presented at the global ministerial forum on research for health bamako, mali 17-19 november 2008...
TRANSCRIPT
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
Transboundary Diseases, Agriculture and Health:
Policy Implications and Research Priorities
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.
Some examples of Transboundary diseases of agricultural importance
HUMAN ANIMAL PLANT (dis+pests)
HIV and AIDS Peste des petits ruminants
(PPR)
Banana Fusarium Wilt
Malaria Foot and Mouth Disease
Banana Weevils
Tuberculosis Contagious bovine/caprine
pleuropneumonia
Coffee Wilt Disease
Highly Pathogenic Avian Influenza
(HPAI)
East Coast Fever Nematodes
Severe Acute Respiratory
Syndrome (SARS)
Bovine SpongiformEncephalopathy
(BSE)
Desert Locust
Cholera Worms Cassava Mosaic Virus
Typhoid Rift Valley Fever Soybean Rust
Dysentery Rinderpest Mango Fruit Flies
Measles Coccidiosis Coconut Leaf Beetle
The Burden of Disease:
a global snapshot
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
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
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
H5N1 Avian Influenza
Severe Acute Respiratory Syndrome (SARS)
Cholera
Peste des Petits Ruminants (PPR)
FAO, 2008
Factors making diseases “transboundary” :
What we know
1. Ecological and Environmental changes2. Human mobility and migration3. Internal and International Trade4. Unregulated movement of animals and plants5. Interaction between humans and animals
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
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)
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
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.
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).
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.
Research TranslationTranslating 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.
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.