation Veterinary Services competence FMD Communication Finances Objective Assessment of Progress of PCP for FMD

  34. AND TO PROGRESS TO STAGE 3: A revised, more aggressive control strategy that has the aim of eliminating FMD from at least a zone of the country has been developed Objective Assessment of Progress of PCP for FMD

  35. PCP Stage 3 Focus: “Progressive reduction in outbreak incidence, followed by elimination of FMD virus circulation in domestic animals in at least one zone of the country” Comparable with population level Risk Management Objective Assessment of Progress of PCP for FMD

  36. 1 2 • Moving up means institutionalisation of FMD control 3 4 5 Identify risk and control options Implement risk-based control Implement Control straegy to eliminate circulation Maintain zero circulation and incursions • Maintain zero circulation; withdraw vaccination • Confirm FMD free Institutionalisation Organisation Studies Incidence Objective Assessment of Progress of PCP for FMD

  37. Stage 3 of the PCP: 5 outcomes • Ongoing monitoring of circulating strains and risk in different husbandry systems • The disease control plan developed at the end of Stage 2 is implemented, resulting in rapid detection of, and response to, all FMD outbreaks in at least one zone in the country • There is further development of an enabling environment for control activities 4. The incidence of clinical FMD is progressively eliminated in domestic animals in at least a zone in the country AND TO PROGRESS TO STAGE 4: • There is a body of evidence that FMD virus is not circulating endemically in domestic animals within the country or zone

  38. Stage 3 of the PCP • NB: Once a country has entered the GF-TADs–supported PCP-Stage 3 and has decided it wants to continue along the pathway to Stage 4 and beyond, implicating the intention to eradicate FMD virus from the domestic animal population, it may ask for formal OIE-endorsement of its national FMD eradication programme Objective Assessment of Progress of PCP for FMD

  39. AND (TO Repeat) – to PROGRESS TO STAGE 4: There is a body of evidence that FMD virus is not circulating endemically in domestic animals within the country or zone Objective Assessment of Progress of PCP for FMD

  40. PCP Stage 4 Focus: “To maintain ‘zero tolerance’ of FMD within the country or zone and eventually achieve OIE recognition of FMD-free with vaccination” Event based (respond/eliminate) control - in addition to population level risk management Objective Assessment of Progress of PCP for FMD

  41. Stage 4 of the PCP: 6 outcomes • Continued FMD surveillance and risk monitoring • The risk of FMD entering the country or zone is mitigated • FMD incidence is very low: only occasional incursions from outside (which must eventually cease if successful application for recognition of “free with vaccination” is to be achieved) • The environment enables the full implementation of control measures • A plan is developed to fulfil the requirements for OIE recognition of “FMD-free with vaccination” status AND TO PROGRESS TO STAGE 5 • The OIE requirements for recognition of “free with vaccination” are fulfilled and a dossier is submitted to OIE for recognition of this status

  42. PCP Stage 5 Focus: “To maintain ‘zero incidence’ of FMD within the country/zone and eventually achieve OIE recognition of FMD-free without vaccination” Event based (respond/eliminate) control - in non-vaccinated populations Objective Assessment of Progress of PCP for FMD

  43. Stage 5 of the PCP: 2 outcomes • Zero incidence of FMD outbreaks is maintained in domestic livestock AND TO EXIT STAGE 5 AND COMPLETE THE PATHWAY: 2.The OIE requirements for recognition of “FMD-free without vaccination” are fulfilled and a dossier is submitted to OIE

  44. Assessment of national PCP stage Don’t forget me when you make your paper strategies

  45. Assessment of PCP Stages –West Eurasia FMD Roadmap • 2008: self-assessment by countries with peer review (FAO) • 2009 (Istanbul): • upon submission of evidence of actions required at each stage • presentation/review at Regional Meeting • 2 month period post-Meeting to supply information , if required • 2009: Roadmap progress on track • 2010: second Progress Review . Used modified PCP following October 2010 review.

  46. 3 2 4 7 1 5 6 West-Eurasia regional roadmap

  47. 3 2 4 7 1 5 6 Virus pools and outlook and Regional Roadmap(South Asia - pool 2) * Afghanistan and Pakistan are participating in the West Eurasia roadmap

  48. 3 2 4 7 1 5 6 Outlook of Southern Africa Regional Roadmap(FAO-OIE meeting in Gaborone, March 2011)

  49. Tool 1: Self Assessment • Written questionnaire forveterinary services: • Follows PCP Guidelines – Outcomes for each Stage • Questions based on defined criteria and questions -each Outcome • Yes/no answersexplainedby manual • Minimum Requirements differ by outcome • Yearly completion - to retain status, demonstrate commitment • Enables PCP- Gap Analysis • Enables review/revision of forecast progress • Yearly completion recommended Objective Assessment of Progress of PCP for FMD

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