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					   ALive Feasibility Study on
Epidemiology Networks in Africa




                  By

          Consultants

Mark Rweyemamu (Team Leader)
   mark.rweyemamu@btinternet.com
         Musa Fanikiso
     Mfanikiso@orangemail.co.bw
           Papa Seck
        drpapaseck@yahoo.fr




             Decembe r 2008
          Rev ised 22d May 2009




                                   1
                             TABLE OF CONTENTS
LIST OF AC RONY MS

EXECUTIVE SUMMARY

SOMMAIRE EXEC UTIF

1. INTRODUC TION

2. CONTEXT FOR THE STUDY/OBJEC TIVE

3. METHODOLOGY

4. REVIEW OF C URRENT SITUATION IN SS-AF RIC A

  4.1. Impleme ntation of OIE Guide lines for Officia l Reporting and Vete rinary
       Governance

  4.2. Re porting and Risk Management of TADs a nd Zoonoses at the Global
       Level

  4.3. Status of Disease Information Systems at National and Re gional Levels

  4.4. Epidemiological Surveillance Network in West and Central Africa

  4.5. Epidemiological Surveillance Network in Easte rn Africa

  4.6. Epidemiological Surveillance Network in Southe rn Africa (SADC)

  4.7. Evolution of Regional Anima l Hea lth Centres (RAHC)

  4.8. Some lessons from epidemiological surveilla nce networks for infectious
       diseases of humans

  4.9. Other  Re levant   Key    Networks   and    Linka ges     to   the   Offic ial
       Epidemiological Surveillance Networks

  4.10.    Linkages Between Epidemiologica l Surveilla nce and La boratory
      Networks

  4.11.    Cost and Impact Assessment


5. RECOMMENDATIONS FOR TECHNC IAL SUSTAINABILITY OF CORE F UNC TIONS
   OF EPIDEMIOLOGICAL SURVEILLANCE NETWORKS IN SS-AF RICA

  5.1. Underlying Considerations as Drivers for Susta ina ble Epidemiologica l
       Surveillance Networks

  5.2. Enhancing Competence in Field Epidemiology

  5.3. Organisation of Ne tworks at the National Level

  5.4. Enhanc ing Governance and Susta inability of Re gional Epidemiological
      Surveillance Networks

  5.5. Linking Regional Epidemiological Surve illance Ne tworks to RECs



                                                                                   2
  5.6. The role of the AU Inte r-African Bureau for Animal Resources (AU- IBAR)
       in coordinating re gional epidemiology networks

  5.7. The role of the Regiona l Animal Health Centres (RAHCs) a nd the
       inte rnational partne rs in setting up the Regional Epidemiological
       Surveillance Networks


6. RECOMMENDATIONS        FOR   PROJEC T  ENABLERS  TO           ENHANCE   THE
   CREDIBILITY  OF         REGIONAL    EPIDEMIOLOGICAL            SURVEILLANCE
   NETWORKING


  6.1. Collaborating with the AU- IBAR and Regiona l Organisations to Esta blish
       Re gional Databases for Early Wa rning a nd Response to TADs a nd
       Zoonoses Linked to the FAO-OIE-WHO GLEWS

  6.2. Supporting sustainable National Disease Information Systems              for
      Offic ial Reporting and Risk Ma nagement of TADs a nd Zoonoses

  6.3. Supporting technologies a nd surveillance systems that e nha nce the
      capture of disease alerts or information at point-of-outbrea k by sub-
      professional, veterinary personne l

  6.4. Supporting Public-Private Pa rtne rships for Epidemiologica l Surveillance

  6.5. Supporting Enabling    Resea rch   on   Infectious   Diseases   by   African
       Institutions

  6.6. Supporting Re gional Forums (or Commissions) for the Control of TADs
       and Zoonoses

  6.7. Supporting    the FAO-OIE- IBAR Regional Animal Hea lth Centres to
       collaborate with Others in promoting the One World One Health Goa ls in
       Africa


7. RECOMMENDATIONS FOR PROJEC T INTERVENTIONS                 ASSOCIATED WITH
   REGIONAL DEVELOPMENT

  7.1. Africa Regional Programmes for Progressive Control of TADs or Zoonoses

  7.2. Supporting Re gional Forums (or Commissions) for the Control of TADs
      and Zoonoses

  7.3. Supporting    the FAO-OIE- IBAR Re gional Anima l Health Centres to
      collaborate with Others in promoting the One World One Health Goa ls in
      Africa

  7.4. Supporting biosec urity-based poultry production a nd risk mana gement
      of Ne wcastle disease and othe r poultry infectious killers of village
      chic kens as a poverty reduction instrument and surrogate for sustaina ble
      surveillance/preparedness for HPAI in rural Africa


8. TARGETING PROJEC T INTERVENTIONS TO SUPPORT EPIDEMIOLOGICAL
   SURVEILLANCE NETWORKS IN SOUTHERN, EASTERN AND WESTERN-
   CENTRAL AF RIC A


                                                                                    3
   8.1. Recommendations for West a nd Centra l Africa

   8.2. Recommendations for Eastern Africa

   8.3. Recommendations for SADC

   8.4. Recommendations for IBAR


9. CONCLUSION


10. OBSERVATION


11. AC KNOWLEDGEMENT


12. REFERENCES

Annex 1: Te rms of Re ference

Annex 2: The Animal Disease Imperative for Epidemiologica l Surveillance
Networks in Africa


Annex   3:   Re port   to   the   SADC   Livestock   Technica l   Committee   of   the
Epidemiology and Informatics Sub-committee


Annex 4: Recomme ndation of Workshop FAO Regiona l Epidemiology a nd
Laboratory Surveillance Networks 21 – 23 Octobe r 2008

Annex 5: List of Persons consulted/inte rvie wed during fie ld missions




                                                                                     4
LIST OF AC RONY MS

ADECF         Animal Diseases Emergency Contingency Fund
AfDB          African Development Bank
AI            Avian influenza
AIDS          Acquired Immunodeficiency Disease
AIMS          Agricultural Information Management System of SADC
ALive         Partnership for Africa Livestock Development
ARIS          AU-IBAR Animal Resource Information System
ASARECA       Association for Strengthening Agricultural Research in East & Central
              Africa
ASF           African swine fever
AU            African Union
AUC           African Union Commission
AU-IBAR       AU Inter African Bureau for Animal Resources
AU-STRC       AU-Science, Technology and Research Commission
BSE           Bovine Spongiform Encephalopathy (Mad cow disease)
CBPP          Contagious Bovine Pleuropneumonia
CCPP          Contagious Caprine Pleuropneumonia
CDC           Centers for Disease Control and Prevention of the USA
CMC-AH        FAO-OIE Crisis Management Centre for Animal Health at FAO HQ
COMESA        Common Market for Eastern and Southern Africa
CSF           Classical Swine Fever
CVL           Central Veterinary Laboratory
CVO           Chief Veterinary Officer
DRC           Democratic Republic of Congo
DVO           District Veterinary Office
DVS           Depart ment of Veterinary Services
EAC           East African Community
ECCAS         Economic Community of Central African States
ECOWAS        Economic Community Of West African States
ECTAD         FAO Emergency Centre for Transboundary Animal Diseases
EDF           European Development Fund
EIS           Epidemiology and Informatics Sub-committee of the SADC LTC

EMPRES        Emergency Prevention System for Transboundary Animal and Plant
              Pests and Diseases (a priority programme of FAO)
EU            European Union
FANR          Food, Agriculture and Natural Resource Directorate of the SADC
              Secretariat
FAO           Food and Agriculture Organization of the United Nations
FE(L)TP       Field Epidemiology and Laboratory Training Programme
FETP          Field Epidemiology Training Programme

FMD           Foot-and-Mouth Disease
GEMP          Good Emergency Management Practices
GF-TADs       Global Framework for the progressive control of Transboundary
              Animal Diseases
GIS           Geographic Information Systems
GLEWS         Global Early Warning System for TADs and Zoonoses
GOARN         Global Outbreak Alert Response Network of WHO
GREP          Global Rinderpest Eradication Programme
HACCP         Hazard Analysis and Critical Control Points
HPAI          Highly Pathogenic Avian Inf luenza
IBAR          Inter-African Bureau for Animal Resources
ICT           Information and Communication Technology
IDSR          Integrated Disease Surveillance and Response
IGAD          Inter-Governmental Authority for Development


                                                                                      5
ILRI       International Livestock and Research Institution
LDT        Livestock Development Trust
LIMS       Livestock Information Management System of SADC
LSD        Lumpy Skin Disease
LTC        Livestock Technical Committee
MoH        Ministry of Health
ND         Newcastle Disease
NEPAD      New Partnership for Africa‟s Development
OIE        Office International des Epizooties (World Organisation for Animal Health)
PACE       Pan African Programme for the Control of Epizootics
PANVAC     Pan-African Vaccine Control Centre
PARC       Pan African Rinderpest Campaign
PPR        Peste des Petits Ruminants
PRINT      Promotion of Regional Integration (SADC livestock project funded by
           EDF)
PVS        Performance, Vision and Strategy
RAHC       Regional Animal Health Centre
REC        Regional Economic Community
RESEPI     Réseau Régional des Réseaux Nationaux d‟épidémiosurveillance
RISDP      Regional Indicative Strategic Development Plan of SADC
RP         Rinderpest
RVF        Rift Valley Fever
SACCT      Southern Af rican Commission for the Control of TADs
SACIDS     Southern Af rican Centre for Infectious Disease Surveillance
SADC       Southern Af rican Development Co mmunity
SARS       Severe Acute Respiratory Syndrome
SAT        Southern Af rican Territories serotype of FMD virus

SERECU     Somali Ecosystem Rinderpest Eradication Coordination Unit
SOP        Standard Operating Procedures
TAD        Transboundary Animal Disease
TB         Tuberculosis
UEMOA      Union Economique et Monetaire Ouest -Africane
UN         United Nations
WAHIS      World Animal Health Information System
WAHID      World Animal Health Database
WHO        World Health Organisation
WHO-AFRO   WHO Regional Office for Africa




                                                                                  6
EXECUTIVE SUMMARY


    Synopsis
    This consultancy was commissioned by the ALive Secretariat in order to review
    the state of epidemiological surveillance networks in sub-Saharan Africa with
    respect to lessons learnt from the past experiences, on-going initiatives and up-
    coming initiatives with respect to organisational arrangements and long term
    sustainability of the networks. The consultants were to evaluate the technical and
    operational feasibility of how epidemiological networks established following the
    outbreak of Highly Pathogenic Avian Influenza can be extended to other
    Transboundary Animal Diseases and Zoonoses in a sustainable manner. The
    consultants found that the objective of the study was in line with the Wor ld Food
    Summit (1996) Comm itment Number 3 Objective 3.1 which requires to “Seek to
    ensure effective prevention and progressive control of plant and animal pests and
    diseases, including especially those of transboundary nature…”

    The assessment of epidemiological surveillance was driven by two underlying
    considerations, namely the requirement for official reporting, guided by the OIE
    norms, and that for risk management of TADs and Zoonoses, including HPAI,
    guided by the FAO EMPRES precepts of early warning, early reaction, enabling
    research and coordination.

    Methodology
    The methodology adopted for study was a combination of desktop study
    composed of the review of relevant documents both in hard copies and on the
    internet, interviews with key FAO experts including ECTAD Regional Managers,
    OIE Representation for Africa and the OIE Sub- Representation for Southern Africa,
    Acting Director of AU-IBAR and his staff, Representative of the Regional Economic
    Communities dealing w ith livestock matters, project team leaders, some Chief
    Veterinary Officers, Regional Epidemiologists and many other key personalities
    associated with animal health. An inception meeting was held at FAO
    headquarters and a brief by the FAO Chief Veterinary Officer who is the Alive
    Champion for the initiative to establish Epidemiology and Laboratory Networks
    was done. The team also interacted by teleconference with the OIE on laboratory
    twinning system and OIE standards and also w ith the three FAO ECTAD managers
    in the FAO-OIE –IBAR Regional Animal Health Centres in Bamako, Nairobi and
    Gaborone. Field missions were also undertaken in all the four regions. The
    consultants also participated in two regional workshops on epidemiological
    surveillance networks for the Southern African Development Community and that
    for West Africa.

    Key F indings from the Study
    In gene ral Sub-Saharan African c ountries have weak Veterinary Services,
    especially those that had to adopt Structural Adjust ment Programme follow ing the
    economic depression in Africa of the 1980s. Countries that participate in
    international trade in livestock and livestock products have reasonable capacity
    and in general meet various OIE standards and guidelines. Botswana, Namibia,
    Swaziland and South Africa are examples of these countries.

    For official reporting, the number of countries that regularly report to the OIE
    using the WAHIS system is increasing and this demonstrates the positive impact
    of the various OIE capacity building programmes that have been initiated in the
    past few years. Several of the countries visited and national epidemiologists
    interviewed appreciate the recent location of the OIE Regional and Sub- Regional
    Representation offices in Africa as a stimulus for the appreciation of the role of
    Veterinary Services and the work of the OIE in standard setting and the promotion


                                                                                    7
of the good governance of Veterinary Services. A further demonstration of this is
that out of 51 countries in Af rica, 36 have already requested for the PVS
evaluation by the OIE and out of these, 32 have already been evaluated. The
expected outcome of this is an objective gap analysis in the veterinary
governance and resource which hopefully will lead to enhanced compliance with
OIE standards.

With respect to the supporting the risk management of TADs and zoonoses, we
note that WAHIS, which has been created for official disease reporting purposes
for over 100 OIE listed diseases is unlikely to fulfil this objective. Thus at the
global level, the FAO EMPRES-i and the FAO-OIE-WHO GLEWS are being
developed to combine disease reporting w ith surveillance data plus non-disease
data which influence disease spread in order to generate an early warning system,
as an outcome of epidemiological surveillance.

At the regional we found that AU-IBAR and SADC had developed ARIS and LIMS,
while FAO had developed TADInfo at national level. They all aim to collect
information for both disease reporting and risk management of animal diseases
and zoonoses.

At the national level, the ALive team found a plethora of Animal Health
Information Systems. Most countries that were in the PACE programme which
initially adopted the ARIS have now abandoned the system in favour of smaller
nationally designed packages based on either Access (e.g. Ethiopia, Nigeria,
Kenya, Senegal) or Excel spreadsheet (e.g. Cameroon, Mali, Kenya). There has
been a proliferation of national information systems as a result of lack of reliable
regional systems that meet the needs of countries. For SADC, LIMS has just been
launched by the PRINT -Livestock project and it is still being tested in Member
States. The TADInfo system which has now matured is also not being widely used
although there has been an increasing interest in the newer Java version which is
based on an open source programming platform. The main problem with the
TADInfo system has been the lack of back-stopping as the system is primarily
only operated from Rome. There is therefore a need for a standardised approach
to animal disease information system in support of the risk management of TADs
and zoonoses, preferably coordinated or guided by FAO. Such an approach would
also overcome the problem of lack of interoperability and exchange of data
between the different systems that now operate in Africa.


With reference to the existence of epidemiological surveillance networks in Sub -
Saharan Africa the team found that PACE did an excellent work in establishing
networks in the programme participating countries at national level w ith regional
coordination at the IBAR headquarters in Nairobi. When PACE came to an end,
regional coordination became dysfunctional, but a few national networks remained
active although they were seriously incapacitated due to lack of funding and the
fact that they were established independent of existing Veterinary Service
structures except only in very few countries like Ghana. So in East Africa, a fter
PACE there was no regional epidemiological surveillance network, but efforts to
establish one through the FAO ECTAD office in Nairobi and the East African
Community are on-going.

For West and Central Africa, the situation is similar to Eastern Africa in that most
national networks were established under the PACE programme, but the recent
outbreak of Highly Pathogenic Avian Influenza in the region has revived most
national networks. The FAO ECTAD office in Bamako is also very busy establishing
the regional network although the long-term coordination of the regional network
remains an outstanding matter to be resolved to avoid the experience of PACE.



                                                                                  8
       ECOWAS and its Member States have expressed a wish to give the network a
       permanent homage for political leverage and sustainability.

       The most advanced regional epidemiological surveillance network in Sub-Saharan
       Africa that the team found on its mission is the Epidemiology and Informatics
       Sub-Committee of the SADC Livestock Technical Committee in the Southern
       African region. This network which is fully funded by SADC Member States has a
       sound institutional framework for epidemiological surveillance with regular
       reporting, coordination meetings for exchange of information and it has now
       started producing a SADC Animal Health Yearbook which presents animal disease
       invent in the region. The network reports to a Committee of Chief Veterinary
       Officers for the region which ultimately reports to a Council of Ministers
       responsible for Food, Agriculture and Natural Resources. The SADC Secretariat
       provides the coordination of the network but this network is chaired by Namibia,
       one of the SADC Member States. The RAHC-ECTAD and regional projects support
       the work of the network, and in fact the ALive T eam was impressed with how each
       of the regional projects associated with the SADC Livestock Sector have some
       element of enhancing the capacity of the Livestock Technical Committee. The
       network was established in 1997 together with other three networks on
       Laboratory Diagnostics, Veterinary Public Heath and Animal Production and
       Marketing 1 . The institutional coordination mechanism adopted by SADC could
       herald a model for setting up and runnin g sustainable epidemiological surveillance
       networks in Sub-Saharan Africa with technical support from the RAHCs and
       funding agencies.

       It should be noted that the SADC Animal Health Yearbook, which is a highly
       commendable development, is a summation of reports and not an early warning
       system. Similarly LIMS does not yet incorporate an analytica l capacity to support
       early warning for TADs and zoonoses.

       The sustainability of epidemiological surveillance networks has been examined
       from the perspectives of the enabling institutional f ramew ork, the ownership of
       networks, the structure of networks and programme funding. Except for the
       network in the SADC region, the other two networks seem to be a form of
       revitalisation of the PACE Programme networks. In our view the PACE networks
       initiative was essential to establish the principle and now a more sust ainable
       approach should be adopted for establishing future networks from the on set.

       Although FAO ECTAD offices in Eastern and West Africa have done very well in
       coordinating epidemiological surveillance network in these regions, the fact that
       these offic es are currently funded out of extra-budgetary allocations brings some
       concern into the long term survival of the networks. From the sustainability
       perspective epidemiological surveillance networks seem to only have long term
       viability if they are linked t o a regional economic grouping and are included in the
       budget of the organisation as demonstrated by SADC w hich budgets for
       coordination meetings of the network. All the Regional Economic Communities
       (SADC, ECOWAS and EAC) consulted have expressed a wish to host the networks.
       However, the Secretariats of these RECs, so far lack the necessary human and
       financial resource capacity to set up and coordinate robust regional
       epidemiological networks driven by the objective of risk management of TADs and
       zoonoses. Therefore, the technical assistance to the RECs by RAHC-ECTAD and
       donor funded projects will be essential during the initial stages of up to 10 years.


1
 Note: The origins of this Subcommittee date back some 20 years, as having been conceived from
with the SADC region: As far back as 1986 Drs Biggs (and later Paskin) of Namibia, Unesu of
Zimbabwe, Mtei of Tanzania and Masupu of Botswana started working on the establishment of the
SADC Epidemiology Network when the SADC Livestock Sector was being coordinated by Dr
Magembe in the Botswana Directorate of Veterinary Services.
                                                                                             9
     Some Key Recommendations
     Having studied past experiences with PACE and the structure of the current
     epidemiological networks in Africa as well as the FAO associated networks
     elsewhere in the world, we have concluded that the sustainability of such
     networks is not simply a financial issue. Credibility and overt reference to the
     national and regional develop ment aspirations must also be important
     considerations in the design of sustainable epidemiological surveillance networks.
     The following are key recommendations:

i.   The governance of epidemiological surveillance networks should be directly linked
     to the Regional Econom ic Community where they operate. This will strengthen the
     governance, operations and ow nership of networks. The SADC Epidem iology and
     Informatics network can serve as a model.

ii. The team commends the work of FAO as the Lead Technical Agency in de veloping
    regional epidem iological surveillance networks and we believe that FAO’s technical
    assistance will be crucial in guiding the process for setting up REC-based
    epidem iological surveillance networks as well as in supporting AU-IBAR to provide
    inter-REC and Continental coordination for the networks.

iii. The core functions of the regional epidem iological network in each REC should be
     to act as a forum for national epidem iologists and experts; to review disease
     national surveillance, response and control programmes; analyse regional and
     international disease trends and provide ear ly warning to National CVOs and
     policy makers; to define disease control, preparedness and response strategies as
     well as identification of areas for project intervention. These should be the same
     core functions for IBAR’s role in providing inter -REC Continental coordination of
     the regional networks.

iv. In designing projects for the above functions, the RECs and IBAR, with the
    support of FAO, should take cognisance of the fact that it takes a long-time (i.e.
    at least 10 years) to develop robust and sustainable epidemiological surveillance
    networks. Accordingly, a clear roadmap towards technical and financial
    sustainability should be part of the project design from the outset.

v.   Such a roadmap could start with an initial phase with full technical assistance by
     FAO, which dovetails with an over-watch phase during which FAO would not have
     resident technical assistance expertise but could continue supporting the network
     with short-term c onsultants to the phase of full unsupervised technical operation
     by REC but with only a back-stopping role for FAO. Donor or extra-budgetary
     financial support should also progressively decrease from the initial phase as the
     RECs progressively assume financ ial responsibility. The speed of technical and
     financial phasing-out and phasing-in will vary from REC to REC. A similar roadmap
     is recommended for IBAR’s responsibility for Continental coordination.

vi. Projects (see Sections 6 and 7 of Main Report) which enhance the effectiveness of
    the networks or whose fulfilment requires epidemiological surveillance should be
    conceived as supportive with a funding, management and operational system that
    is separate from the core functions of the regional network. For cohe sion, such
    projects would need to make progress reports to the networks but not to be
    managed by the networks. Here again we see value in the involvement of FAO
    and its partners in the RAHCs in providing technical assistance.

vii. At the national level, epidemiology networks should form part of the normative
     functions of National Veterinary Serv ices.

viii. After identifying a set of priority diseases in agreement with the National Chief
      Veterinary Officers, each regional epidemiological network should def ine a


                                                                                    10
     categorisations system that addresses surveillance as part of disease risk
     management strategy. This should include identification of at most three diseases
     whose control could serve as main drivers for network activities. Such selection
     should take into account both the epidemiological and developmental im peratives.
     For example, in parts of West Africa progressive control of HPAI is appropr iate
     while in the SADC region the requirement is prevention and preparedness.

ix. There is need to rationalise and standardise animal disease information systems
    at the national and regional levels to support the risk management of TADs and
    zoonoses. It is essential to ensure interoperability of such systems and capacity
    for data exchange and to be linked to an analytical platf orm to assist early
    warning. We recommend that FAO should lead such an effort and should work
    closely with IBAR to support the RECs and national veterinary systems. Such a
    programme will require specific donor funding.

x.   After observing that many countries have expressed keen interest in the new Java
     TADInfo, it is recommended that the back-stopping of the information system be
     decentralised to RAHC offices in various regions to encourage even higher
     adoption rate. Many epidemiologists working with the infor mation system have
     expressed some frustration with back-stopping from Rome as it tends to be slow-
     coming, albeit highly competent. The current arrangement of having only one
     back-stopping off icer in Rome for all F AO Mem ber Countries that wish to adopt
     TADInfo could be wanting as the uptake of the system increases.

xi. It is important for each REC to have a system of formal linkage between the
    epidem iology and laboratory networks as both contribute to the common goal of
    disease/infection surveillance. Furthermore, we recommend that there be an
    umbrella set-up which links epidem iology, laboratory, veterinary public health,
    communication and socio-economic networks and coordinates their reporting to a
    forum of the National Chief Veterinary Officers and/or National Directors of
    Livestock Development. We believe that the SADC system provides a model which
    the other networks could follow.

xii. IBAR to seek technical support from FAO for strengthening IBAR’s own normative
     and policy functions. Such support, which should be distinct from IBAR’s
     participation in the RAHC or operational projects, will also serve to strengthen
     mutual confidence between IBAR and FAO and will enable IBAR to have direct
     access to the enormous knowledge base of FAO in the agricultural and livestoc k
     sectors as well as such support technologies as ICT.


In conclusion, the role of IBAR in epidemiological networks should be one of
promoting interaction among various REC based regional epidemiological networks in
Africa and to use its association with OIE and FAO as well as other partners to bring
global experience to bear on the modernisation of African regional networks. It would
be expected that IBAR could play a leading role in re-establishing a continental forum
as opposed to micro management of regional epidemiology units.




                                                                                   11
SOMMAIRE EXEC UTIF

Résumé
Cette consultation a été commissionnée par le Secrétariat d‟ ALive pour passer en revue
l'état des réseaux de surveillance épidémiologique en Afrique subsaharienne au regard
des leçons apprises des expériences passées, des initiatives en cours et des initiatives
prochaines, au regard des dispositions organisationnelles et de la durabilité à long terme
des réseaux.
Les consultants devaient évaluer la faisabilité technique et opérationnelle de c omment les
réseaux épidémiologiques établis après l‟apparition de la Grippe Aviaire Hautement
Pathogène peuvent être étendus à d'autres Maladies Animales Transfrontalières et
Zoonoses dans une façon durable. Les consultants ont trouvé que l'objectif de l'é tude
était en droite ligne avec l’Objectif 3.1 de l’Engagement Numéro 3 du Sommet Mondial de
l’Alimentation, qui requiert de " s'efforcer d'assurer une prévention efficace et une
maîtrise progressive des infestations de ravageurs et des maladies des animaux et des
plantes, notamment lorsqu'elles sont de nature transfrontière … "

Deux considérations ont sous-tendues l'évaluation de la surveillance épidémiologique, à
savoir l'exigence du rapportage officiel, guidée par les normes de l‟OIE et celle pour la
gestion du risque des maladies transfrontalières et Zoonoses, y compris GAHP, guidée
par les préceptes FAO EMPRES d‟alerte précoce, de réaction précoce, permettant la
recherche et la coordination.


METHODOLOGIE
La méthodologie adoptée pour cette étude était une combinaison d'étude de bureau
composée de la revue de documents appropriés tant en versions papiers qu‟
électroniques et sur internet, des interviews avec les experts clés de la FAO incluant les
Responsables Régionaux d‟ ECTAD , la Représentation de l‟OIE pour Af rique et la Sous-
Représentation de l‟OIE pour l‟Af rique du sud, le Directeur par Intérim de l‟AU-IBAR et
son personnel, les Représentants des Communautés Économiques Régionales traitant des
questions du bétail, les chefs de projets, quelques Chefs Vétérinaires Officiaux, des
Epidémiologistes Régionaux et beaucoup d'autres personnalités clés de la santé animale.
Une réunion de lancement a été tenue aux quartiers généraux de la FAO à Rome et un
briefing a été fait par le Chef Vétérinaire Off iciel de la FAO, qui est le « ALive Champion »
pour l‟initiative d‟établir des Réseaux d‟Epidémiologie et de Laboratoire. L'équipe a aussi
échangé par téléconférence avec l‟OIE sur le système de jumelage de laboratoires et
Normes de l‟OIE, aussi avec les trois Responsables Régionaux d‟ ECTAD de la FAO au
niveau des Centres Régionaux de Santé Animale FAO-OIE-IBAR de Bamako, Nairobi et
Gaborone.
Des missions de terrain ont aussi été faites dans toutes les quatre régions. Les
consultants ont aussi participé à deu x ateliers régionaux pour les réseaux de surveillance
épidémiologique ; pour la Communauté pour le Développement des Pays de l‟Afrique du
Sud et celui pour l‟Afrique de l‟Ouest.


QUELQUES OBSERVATIONS CLEES

Les Pays de l'Af rique Sub-saharienne ont en général des Services Vétérinaires faibles,
surtout ceux qui ont dû adopter le Programme d‟Ajustement Structurel suivant la
dépression économique en Afrique des années 80. Les pays qui participent au commerce
international du bétail et produits du bétail ont une capacité raisonnable et en général
remplissent les Normes et Directives de l‟OIE. Botswana, Namibie, Swaziland et l‟Afrique
du Sud sont des exemples pour ces pays.

Pour le rapportage officiel, le nombre de pays qui, régulièrement font des rapports à l'OIE
en utilisant le système WAHIS est en augmentation et cela démontre l'impact positif des
Programmes variés de renforcement des capacités, initiés ces cinq dernières années.


                                                                                           12
Plusieurs des pays visités et des épidémiologistes nationaux interviewés ap précient
l'emplacement récent des Représentations Régionales et Sous -Régionales de l'OIE en
Afrique comme un stimulus pour l'appréciation du rôle de Services Vétérinaires et le
travail de l'OIE dans l‟établissement des Normes et la promotion de la bonne
gouvernance des Services Vétérinaires. Une démonstration supplémentaire de ceci est
qu‟en dehors de 51 pays en Afrique, 36 ont déjà demandé pour l'évaluation PVS de l'OIE
et en dehors de ceux-ci, 32 ont été évalués déjà. Le résultat attendu de ceci est une
analyse objective des gaps dans la gouvernance vétérinaire et les ressources qui, de
façon optimale mèneront à augmenter la conformité avec les Normes de l‟OIE.

En ce qui concerne l‟appui à la gestion du risque des maladies animales transfrontalières
et zoonoses, nous notons que WAHIS, qui a été créé à des fins de rapportage officiel de
plus de 100 maladies listées par l‟OIE, a peu de chances d'atteindre cet objectif. Ainsi au
niveau global, la FAO EMPRES-i et la FAO-OIE-OMS GLEWS ont été développées pour
combiner le rapportage des maladies aux données de surveillance plus les données
autres que maladies qui influencent la diffusion des maladies en vue de produire un
système d‟alerte précoce, comme résultat de surveillance épidémiologique.

Au niveau régional nous avons constaté que IBAR et SADC avaient développé ARIS et
LIMS, tandis que la FAO avait développé TADinfo au niveau national. Ils aspirent tous à
collecter l'information à la fois pour le rapportage des maladies et la gestion du risque
des maladies animales et zoonoses.

Au niveau national, en ce qui concerne les systèmes d‟information des maladies
animales, l'équipe ALive a trouvé une pléthore de Systèmes d‟Information de la Santé
Animale. La plupart des pays qui étaient dans le programme PACE q ui initialement ont
adopté le système ARIS l‟ont maintenant abandonné en faveur de petits dispositifs
nationaux conçus à partir des logiciels ACCESS (exemple Ethiopie, Nigeria, Kenya,
Sénégal) ou EXCEL (exemple Cameroun, Mali, Kenya) . Il y a eu une prolif ération de
systèmes d'information nationaux suite au manque de systèmes régionaux fiables qui
répondent aux besoins des pays. Pour SADC, LIMS vient juste d‟être lancé par le projet
PRINT et il est encore en phase de test dans les Etats Membres. Le système TADInfo qui
a maintenant mûri n'est pas aussi largement utilisé bien qu'il y ait eu un intérêt croissant
dans la nouvelle version Java qui est basée sur une plate-forme programmée en source
ouverte. Le principal problème avec le système TADInfo a été le ma nque d‟appui
constant, étant donné que le système est à la base opéré de Rome. Il y a donc un besoin
d'une approche standardisée du système d'information des maladies animales dans
l'appui à la gestion du risque des maladies transfrontalières et zoonoses, de préférence
coordonné ou guidé par la FAO. Une telle approche surmonterait aussi le problème de
manque d'inter-fonctionnement et d‟échange de données entre les différents systèmes
qui fonctionnent maintenant en Afrique.


En référence à l'existence de réseaux de surveillance épidémiologique en Af rique Sub-
saharienne, l'équipe a trouvé que PACE a fait un excellent travail dans d‟établissement
des réseaux au niveau national dans les pays qui ont participé au programme avec une
coordination régionale au niveau des quartiers généraux de l‟IBAR à Nairobi. Quand PACE
est arrivé à sa fin, la coordination régionale est devenue dysfonctionnelle, mais quelques
réseaux nationaux sont restés actifs bien qu'ils aient été affaiblis dû au manque de
financement et le fait qu'ils ont été établis indépendamment aux structures existantes
des Services Vétérinaires, excepter dans très peu de pays seulement comme le Ghana.
Donc en Afrique de l'Est, après PACE il y avait aucun réseau de surveillance
épidémiologique régional, ma is des efforts sont en cours pour en établir un à travers le
bureau ECTAD de la FAO à Nairobi et la Communauté des Etats de l‟Afrique de l'Est.

Pour l‟Afrique de l‟Ouest et du Centre, la situation est semblable à l‟Afrique de l'Est dans
la plupart des réseaux nationaux établis sous le programme PACE, mais l‟apparition des
premiers foyers de Grippe Aviaire Hautement Pathogène dans la région, a ranimé la


                                                                                         13
plupart des réseaux nationaux. Le bureau ECTAD de la FAO de Bamako est aussi très
animé dans l‟établissement du réseau régional bien que la coordination à long terme du
réseau régional demeure un problème pendant à résoudre pour éviter l'expérience du
PACE. La CDEAO et ses Etats membres ont exprimé le désir de donner au réseau un
hommage permanent pour la force de levier politique et la durabilité.
Le réseau de surveillance épidémiologique régional le plus avancé en Afrique
Subsaharienne que l'équipe a trouvé sur sa mission est la Sous-commission
Epidémiologique et Informatique du Comité Technique pour le Bétail de la SADC, dans la
région du Sud de l‟Af rique.

Ce réseau qui est complètement financé par les Etats Membres de la SADC, a une
structure institutionnelle saine de surveillance épidémiologique avec un rapportage
régulier, des réunions de coordinat ion pour échanger des informations et il a commencé
à produire maintenant un livre annuel de la SADC qui présente l‟inventaire des maladies
animales dans la région. Le réseau rapporte à un Comité de Chefs Vétérinaires Officiaux
de la région qui à la fin rapporte à un Conseil des Ministres de l‟Alimentation, Agriculture
et Ressources Naturelles. Le Secrétariat de la SADC fournit la coordination du réseau
mais ce réseau est présidé par la Namibie, un des Etats Membres de la SADC. Le CRSA -
ECTAD et les projets régionaux soutiennent le travail du réseau, et en fait l'équipe ALive
a été impressionnée de comment chacun des projets régionaux associés au Secteur du
Bétail de la SADC a quelques éléments pour rehausser la capacité du Comité Technique
du Bétail. Le réseau a été établi en 1997 avec trois autres réseaux sur le Diagnostic de
Laboratoire, la Santé Publique Vétérinaire, la Production Animal et Marketing 2 .

Le mécanisme de coordination institutionnelle adopté par la SADC pourrait annoncer un
modèle pour mettre en place et tenir de façon durable un réseau de surveillance
épidémiologique en Afrique Sub-saharienne avec le soutien des CRSA et des agences de
financement.

Il devrait être noté que l'Annuaire de Santé Animale de la SADC, qui est un
développement fortement louable, est une compilation de rapports et pas un système
d‟alerte précoce. De même LIMS n'incorpore pas encore une capacité analytique pour
supporter l‟alerte précoce pour les maladies transfrontalières et zoonoses.


La durabilité des réseaux de surveillance épidémiologiques a été examinée des
perspectives de la structure institutionnelle habilitante, la propriété de réseaux, la
structure du financement de programme et des réseaux. A part le réseau dans la région
SADC, les deux autres réseaux semblent être une forme de revitalisation des réseaux du
Programme PACE. De notre point de vue, l'initiative des réseaux PACE était essentielle
d'établir le principe et maintenant une approche plus durable devrait être adoptée pour
établir des réseaux futurs sur ça.

Bien que les bureaux ECTAD de la FAO en Afrique de l‟Est et de l‟Ouest aient fait très bien
dans la coordination du réseau de surveillance épidémiologique dans ces régions, le fait
que ces bureaux soient actuellement financés sur des fonds extra-budgétaires apporte
quelques inquiétudes dans la survie à long terme des réseaux. De la perspective de
durabilité les réseaux de surveillance épidémiologique semblent avoir seulement une
viabilité à long terme s'ils sont liés avec un groupement économique régional et s‟ils sont
inclus dans le budget de l'organisation comme démontré par la SADC qui budgétise les
réunions de coordination du réseau. Toutes les Communautés Économiques Régionales
(SADC, CDEAO et CEA) consultées, ont exprimé leur désir d'accueillir les réseaux.
Cependant, les Secrétariats de ces CER, manquent jusqu'ici de la capacité en ressources

2
 Note: The origins of this Subcommittee date back some 20 years, as having been conceived from
with the SADC region: As far back as 1986 Drs Biggs (and later Paskin) of Namibia, Unesu of
Zimbabwe, Mtei of Tanzania and Masupu of Botswana started working on the establishment of the
SADC Epidemiology Network when the SADC Livestock Sector was being coordinated by Dr
Magembe in the Botswana Directorate of Veterinary Services.
                                                                                            14
humaines et financières nécessaires pour fonder et coordonner des réseaux
épidémiologiques régionaux robustes conduits par l'objectif de gestion du risque des
maladies transfrontalières et zoonoses. Donc, l'aide technique au CER par les CRSA -
ECTAD et les projets financés par les donneurs sera essentiel pendant les étapes initiales
de jusqu'à 10 ans.




QUELQUES RECOMMANDATIONS CLES
Ayant étudié des expériences passées avec PACE et la structure des réseaux
épidémiologiques actuels en Afrique aussi bien que des réseaux a associé à la FAO
ailleurs dans le monde, nous avons conclu que la durabilité de tels réseaux n'est pas
simplement une question finançière.
La crédibilité et la référence manifeste aux aspirations de développement nationales et
régionales doivent aussi être des considérations importantes dans la conception de
réseaux de surveillance épidémiologique durables. La suite représente des
recommandations clés :

  i.    La gouvernance de réseaux de surveillance épidémiologique devrait être
         directement liée avec la Communauté Économique Régionale où ils fonctionnent.
         Ceci va renforcer la gouvernance, les opérations et l’appropriation des rés eaux.
         Le réseau Epidém iologique et Informatique de la SADC peut faire office de
         modèle.

  ii.   L'équipe recommande le travail de la FAO comme l'Agence Technique Principale
         dans le développement de réseaux de surveillance épidém iologique régionaux et
         nous croyons que l'aide technique de la F AO sera cruciale dans la direction du
         processus pour fonder des réseaux de surveillance épidém iologique basés au
         niveau des CER aussi bien que dans le soutien de AU -IBAR pour fournir une
         coordination Inter-CER et Continentale pour les réseaux.
         .
 iii.      Les fonctions principales du réseau épidém iologique régional dans chaque CER
         devraient devoir agir comme un forum pour les épidémiologistes nationaux et les
         experts; passer en revue la surveillance nationale de la maladie, les programm es
         de réponse et de contrôle ; analyser les tendances régionales et internationales
         de maladies et fournir tôt l'avertissement aux CVO nationaux et décideurs; définir
         le contrôle des maladies, l'état de préparation et des stratégies de réponse aussi
         bien que l'identification de secteurs d’activité pour les projets. Ceux-ci devraient
         être les mêmes fonctions principales pour le rôle de l'IBAR en fournissant la
         coordination Continentale inter-CER des réseaux régionaux.

 iv.    Dans la conception des projets pour les fonctions précités, les CER et IBAR, avec
         l'appui de la FAO, devraient prendre conscience du fait qu'il prend un long temps
         (c'est-à-dire au moins 10 ans) pour développer des réseaux de surveillance
         épidém iologiques robustes et durables. En conséquence, une feuille de route
         claire pour la durabilité technique et financière devrait faire partie de la
         conception du projet depuis le début.
        -
  v.    Une telle feuille de route pourrait commencer par une phase initiale par l'aide
         technique complète de la F AO, qui se rac corde avec une phase s'observant
         pendant laquelle la F AO n'aurait pas l'expertise d’aide technique résidente, mais
         pourrait continuer à soutenir le réseau avec des consultants à court terme
         pendant la phase d'opération technique non supervisée pleinement par la CER,
         mais avec seulement un rôle d’appui de la FAO. Donneurs ou supports financiers
         extra-budgétaires devraient aussi progressivement dim inuer à partir de la phase
         initiale comme la CER assume progressivement la responsabilité financière. La
         vitesse de synchronisation technique et financière progressivement variera de



                                                                                          15
            CER à CER. Une semblable feuille de route est recommandée pour la
            responsabilité d'IBAR pour la coordination Continentale.
           -
    vi.    Les projets (voir les Sections 6 et 7 du Rapport Principal) qui augmentent
            l'efficacité des réseaux ou dont l'accomplissement exige la surveillance
            épidém iologique doivent être conçue comme soutien avec un financement, la
            gestion et système opérationnel séparés des fonctions principales du réseau
            régional. Pour cohésion de tels projets auraient besoin de faire des rapports de
            progrès aux réseaux mais ne pas être dirigés par les réseaux. Ici nous voyons
            encore la valeur dans la participation de la F AO et ses partenaires des CRSA dans
            la fourniture de l’assistance technique.

    vii.   Au niveau national, les réseaux épidém iologiques devraient faire partie des
            fonctions normatives de Services Vétérinaires Nationaux.
           -
viii.      Après avoir identifié un ensemble de maladies prioritaires en accord avec les
            Chefs Vétérinaires Officiaux Nationaux, chaque réseau épidém iologique régional
            devrait définir un système de catégorisation qui adresse la surveillance comme
            partie de la stratégie de gestion du risque de la maladie. Cela devrait inclure
            l'identification d'au plus trois maladies dont le c ontrôle pourrait servir de
            conducteurs principaux pour les activités du réseau. Une telle sélection devrait
            prendre en compte d'impératifs tant épidémiologiques que liés au
            développement. Par exem ple, dans les parties de l'Afrique de l’Ouest le contrôle
            progressif de la GAHP est approprié tandis que dans la région de la SADC
            l'exigence est à la prévention et préparation.

    ix.    Il y a le besoin de rationaliser et standardiser les systèmes d'information des
            maladies animales au niveau national et régional pour appuyer la gestion du
            risque des maladies transfrontalières et zoonoses. Il est essentiel d'assurer
            l'inter-fonctionnement de tels systèmes et la capacité pour l'échange de données
            et à être lié à une plate-forme analytique pour aider à l’alerte précoce. Nous
            recommandons que la FAO devrait mener un tel effort et devrait travailler
            étroitement avec l’IBAR pour soutenir les CER et les systèmes vétérinaires
            nationaux. Un tel programme exigera un financement spécifique des donneurs.
-
-
     x.    Après avoir observé que beaucoup de Pays ont exprimé un vif intérêt dans la
            nouvelle version Java de TADInfo, il est recommandé que l’appui technique du
            système d’information devrait être décentralisé aux bureaux du CRSA dans les
            diverses régions pour encourager même le plus haut taux d’adoption. Beaucoup
            d'épidém iologistes qui travaillent avec le système d’information ont exprimé un
            peu de frustration sur l’appui technique depuis Rome comme il a tendance à
            venir lentement, bien que fortement compétent. Le système actuel d'avoir qu’un
            seul agent à Rome comme support technique pour tous les Etats membres de la
            FAO qui souhaitent adopter TADinfo pourrais laisser à désirer comme l'adoption
            du système augmente.

    xi.    C'est important pour chaque CER d'avoir un système de lien formel entre les
           réseaux d’épidém iologie et de laboratoire comme tous les deux contribuent au
           but commun de la surveillance des maladies/infections. En outre, nous
           recommandons qu'il y ait une parapluie qui lie l'épidém iologie, le laboratoire, la
           santé publique vétérinaire, la communication et réseaux socio-économiques, et
           coordonne leurs rapports à un forum des Chefs Vétérinaires Officiaux et/ou
           Directeurs nationaux de l’Elevage. Nous croyons que le système de la SADC
           fournit un modèle que les autres réseaux pourraient suivre.




                                                                                           16
xii.   IBAR de rechercher l'assistance technique de la F AO pour renforcer les propres
        fonctions politiques et normatives de l’IBAR. Un tel appui, qui devrait être distinct
        de la participation de l'IBAR dans le CRSA ou les projets opérationnels, servira
        aussi pour renforcer la confiance mutuelle entre IBAR et la FAO et permettra à
        IBAR d'avoir un accès direct à l'énorme base de connaissances de la FAO dans les
        secteurs agricole et du bétail aussi bien que de telles technologies d'appui comme
        les TIC.


   En c onclusion, le rôle d'IBAR dans les réseaux épidémiologiques devrait être de
   promouvoir l'interaction parmi les diverses CER à la base des réseaux
   épidémiologiques régionaux en Afrique et utiliser son association avec l‟OIE et la FAO
   aussi bien que d'autres partenaires pour apporter l'expérience globale pour porter sur
   la modernisation des réseaux régionaux africains. Il serait attendu qu'IBAR puisse
   jouer un rôle principal dans le rétablissement d'un forum continental par opposition à
   la micro gestion d'unités épidémiologiques régionales.




                                                                                          17
FEASIBILITY STUDY FOR ESTABLISHING EPIDEMIOLOGY NETWORKS FOR HPAI
        and OTHER TRANSBOUNDARY ANIMAL DISEASES IN AF RICA




1. INTRODUC TION

This consultancy was commissioned by the ALive Secretariat in order to review the state
of epidemiological surveillance networks in Sub-Saharan Africa with respect to lessons
learnt from past experiences, on-going and pipeline initiatives. This is to lead to an
assessment of the feasibility of capitalising on the current momentum created by the
concerns about avian influenza in order to put into place sustainable epidemiological
surveillance systems and networks that would improve both the efficiency of regional and
international reporting of animal diseases and the risk management (including
preparedness, tactical and progressive control) of transboundary animal diseases and
major zoonoses, including H5N1 highly pathogenic avian inf luenza (HPAI).

Throughout this report we have adopted the FAO-OIE def inition for transboundary animal
diseases as “those animal diseases that are of signif icant economic, trade and/or food
security importance for a considerable number of countries; which can easily spread to
other countries and reach epidemic proportions; and where control/management,
including exclusion, requires cooperation between several countries”.

Similarly we have adopted the WHO def inition for zoonoses as “Diseases or infections
which are naturally transmitted between vertebrate animals and humans”.

2. CONTEXT FOR THE STUDY/OBJEC TIVE

This feasibility has been undertaken against the backdrop of several new developments
that may not be readily apparent within Africa in the face of major issues of poverty, food
insecurity, governance and the devastating impact of HIV/AIDS, malaria and
tuberculosis.

All recent trend analyses of the agricultural sector point to the livestock sub-sector as the
fastest growing and as a significant contributor to the goals of poverty reduction and food
security. The same studies point to the fact that this is being fuelled by the increase in
population, urbanisation and economic growth, all which are contributing to
unprecedented demand for animal protein. This has been popularly termed the “livestock
revolution”. Several studies in Africa, especially by ILRI and FAO, have show n that
animal agriculture can be a major contributor to rural poverty reduction.

Transboundary animal diseases and zoonoses are considered to be the greatest
impediment to international trade in livestock commodities. Together with vec tor-borne
diseases they constitute a serious impediment to economic animal agriculture in Africa.
Several studies, particularly the Foresight study on infectious diseases have shown that
Africa and, to a lesser extent, Asia have the highest burden of infec tious diseases of
animals and humans. These regions also seem to have the hot -spots for many of the
emerging, epidemic diseases. Considerations of this nature have propelled the FAO and
OIE, in collaboration with the WHO, to launch jointly the Global Framework for the
progressive control of TADs and Zoonoses (GF -TADs) in which the central emphasis is on
controlling such diseases at source in the endemic settings of the developing world. The
emergence of the H5N1 epidemic of avian inf luenza which started in East Asia and spread
to other parts of Asia to Europe and to Africa has emphasised the concepts embedded in
the GF-TADs framework. These have now been reinforced by the concerted support of
the international community to the FAO-OIE-WHO global programme for highly
pathogenic avian influenza (HPAI). The establishment of the FAO-OIE-IBAR Regional



                                                                                          18
Animal Health Centres is part of this effort to enhance the capacity for tackling TADs and
zoonoses at source.

The ALive consortium was set up to collaborate with the African institutions in order to
stimulate sustained economic animal agriculture in Africa driven by market access and
safe trade in livestock commodities, in compliance with international standards. Clearly
without such concerted effort as embedded in the GF-TADs and the ALive initiatives there
is a grave risk that Africa will not participate adequately in the Livestock Revolution, in
international trade for livestock commodities and w ill have a population with
compromised health from disease and food security perspectives. It should be noted,
inter alia, that 51% of all infectious diseases of humans and 75 to 80% of all emerging
infectious human diseases over the last 30 years have been shown to have originated in
animals or animal products. The economic animal agriculture and the control of animal
diseases are crucial elements for Africa‟s ability to address key UN Millennium
Development Goals 1, 4, 5, 6 and 7.

Thus in interpreting our Terms of reference (Annex 1) we have been guided by the stated
objective for the feasibility study as: evaluating the technical and operational feasibility,
invest ment and benefits related to the establishment and adoption of epidemiology
networks in Africa for control and prevention of HPAI and other Transboundary Animal
Diseases (TADs).

We have found this to be in line with the World Food Summit Commit ment Number 3
Objective 3.1 which requires to “ Seek to ensure effective prevention and progressive
control of plant and animal pests and diseases, including especially those which are of
transboundary nature…”

Thus the study has been driven by two underlying targets for enhancing (a) Official
disease reporting based on OIE Standards/Norms; (b) Disease risk management
governed by the FAO-EMPRES precepts of early warning, early reaction, enabling
research and coordination. It builds on guidelines contained in the Joint FAO-OIE-WHO
GF-TADs, the FAO-OIE global strategy for the prevention and control of H5N1 highly
pathogenic avian influenza, the Final Evaluation of the Pan-African Programme for the
Control of Epizootics (PACE), the OIE Evaluation of the epidemiological surveillance
networks in PACE member countries and the report of the SADC Epidemiology and
Informatics workshop on building capacity for improved veterinary epidemiological
surveillance in Southern Africa.

In this report we have adopted the OIE definition for epidemiological surve illance as the
systematic ongoing collection, collation, and analysis of information related to animal
health and the timely dissemination of information to those who need to know so that
action can be taken. With respect to the risk management of TADs, the FAO Manual on
Disease Surveillance and Information Systems has sharpened this definition further as:
“All regular activities aimed at ascertaining the health status of a given population with
the aim of early detection and control of animal diseases of importance to national
economies, food security and trade”.

With both variants there is a clear link between surveillance and a dete rmination of a
disease control (or risk management) action. By contrast disease monitoring, which
uses the same techniques, has been def ined by the OIE as: the intermittent performance
and analysis of routine measurements, aimed at detecting changes in the environment or
health status of a population. Thus while monitoring would be sufficient for the purpose
of disease reporting, it would be inadequat e for the purpose of risk managing TADs and
zoonoses.




                                                                                          19
3. METHODOLOGY

The study started with the briefing at FAO HQ by the FAO Chief Veterinary Officer, who is
the Alive Champion for the initiative to establish epidemiology and laboratory networks.
This was followed by meetings and presentations by key FAO officers involved with the
EMPRES Programme, GLEWS, ECTAD and CMC-AH, Networks for laboratories (FAO and
OFFLU), epidemiological surveillance, Veterinary Public Health, tsetse and trypanosomes
(PAAT) and wildlife surveillance.

The team also interacted by teleconference with the OIE on the laboratory twinning
system and standards inspection systems such as PVS as well as with the 3 FAO ECTAD
Managers in the FAO-OIE-AU Regional Animal health Centres (RAHC) in Bamako, Nairobi
and Gaborone.

The team was provided w ith a set of briefing documents both electronically and as hard
copies by the FAO staff.

The meetings at FAO HQ were helpful not only in establishing contact with key focal point
officers of FAO but also in setting in motion teamwork for the study.

After extensive discussions w ithin the team and together w ith members of the laboratory
network feasibility study, the framework for the study was developed.

The key elements for this study are as follows:

      Desk study of the relevant literature at base and further refinement of the study
       framework;
      Missions to each of the 3 RAHC as well as to AU-IBAR, the Secretariats of SADC
       and ECOWAS, the OIE Regional and Sub-regional representations and the WHO-
       AFRO office.
      Participation in key relevant workshops including a workshop of the managers and
       epidemiologists of the FAO coordinated regional networks in Asia, Central Asia and
       Africa; the SADC meeting on developing the regional livestock policy and that of
       the SADC Epidemiology and Informatics Sub-committee (SADC Epidemiology
       network) including specific interview ing of the National Epidemiologists of
       Namibia, Lesotho, Malaw i, Botswana and Tanzania, the AU/ST RC Meeting of AU
       Policy on Infectious Diseases and Research Networks and the regional workshop
       of the FAO coordinated West and Central African Laboratory and Epidemiology
       Networks.
      Missions to selected indicator countries i.e. Botswana, Cameroon, Congo
       Brazzaville, Kenya, Ethiopia, Uganda, Nigeria and Mal i.
      Key discussion points to guide the consultations during the above missions;
      Identif ication of stakeholders to be visited in each country and participation in the
       regional workshops;


4. REVIEW OF C URRENT SITUATION IN SS-AF RIC A


   4.1. Impleme ntation of OIE Guide lines for Officia l Reporting and Vete rinary
        Governance

OIE standards are published in the four Codes which are:
    The Terrestrial Animal Health Code
    The Aquatic Animal health Code
    The Manual of Diagnostic Tests and Vaccines for Terrestrial Animals
    The Manual on Diagnostic Tests For Aquatic Animals



                                                                                          20
Although the OIE standards are adopted democratically, the participation of experts from
African countries during the development of the standards is low, resulting in standards
skewered towards developed countries.

In general, sub-Saharan African countries have weak veterinary services especially those
that had to adopt Structural Adjust ment Programmes following the economic depression
in Africa during the 1980‟s. Those where such programmes were not neces sary and
which participate in formal international trade (e.g. Botswana, Namibia, South Africa and
Swaziland) tend to have a better record for complying with OIE standards on reporting
disease outbreaks, submission of six monthly and annual reports as well as governance
of Veterinary Services. Apart from Botswana, South Africa, Zimbabwe and Swaziland
other OIE member States in the region make little or no contribution to the OIE standard
setting processes. An internally commissioned study is underway within SADC on how to
improve participation of Member States in the OIE standard setting processes.

Nevertheless, overall there seems to be an upward trend in the number of African
countries that now regularly report to the OIE using the WAHIS system (Table 1).
Several of the countries visited and National Epidemiologists interviewed appreciate the
recent location of the Regional and Sub-Regional OIE offices in Africa as a stimulus for
the appreciation of the role and work of the OIE by African governments beyon d just
veterinary services and the increasing trend towards compliance with the OIE standards.
One reflection of this is that out of 51countries in Africa, 36 have requested for PVS
evaluation by the OIE and out of these, 32 have already been evaluated. The expected
outcome is an objective gap analysis in the veterinary governance and resource which
hopefully will lead to enhanced compliance with OIE standards.

Table 1: Adoption of WAHIS by African OIE Member Countries at 23 Oct 2008

                      2007_S1             2007_S2           2007_A         2008_S1
Afrique du Sud         WAHIS               WAHIS             WAHIS          WAHIS
Algérie                WAHIS               WAHIS             WAHIS          WAHIS
Angola                 WAHIS               WAHIS             WAHIS          WAHIS
Bénin                   WAHIS               WAHIS           WAHIS           WAHIS
Botswana                WAHIS               WAHIS           WAHIS           WAHIS
Burkina Faso           WAHIS                WAHIS           WAHIS           WAHIS
Cameroun               WAHIS                WAHIS
Congo (Rep         Formulaire papier
Dem du)
Cote d'Ivoire           WAHIS               WAHIS
Djibouti                WAHIS               WAHIS            WAHIS          WAHIS
Egypte                  WAHIS               WAHIS            WAHIS          WAHIS
                        WAHIS               WAHIS          Formulaire
Erythrée                                                     papier         WAHIS
Ethiopie                WAHIS               WAHIS            WAHIS          WAHIS
Gabon                   WAHIS               WAHIS            WAHIS          WAHIS
Ghana                   WAHIS               WAHIS            WAHIS          WAHIS
Guinée                  WAHIS               WAHIS            WAHIS
Guinée-Bissau           WAHIS               WAHIS           WAHIS           WAHIS
Kenya                   WAHIS               WAHIS           WAHIS
Lesotho                 WAHIS               WAHIS           WAHIS           WAHIS
Libye                  WAHIS               WAHIS             WAHIS          WAHIS
Madagascar         Formulaire papier   Formulaire papier   Formulaire
                                                             papier
Malawi                                 Formulaire papier
Mali                   WAHIS               WAHIS             WAHIS          WAHIS
Maroc              Formulaire papier   Formulaire papier   Formulaire     Formulaire
                                                             papier         papier


                                                                                       21
Maurice                 WAHIS               WAHIS             WAHIS
Mauritanie              WAHIS               WAHIS             WAHIS           WAHIS
Mozambique              WAHIS               WAHIS             WAHIS           WAHIS
Namibie                 WAHIS               WAHIS             WAHIS
Niger                   WAHIS               WAHIS             WAHIS           WAHIS
Nigeria                 WAHIS               WAHIS             WAHIS
Ouganda                 WAHIS               WAHIS             WAHIS
Réunion (Fr)            WAHIS               WAHIS             WAHIS           WAHIS
Rwanda                  WAHIS               WAHIS             WAHIS
Sénégal                 WAHIS               WAHIS             WAHIS           WAHIS
Soudan                  WAHIS               WAHIS             WAHIS           WAHIS
Swaziland               WAHIS               WAHIS             WAHIS           WAHIS
Tanzanie                WAHIS               WAHIS             WAHIS
Tchad                   WAHIS               WAHIS             WAHIS
Togo                    WAHIS               WAHIS             WAHIS           WAHIS
Tunisie                WAHIS               WAHIS              WAHIS           WAHIS
Zambie                 WAHIS               WAHIS              WAHIS
Zimbabwe           Formulaire papier   Formulaire papier




   4.2. Re porting and Risk Management of TADs a nd Zoonoses at the Global
        Level

At the global level, FAO, OIE and WHO constitute the triumvirate with responsibility for
international animal health including its impact on or interface with human health.
Agreements between them date back to the early days of the est ablishment of the United
Nations. International disease reporting for animal health including zoonoses is covered
by provision of the OIE Codes and for public health including zoonoses by the WHO
International Health Regulations. FAO has been the principal technical assistance agency
for animal health (including zoonoses) to developing countries, those described as middle
income economies and those in economic or political transition.

Since the late 1980‟s all three organisations have sought to draw the at tention of the
international community to the increasing impact of infectious diseases of animals and
humans and all three have developed new priority programmes to address the issue. The
success of the WHO coordinated programme for small pox eradication e ncouraged FAO
and OIE to jointly embark on promoting global eradication of rinderpest and WHO to
launch new programmes for internationally coordinated control programmes for such
diseases as poliomyelitis and measles. To further strengthen their collaborat ion in animal
health, including zoonoses, the three organisations initiated in the mid 1990‟s a system
of formal inter-agency annual meetings to review their separate and joint programmes in
animal health. The emergence of major epidemics and epizootics such as foot-and-mouth
disease, severe acute respiratory syndrome (SARS) and highly pathogenic avian
influenza has made such collaboration not simply a matter of good governance practices
but an absolute necessity.

In 1998, through a Resolution of the OIE t he three organisations were asked to initiate
steps towards a global early warning system for transboundary animal diseases and
zoonoses. Since then both the OIE and WHO have revised their regulations for
international disease reporting, respectively the OIE Code(s) and the International Health
Regulations (2005). The FAO, through its EMPRES programme has also stepped up its
disease situation analysis and early warning system. The complementarity of the OIE and
FAO systems has probably been best exemplified by the HPAI epidemic where the OIE
has been the source of authoritative official reports while FAO-EMPRES through its HPAI
Update and AIDE News has provided more descriptive and epidemic situation analyses.


                                                                                        22
The updated agreement between FAO and OIE, whic h was signed in 2004, included as
one its pillars, a joint commit ment for the Global Framework for the Progressive Control
of Transboundary Animal Diseases and Zoonoses (GF -TADs). This was joined in 2006 by
WHO with respect to zoonoses. Since the beginning of 2006, FAO, OIE and WHO have
agreed to develop the Global Early Warning and Response System (GLEWS) as “a joint
system that builds on the added value of combining and coordinating the alert and
response mechanisms of OIE, FAO and WHO for the international community and
stakeholders to assist in prediction, prevention and control of animal disease threats,
including zoonoses, through sharing of information, epidemiological analysis and joint
field missions to assess and control the outbreak, whenever needed”. While the GLEWS
platform is based at FAO HQ it is jointly owned by the three organisations, with a
tripartite task-force of specifically nominated GLEWS focal points in each organisation
and SOPs which are jointly developed and monitored by the three organisations.

Realising that in 2006 there was no global response network for animal diseases that
corresponded to the WHO Global Outbreak Alert Response Network (GOARN), FAO
expanded its response system to TADs by establishing a new entity which linked the
normative response capacity of EMPRES with FAO‟s Technical Assistance/Emergency
Programme to create the Emergency Centre for Transboundary Animal Diseases (ECTAD)
in 2007 under the FAO Chief Veterinary Officer. Since early 2008, FAO and OIE have
established the Crisis Management Centre-Animal Health (CMC-AH) at FAO Headquarters
to strengthen their joint response to animal disease and food safety emergencies, which
operates in close collaboration with WHO w ith respect to zoonoses and food safety.

Thus at the global level the ALive Team found that on the one hand OIE and WHO have
up-dated the official reporting systems while on the other FAO, OIE and WHO have built
on the prime elements of EMPRES to develop a comprehensive global strategy for the
risk managing TADs and Zoonoses, as shown in Fig 1.




     Fig 1: Global Strategy for Risk Management of TADs and
     Zoonoses by FAO, OIE and WHO

           EARLY WARNING
                    FAO-OIE-WHO GLEWS
                        A development beyond WAHID, EMPRES-I, WHO-Alert
           EARLY REACTION
                    FAO-ECTAD
                    FAO-OIE-WHO Crisis Management Centre – Animal Health (CMC-AH)
           ENABLING RESEARCH
                      OIE-FAO OFFLU
                      OIE-FAO Reference Laboratories/Centres
                      FAO/OIE/WHO Collaborating Centres
                      Commissioned studies with academic and research experts/institutions
           COORDINATION ----- FAO-OIE-(WHO) GF-TADs; ONE WORLD-ONE
            HEALTH
                    Eradication/Progressive Control
                         GREP
                         HPAI
                         FMD (planning stage)
                    Tactical Interventions
                         Disease emergencies or assisting local control e.g. RVF, CBPP, Rabies,
                           Newcastle disease etc




                                                                                                   23
The three organisations seem to have developed their inter-agency collaboration, always
seeking synergy, building on their individual strengths rather than weaknesses and on
the guiding principle that “t he whole is greater than the sum of the parts”.


      4.3. Status of Disease Information Systems at National and Re gional Levels

The ALive Team found a plethora of animal health information systems. Most countries in
the PACE that had adopted the ARIS system have now abandoned the system in favour
of locally designed small packages based on either Access or Excel spreadsheet. LIMS
has only just been launched by the PRINT project of the SADC Secretariat. It is Access
based. So it is effectively still in the field t esting phase. The TADInfo system, which has
now matured, is also not widely adopted although there has been an increasing interest
in the new Java version which is based on an open source programming platform with
capacity to operate either off-line or via internet access. The greatest concern about
TADInfo by those who have actually experienced the latest version is the lack of back-
stopping that is based in Af rica. Several of the national epidemiologists interviewed
expect this function to be assumed by t he new structure of the Regional Animal Health
Centres. Many of the countries that previously had their ow n national systems have been
cautious in changing. Of the countries that previously participated in the PACE
programme, Ghana seems to have evolved the best integrated livestock information
system that recognises the dual objective of a baseline database and a specialised subset
for the management of animal diseases and zoonoses. Thus Ghana has been able to
integrate the TADInfo system seamlessly in a structured manner from National HQ to
sub-national nodes of the internet enabled version.

Because of a lack of an agreed and standardised approach and an inadequate
appreciation of the distinction between the requirements for official reporting and support
to risk management of TADs and zoonoses, there is a possibility of duplication in several
countries using TADInfo and LIMS or ARIS or other systems at the same time for disease
reporting.

There appears to be an inadequate appreciation that actually this problem can readily be
avoided if countries using TADInfo can produce a LIMS data export function in a standard
format. We strongly recommend that such an export function be integrated into the
TADInfo National programme as a matter of urgency. This will minimise the risk of
countries using 3 or more software systems (TADInfo, LIMS, and WAHIS etc) to submit
disease reports at national, regional and global level respectively.


      4.4. Epidemiological Surveillance Network in West and Central Africa

This Network covers two RECs, the Economic Community Of West African States
(ECOWAS) 3 and the Economic Community of Central African States (ECCAS) 4 . Although
West and Central Africa have tended to be grouped around linguistic clustering
(Anglophone versus F rancophone), the recent emergence of the ECOWAS with 15
Member States and ECCAS with 11 Member States is conveniently clustering West and
Central Af rica into epidemiologically coherent groupings. Of the two RECs, ECOWAS has
the more established institution. Accordingly the ECOWAS has a Regional Agricultural
Policy and has a West African Health Policy. The ECOWAS Secretariat now includes a post
for livestock matters within the Commission for Agriculture, Environment and Water


3
    CEDEAO in French: Co mmunauté Economique des Etats d’Afrique de l’Ouest
4
    CEMA C : Co mmunauté Economique et Monétaire de l’Afrique Centrale
                                                                                         24
Resources. Nevertheless, as yet there are no specialised institutional structures for
animal health as exist in the SADC region.

Currently, there is no regional animal disease database in West and Central Africa that is
comparable to the LIMS system of the SADC Secretariat. Countries report to the OIE
using WAHIS. For supporting disease risk management most countries now look to FAO
to provide support through the adoption of TADInfo at the national level, having been let
down by the collapse of the ARIS system after the end of PACE. This was a key
conclusion of the two recent workshops (October and November) which were organised
by OIE and FAO, respectively on information systems and epidemiological surveillance
network.

The West and Central African Epidemiological surveillance Network has been deve loped
directly from the PACE coordination mechanism, reinforced by the formation of the
ECTAD- Regional Animal Health Centre. Supported by FAO TCP in addressing the
epidemiological surveillance needs for HPAI, the network has started from the baseline of
the structures, organisation, expertise, practices and performance criteria that had been
laid by the PACE programme. Now in several countries such as Cameroon, Ghana, Mali,
Niger, Nigeria, Senegal and Chad national epidemiology units have been successfully
integrated into national Veterinary Services supported by appropriate legislation.

In both Ghana and Nigeria there has been a long history of national epidemiology units
on which, PARC, PACE, HPAI and other projects have built.

In Mali the national epidemiological surveillance network is now a legally constituted
agency of the National Veterinary Services with a focus on a given set of nationally
priority animal diseases for its programme. The unit produces a monthly newsletter
which has a wide circulation to various stakeholders and in terms of risk management, it
has categorised diseases in the country into those which are notifiable and others for
general surveillance.

Epidemiological surveillance at the national level is particularly challenging in the two
Congo (Brazzaville and DRC). Some NGOs such as Veterinaires Sans Frontieres (VSF) are
assisting in addressing this challenge. Nevertheless, there does not seem to have been
the same level of involvement in epidemiological surveillance as in southe rn Sudan and
Somalia, in Eastern Africa.

The West and Central African Epidemiological Surveillance Network ( Réseau Régional des
Réseaux Nationaux d‟épidémiosurveillance – RESEPI) is currently animated and
coordinated primarily by the FAO-ECTAD set up in the Regional Animal Health Centre,
Bamako. There are now moves to enhance the role of the ECOWAS Secretariat in the
network, with respect to West Africa. There is some indication that ECOWAS might meet
part of the cost of running the epidemiological survei llance network. ECOWAS has
recently appointed its focal point to operate and work with the RAHC in Bamako. There is
clear interest at the ECOWAS Secretariat in the work of the RAHC Bamako and an
appreciation of its role in containing HPAI in the countries that were affected and in
elaborating the surveillance and preparedness plans for the region. It is also appreciated
that the current efforts to widen the scope of the network to a wider aspect of TADs and
zoonoses will be beneficial to the region.

A view was commonly expressed at both the ECOWAS Secretariat and several national
epidemiologists and National Directors of Veterinary Services that, from the perspective
of sustainability, it could be advantageous to set the West African component of the new
network under the umbrella of ECOWAS with the guidance and technical assistance of the
RAHC, especially FAO-ECTAD. An example that was repeatedly quoted is that of PANVAC,
which although was executed by FAO for the initial 10 years, it was conceived from th e
outset as an AU institution. Throughout the period of custody by FAO, the
institutionalisation of PANVAC was always a constant agenda. By contrast the


                                                                                         25
ELISA/Laboratory network which was set up by FAO-IAEA did not become
institutionalised within the AU system as it appeared to be seen as owned by the FAO-
IAEA.

The ALive Team did not detect any animosity towards technical assistance by the RAHC -
ECTAD. On the contrary there was universal appreciation of the support that is being
offered. There is a realisat ion that it is necessary in the short to medium term to have a
structure with enough dynamism, appropriate human resources and know -how to make
the regional networks function effectively. What is required is a designed roadmap
towards full technical responsibility by the RECs.

Accordingly the long-term sustainability for the West and Central African network will
depend on identifying an enabling institutional framework.


   4.5. Epidemiological Surveillance Network in Easte rn Africa

Like its counterpart in West and Central Africa, this network also has benefited from the
structures and practices that had been put in place by PACE. It has focused effectively on
avian influenza, initially within the financial and technical framework of the FAO Technical
Cooperation Programme (TCP) and recently with additional financial support from donors
including USAID, Canada and the European Union. Furthermore, outbreaks of Rift Valley
fever and PPR in the region have required of the network to expand its disease scope.
Thus at both the national and regional levels there are beginning to be moves to
internalise the lessons from HPAI preparedness plan as a template for preparedness
against other TADs and zoonoses and the HPAI inter-sectoral collaboration as the
template for zoonoses in general, especially RVF and Rabies. Ethiopia seems to have
promptly adopted the contingency plan and approaches, including risk assessment and
communication strategies and communication strategies, which had been designed for
HPAI to address the RVF emergency.

The Eastern African Epidemiological surveillance network has to deal with 3
Organisational set-ups, namely IBAR with its continental mandate, the East African
Community (EAC) of 5 countries and the Inter-Governmental Authority for Development
(IGAD) of 6 countries.

The ALive Team was impressed by the emerging close collaboration between FAO-ECTAD
and IBAR, despite the absence of a formal MoU. Apart from day -to-day interactions,
there is now agreement for a formal meeting every two months and an agreement to
develop joint programmes. This is already happening as evidenced by the planned joint
simulation exercise in Zanzibar and the workshop on regional epidemiological
surveillance in Kigali.

IBAR (through PACE) has pioneered a cross-border, ec osystem based surveillance
programme for rinderpest (SERECU), which has worked with the guidance and
collaboration of the FAO-GREP. That relationship has now evolved to a stage whereby
FAO is in the process of placing an epidemiologist in the SERECU set up. IBAR and FAO-
ECTAD are adopting a similar eco-system based approach for risk management of PPR in
Eastern Africa. There is now a realisation within IBAR that during PARC and PACE, FAO
actually introduced activities in all the 4 prime elements of EMPRES, namely early
warning, early reaction, enabling research and coordination either directly through the
activities of the EMPRES and GREP or through PANVAC and FAO-IAEA or through FAO‟s
involvement in the regional projects. After the end of PACE, FAO has also helped
considerably in the design of epidemiological surveillance strategy for rinderpest freedom
accreditation, for RVF and for avian influenza. In the past, these interventions by FAO
have tended to be viewed by AU-IBAR more as technical assistance activities than as an
orientation of AU-IBAR‟s own strategic planning. This distinction is now becoming
recognised and valued by AU-IBAR, which now realises the value to IBAR and AU Member


                                                                                         26
Countries of a close interaction with the normative work of FAO-EMPRES and GLEWS for
effective early warning and preparedness/response strategies against the threats of such
diseases as RVF and HPAI. There is therefore a need for FAO to assist AU-IBAR to
develop its own normative function in regional risk management of TADs a nd zoonoses in
a manner that is compatible with current systems that are being pursued at the global
level.

Several Eastern African countries, including Ethiopia, Somalia, Sudan, Kenya, Uganda
and Tanzania, have built on the PACE experience to mainstrea m participatory
epidemiology disease search practices, including the use of community -based animal
health workers into the national epidemiological surveillance programmes.

For the East Africa Community, FAO-ECTAD (through EDF f inancial support) will be
assisting the EAC with the setting up of an Animal Health desk within the Secretariat in
parallel with the launching of the epidemiological surveillance network for Eastern Africa.
The EAC is developing institutional structures which seem to be driven by the One Health
concept. For example, the medical and livestock teams are within the same
administrative unit of the EAC Secretariat. There is an EAC Technical Committee (of
Directors and Experts) for Communicable and non-communicable diseases of humans
and animals, which reports to the EAC Council of Ministers. This committee also includes
representation from the wildlife sector.

There is an emerging development for allocating places to veterinarians in the Field
Epidemiology (FELP), 2-year postgraduate training programmes of the universities of
Makerere (Uganda), Nairobi (Kenya) and Muhimbili (Tanzania).

IGAD does not seem to have developed an institutional framework for animal health akin
to that of either the EAC or SADC. But FAO is involved in livestoc k policy studies for the
IGAD through its pro-poor programme coordinated from the FAO Sub-regional Office for
Eastern Africa in Addis Ababa.

There is no regional animal disease database for either EAC or IGAD or the evolving
epidemiological surveillance network for Eastern Af rica that is comparable to that of the
SADC Secretariat. However, IBAR has been trying to develop a continental database
using the ARIS system. There is need for FAO‟s technical support to rationalise the
animal health information system for supporting national and regional risk management
of TADs and zoonoses for Eastern Af rica and IBAR (see section 7.1).

So the long-term sustainability for the Eastern African network should take into account
the uniqueness of the institutional arrangements and the requirement for close inter-
sectoral collaboration.


   4.6. Epidemiological Surveillance Network in Southe rn Africa (SADC)

Epidemiological surveillance in the SADC region is coordinated by the Epidemiology and
Informatics Sub-committee (EIS) or network of the SADC Livestock Technical Committee
(LTC) http://www.sadc.int/fanr/print/technical_committee.php of SADC Member States,
which is linked to the Directorate of Food, Agriculture and Natural Resources (FANR) of
the SADC Secretariat. It is one of the four Sub-Committees/networks established by the
LTC and approved by the SADC Council of Ministers since 1997; the others being for
Laboratory and Diagnostics, for Veterinary Public Health and Food Hygiene and for
Animal Production and Marketing.

Thus, the EIS is aligned totally to the institutions of the SADC. It comprises Heads of
National Epidemiology Units; reports to the LTC and the inter-sectoral SADC Joint
Technical Co mmittee for avian influenza. There is an established mechanism for the
recommendations from the SADC-EIS to progress to the SADC Livestock Sector Technical


                                                                                        27
Committee, the Council of Ministers and, as appropriate, ultimately to the SADC Summit.
The interventions through the RAHC and regional projects in the SADC region strengthen
the capacity of the SADC EIS to fulfil its mandate. Thus support through the RAHC and
projects add value to an established structure. Currently there are 6 sets of regional
donor funded projects/programmes, all of which can be traced to recommendations of
either the LTC or its subcommittees. They all report to the LTC and the relevant sub -
committees, their work plans and progress. These project sets are:
        4.6.1. Systematic PVS evaluation of the national veterinary services of SADC
             Member States by the OIE was recommended by the LTC;
        4.6.2. The EDF funded PRINT project framework is based on recommendations of
             the LTC and is aligned to the Dar es Salaam Declaration by the SADC
             Summit in 2005. It focuses on establishing a regional livestock baseline
             database for animal production, animal diseases, livestock marketing and
             infrastructure as well as on training and gap analysis commissioned studies.
        4.6.3. Emergency support for the control of TADs, funded by South Africa and
             implemented by FAO in six Member States, was in response to the SADC
             Appeal for emergency relief in 2003 and has focused on emergency control of
             FMD and CBPP;
        4.6.4. The EDF funded SADC FMD project is in line w ith the recommendations of
             the SADC CVOs and the SADC Appeal for emergency relief in 2003 and
             focuses of FMD control in Zimbabwe and the neighbouring countries plus
             related studies;
        4.6.5. The AfDB funded SADC TADs project which targets strengthening the
             epidemiology and laboratory capacity of 5 countries in the northern band of
             SADC is also a direct outcome of the recommendations of the SADC CVOs
             and the SADC Appeal in 2003. This project focuses on enhancing the capacity
             of the 5 countries as well as the SADC Secretariat for the risk management
             of TADs;
        4.6.6. The avian influenza suite of projects. Although these have been conceived
             as part of the global and African continental strategies, the SADC structures
             play a key oversight role for their implementation. This set of projects is
             focusing on laying down the foundations for a structured emergency
             preparedness strategy against avian influenza that is applicable to other
             TADs and zoonoses.

While the SADC region has had an institutional f ramework for epidemiological
surveillance, with sound reporting, coordination and exchange of information, the region
has not run an epidemiological surveillance network as such, with Standard Operating
Procedures. There has been an established view in the SADC region that such an
approach requires a clear link to a regional disease control or preparedness programme.

Since 2003, FAO has guided the SADC region to categorise TADs and zoonoses according
to surveillance and risk management strategies (Annex 2). This resulted in the decision
of the SADC CVOs to plan for a long-term regional programme for the progressive control
of FMD and CBPP. This then provided direction to the SADC Secretariat on what type of
enabling projects to develop: the first for enhancing epidemiological surveillance by
upgrading of the epidemiology and laboratory capacity of the northern band of SADC
Member States to try and bridge the gap between the northern and southern band
countries and the second for disease control in Zimbabwe and strengthening surveillance
and preventive measures in the southern band of Member States. But all SADC Member
States are coordinated by the established Sub-committees. The newly proposed
surveillance network that will link the laboratory and epidemiology sub-committees as
will the Southern African Commission for the Cont rol of TADs. One of the regional
training workshops that was coordinated by the PRINT project was on identifying needs
for a southern Af rican epidemiological surveillance network. At its November 2008
meeting the Epidemiology and Informatics Sub-committee resolved to commission a
study on the capacity and practices for epidemiological surveillance in Member States.



                                                                                       28
When the need for a coordinated preparedness for avian influenza arose, the required
activities could readily be fitted into a pre-existing framework of the Epidemiology and
Laboratory Sub-committees (or networks).

The ALive Team was impressed by how each of the regional projects associated with
SADC includes some element of enhancing the capacity of the LTC.

The ALive Team was also impressed by how the SADC Secretariat and the LTC value the
collaboration with both the OIE and FAO for their normative functions. For example, the
LTC always meets about a month before the OIE General Session with an agenda that
includes items for the OIE Internat ional Committee and its Commissions. SADC countries
have agreed to request a PVS inspection by the OIE. FAO has been assisting SADC to
develop a Regional Agricultural Policy. Thanks to the established institutional framework
the LTC Sub-committees were the first to hold a joint workshop and make
recommendations for animal production, infrastructure and livestock trade and for animal
health. This set of recommendations took fully into account the contents of an advisory
document that had been tabled jointly by the Regional Animal Health Centre, Gaborone.

Given the above, it should be possible for the SADC institutional systems and the
associated projects to work with the Regional Animal Health Centre in Gaborone to
internalise the recommendations for regional networks that came out of the FAO
workshop on regional networks as they already do with issues arising from the OIE
International Committee and Commissions. It also appears that the proposed Southern
African Commission for the Control of TADs may provide the regional institutional
framework through which the RAHC can readily introduce the GF -TADs framework.

Thus, the activities of the SADC networks, with the associated support projects can
readily be aligned to the 4 prime elements of EMPRES that we hav e adopted for
assessing the risk management strategies for TADs and zoonoses (Fig 2)




          Fig 2: Risk Management of TADs and Zoonoses at SADC Level
     •   EARLY WARNING
               • Epidemiology Sub-committee – aided by SADC TADs & PRINT projects
               • Digital pen and mobile telephone technology being introduced in several MS
     •   EARLY REACTION
               • Preparedness against HPAI
               • Contingency fund under SADC TADs project
               • Consultancy being commissioned for FMD emergency vaccine
     •   ENABLING RESEARCH
               •   Laboratory Sub-committee for diagnosis and research
               •   Two OIE-FAO Reference Laboratories/Centres in region
               •   A regional lab for HPAI; second TBA
               •   SACIDS network

     •   COORDINATION ----- SACCT for GF-TADs at SADC Level
               • Progressive Control/Elimination
                     – FMD – aided by SADC FMD and SADC TADs projects
                     – CBPP – aided by SADC TADs and FAO-RSA projects
               • Tactical Interventions
                     – Disease emergencies or assisting local control e.g. RVF, ASF, Rabies, Newcastle disease etc
                       (Epi-network decided to discuss options for Rabies control in SADC at next mtg)


                                                                                                                     2




                                                                                                               29
The EIS and LTC already have on their agenda increasing interaction with human health
sector and the wildlife sector. This too augurs well for the RAHC to collaborate with SADC
and its institutions in promoting the One World – One Health concept.

We consider the following to have been key factors that have contributed to the
sustainability of the EIS and other SADC Networks:
     They are owned by the REC (SADC)
     They are not an evolution of a project
     They are funded by SADC Member States
     They stem from a Common Vision of SADC Member States of working towards a
        Common Market, including facilitating the intra-regional and export trade in
        livestock and livestock products
     The Networks          are integrated into National Veterinary Services structures,
        underpinned by an enabling legal framework
     Each of the 4 Sub-committees/networks has a convener/chairman elected by
        peers representing Member States
     The EIS, like other Sub-committees/networks, has Terms of Reference which
        require, inter alia, its members to meet at least once a year and produce a report
        to the LTC and Ministers (- see Annex 3, as an example)
     The LTC ensures collaboration between the 4 Sub-committees/ networks

The key sustainability issue for the SADC seems to be one of enhancing the efficiency of
the systems in place rather than developing parallel structures.


   4.7. Evolution of Regional Anima l Hea lth Centres (RAHC)

The Regional Animal Health Centres were established as a co llaborative effort between
FAO, OIE and AU-IBAR in response to the HPAI outbreak in Af rica.

The main objective of the Centres is to use the combined strengths of the three
organisations to better coordinate and harmonise the control of major animal disea ses
particularly HPAI, including:
      Support in the elaboration of national control strategies with respect to HPAI
      Reinforcement of epidemiological surveillance for HPAI in domestic and wild birds
      Improvement in animal disease reporting system
      Strengthening of diagnostic capacities
      Training of OIE delegates and their collaborators
      Providing relevant disease information to the public and other stakeholders
      Providing technical assistance to countries in the implementation of disease
        control programmes
      Creation of vaccine banks and;
      Evaluation of Veterinary Services in order to identify gaps, weaknesses and areas
        for priority interventions or invest ments

Technical experts are supposed to be provided by the relevant organisations to achieve
the common objectives. The first RAHC was established in Bamako, Mali where the OIE
Regional Representation for Africa provides the secretariat and the technical supervision
is done by the three organisations within the framework of the Executive Committee of
the ALive. Other RAHCs have since been established in Gaborone, Botswana for the
Southern Af rican Development Community (SADC), Nairobi, Kenya for East and Central
Africa and Tunis, Tunisia for North African countries.

Each of the 3 agencies in the RAHC funds its own activ ities either from its core
programme or from donor support to that agency. There is no pooled funding and no
unified programme of work for the RAHC. However we noted that the RAHC in Gaborone
does from time to time produce single documents reflecting a common advice by the
partners in the RAHC to the SADC Secretariat, the LTC and its sub-committees. In


                                                                                       30
Nairobi the interaction so far has been between FAO-ECTAD and IBAR as OIE is not yet
represented there.

So far there is only one MoU which officially defines the establishment of the RAHC in
Bamako. Those for the other two centres are still being negotiated. Nevertheless the
ALive Team did not perceive any specific impediment in the work of the RAHC.


The FAO Emergency Centre for Transboundary Animal Disease s (ECTAD) in the RAHCs
has depended, so far on short -term FAO internal resource (i.e. TCP) and on extra-
budgetary funding. Nevertheless it has been sanctioned by the Director-General of FAO
with a proviso for satisfactory independent evaluation after 5 yea rs. The ALive Team has
been informed that such a 5-year lag period is not unusual in FAO even for some of the
eventual FAO flagship programmes. Therefore, performance might be the key
determinant for FAO‟s capacity in the RAHC either through physical locat ion in the same
premises or in FAO‟s Sub-regional offices which are already aligned to RECs through
FAO‟s policy of decentralisation. FAO‟s involvement in the RAHCs is part of its
decentralisation policy which involves working closely with the AUC and RECs , including a
formal agreement with the AUC to comply with the Maputo Declaration of AU Heads of
States on food security and agricultural development.

The OIE location in the RAHCs in Bamako and Gaborone coincides with its own regional
and sub-regional offices as part of its decentralisation policy. OIE‟s presence in the RAHC
Nairobi had not been realised at the time of this study. The OIE has depended on extra -
budgetary funding either in the setting up of the representations or in funding of
technical assistance staff.

So far AU-IBAR has only project supported staff in the RAHCs. IBAR has yet to define a
mechanism for long-term presence beyond the needs of HPAI in view of AU‟s policy to
work through the RECs. IBAR also has issues about the relationship be tween the
proposed RAHC for Eastern Africa and IBAR w ith its continental mandate. These issues
will need to be addressed by partners.


   4.8. Some lessons from epidemiological surveilla nce networks for infectious
        diseases of humans

We examined the epidemiologic al surveillance systems that operate for communicable
diseases of humans through visits to the WHO-AFRO HQ, literature study and through
discussions w ith Public Health officials in Botswana, Kenya and Tanzania. There are
vertical systems for centrally funded programmes like HIV/AIDS and that for general
surveillance. It is the latter that is most relevant to the veterinary epidemiological
surveillance networks under study. The equivalent for human infectious diseases is the
Integrated Disease Surveillance and Response (IDSR) system. This has been in place in a
number of countries in Africa and has been promoted by the WHO, initially with financial
assistance from the USAID. Now in most countries the system has been mainstreamed in
national programmes of Ministries of Health, with national budget support.
There are regional and sub-regional networks for IDSR. But the most crucial element is
that IDSR is rooted in the national health systems. So, IDSR is a strategy that assists
health workers to detect and respond to diseases of epidemic potential, of public health
importance, and those targeted for eradication and elimination. The information can help
health teams respond as quickly as possible to outbreaks, set priorities, plan
interventions, mobilize and allocate resources. The IDSR focuses at Community, Health
facility, district, region/province and national levels. The overall objective of integrated
disease surveillance is to provide epidemiological evidence for use in making decisions
and implementing Public Health interventions for the control and prevention of
communicable diseases.


                                                                                         31
We have focused on Tanzania and Kenya so as to make comparison w ith the system that
was introduced on the veterinary side through the PACE programme and IDSR and also
where the recent outbreak of Rift Valley fever has provided opportunity for the two
sectors to work together and compare notes, in addition to the impetus provided by HPAI
preparedness.
Conceptually, the two systems have a lot in common. They set out clear guidel ines and
epidemiological surveillance performance indicators. The IDSR is rooted in the health
facilities right down to the village dispensary. While the veterinary system appears to
have a community based anchorage and perhaps better able to undertake act ive
surveillance. However for the RVF outbreak in 2006/7, the veterinary system was found
to be wanting in not being embedded in the disaster management structures at the
district and local level. As a result in both Kenya and Tanzania the alarm for RVF wa s
raised much more prominently by the IDSR system in the medical sector than disease in
animals. In both countries lessons are being learnt and now human and animal disease
epidemics are being integrated into the national disaster management system and the re
are moves to include District Veterinary Officers into the District based disaster
management committees, along w ith their medical colleagues who have been established
members. It was also realised that the IDSR had a much better communication strategy
with the public and the donor community than the veterinary system.
In both Tanzania and Kenya the IDSR is also set up to:
             Improve communication between all levels of health care and public health
              system using data that can alter the availability of resources and strengthen
              the ability of health staff to provide improved services.
             Improve communication with the public, target populations, donors, and
              organizations that provide similar services. Coordination and collaboration can
              take place between groups; agencies and organizations that share similar
              target populations for disease control objectives.
             Increase the access to and use of standard surveillance case definitions and
              laboratory services for confirming suspected cases.
             Increase district level decision making for defining, recognizing and responding
              to issues and needs in the local area as well as to meeting national priorities
              and targets.
             Strengthen preparedness by integrating transportation, training and
              supervisory activities.
             Integrate multiple systems so that forms, people and resources can be used
              more efficiently and allow health staff to focus more on disease prevention,
              control and reporting.
             Provide district level support in using epidemiological tools to detect,
              investigate and respond to epidemics.
             Increase the alertness of clinicians to respond to a possible public health
              epidemic of even a single case or more diseases and the value of sharing
              information about these cases with health staff responsible for surveillance.


The national avian influenza preparedness plans have taken on board elements from the
veterinary and IDSR systems. The challenge to the veterinary epidemiological
surveillance network is w hether the lessons from the IDSR can be mainstreamed into the
veterinary network beyond HPAI preparedness.
Apart from funding issues, there appear to have been four key differences in the
evolution of the IDSR and the PACE epidemiological surveillance networks:
   (i)        The IDSR f ramework was designed and endorsed by WHO. The PACE system
              was developed through projects with support of FAO and OIE but did not set
              out to implement a strategy that was pre-endorsed by the FAO and OIE,
              except in general terms.
   (ii)       The IDSR integrated surveillance with response targets at different
              administrative levels in the national and local government structures. Although

                                                                                           32
              the EMPRES prime elements emphasise the link between surveillance/early
              warning and early reaction/response. These prime elements were not explicitly
              integrated into the PACE epidemiological surveillance networks.
   (iii)      The IDSR, like the PACE system, had a set of priority target diseases. But from
              the outset, IDSR categorised these priority diseases into 3 categories, i.e.
              those targeted for elimination/eradication, epidemic prone diseases and
              diseases of public health importance (See Annex 3). Accordingly, surveillance
              indicators and response thresholds were determined for each disease
              category.
   (iv)       From the outset the IDSR was conceived as an evolutionary programme for
              Public Health systems to be developed, practised and assimilated into the
              health service systems on a progressive long-term basis (i.e. over 10 years).
From the above, and w ith the benefit of hindsight as well as the post PACE experience, it
would seem that the PACE epidemiological surveillance syste m might have been
conceived as a project delivery approach without adequate prior programming for
mainstreaming it into the animal health systems at the national and regional levels. The
new structure of the Regional Animal Health Centre and the enhanced inter-agency
collaboration between FAO-OIE-WHO now offer an opportunity for the design of the new
epidemiological surveillance that can be programmed to be progressively mainstreamed
into the animal health systems at sub-national, national and regional levels.


   4.9. Other  Re levant   Key    Networks   and             Linka ges   to    the   Offic ial
        Epidemiological Surveillance Networks


The ALive Team found that there are a number of animal health related networks in
Africa whose work and outcomes could have a bearing on the efficiency a nd even
sustainability of the official Epidemiological Surveillance Networks. However in many
cases there is no forum for such networks to make an input into the official system. The
end result is that the official epidemiological surveillance networks do not seem to be
adequately underpinned by the research activities of African institutions.

Some examples of such relevant networks are:

   •       Various NGOs that operate in the animal health sector and which in several cases
           have an established animal health outreach and surveillance capacity at
           grassroots and difficult-to-reach areas.

   •       The AHEAD Network which is the Animal Health for the Environment And
           Development) Forum. This focuses primarily on w ildlife health and its impact on
           human and animal health.

   •       SACIDS, the Southern African Centre for Infectious Disease Surveillance. SACIDS
           is a ONE HEALTH consortium of southern African medical and veterinary,
           academic and research institutions involved with infectious diseases, initially of
           humans and animals but subsequently to include those of plants. There are
           discussions w ith the SADC relevant organs on how to link the work of SACIDS to
           the relevant LTC Sub-committees and the SADC Secretariat. A recent expert
           meeting of the AU/ST RC recommended the setting up of similar infectious disease
           research networks in other regions of Africa under the umbrella of the AU/STRC
           and the Science and Technology Units within the Secretariats of the RECs.

   •       USAID-funded project/programme entitled: Enhancing livestock health systems in
           Africa to prevent and control emerging infectious disease threats. This project is
           lead by ILRI collaborating closely w ith AU-IBAR and its objectives include


                                                                                              33
       enhancing (i) early disease detection, surveillance and prevention, (ii) public -
       private partnerships, and (iii) Pan-African animal disease know ledge bank.

   •   Various networks of academic institutions e.g. RUFORUM, ANAFE

   •   Various agricultural research networks, such as FARA and its sub-regional nodes


It appears that any link that exists between such NGOS or networks and the official
epidemiological surveillance networks is informal and of a tactical nature.


Recommendation:
It is strongly recommended that the emerging epidemiological surveillance networks
and/or the Regional Animal Health Centres should set themselves up as an inclusive
forum to foster such linkages.



   4.10.    Linkages Between Epidemiologica l Surveilla nce and La boratory
       Networks

The SADC region seems to be the only one that currently has an established linkage
between the epidemiology and laboratory networks as they both report to the Livestock
Sector Technical Committee. This linkage is due to be further strengthened through the
formation of a surveillance network as a common forum for the two networks and the
formation of the Southern African Commission for the Control of TADs both to be initiated
with funding from the African Development Bank under the SADC TADs project and the
EU funding under the SADC FMD project.

Elsewhere the linkage between the two networks is not yet structured alt hough the need
is well realised. The modalities of operation have yet to be established for the
cooperation between the two sets of networks.

Both ECOWAS and EAC have identified animal disease control programmes. These might
provide a platform for institutional linkage between the laboratory and epidemiology
regional networks.

It is important that for each REC a system of formal linkage between the epidemiology
and laboratory networks be set up as both contribute to the common goal of
disease/infection surveillance. Furthermore, we recommend that there be an umbrella
set-up which links epidemiology, laboratory, veterinary public health, communication and
socio-economic networks and coordinates their reporting to a forum of the National Chief
Veterinary Officers and/or National Directors of Livestock Development. We believe that
the SADC system provides a model which the other networks could follow.

At the national level, it is important that there be close contact between the epidemiology
and laboratory systems, which should include the following elements:
    • Linking laboratory sample data to field data in the national epidemiology
       database;
    • Distinguishing diagnoses based on syndromic observations only from those
       confirmed by laboratory diagnosis.
    • An appreciation by epidemiologists of the nature of laboratory tests, the meaning
       and limitations of laboratory results.
    • Epidemiologists and laboratory specialists should jointly design surveys and
       sampling strategies, as this is crucial for both cost-effectiveness and authenticity
       of results.



                                                                                        34
   •    Both official networks should be able to capture relevant disease data from
        unofficial sources whether those are members of the national networks or not.

Our mission did not study in detail the efficiency of linkage between the laboratory and
epidemiology activities at the national level. In most countries we noted that the
epidemiology units tended to be part of the office of the National CVO, linked to field
service and/or planning. In Uganda the epidemiology and communicatio n units are in the
same premises as the national veterinary laboratory. Also we did not assess to what
extent the declared diagnoses are based on syndromic or specific laboratory results.
These issues will need to be addressed in developing national epide miological
surveillance networks.


   4.11.      Cost and Impact Assessment

NB: in view of the absence of a socio-economist cum financial analyst on the Team, this
section will be addressed in the next phase of the feasibility study.


5. RECOMMENDATIONS FOR TECHNC IAL SUSTAINABILITY OF CORE F UNC TIONS
   OF EPIDEMIOLOGICAL SURVEILLANCE NETWORKS IN SS-AF RICA


   5.1. Underlying Considerations as Drivers for Susta ina ble Epidemiological
        Surveillance Networks

Sustainability of the epidemiological surveillance networks has been examined from the
perspectives of the enabling institutional framework, the ownership of the networks, the
structure of the networks and programme funding. Except for the networks in the SADC
region, the other two networks seem to be a form of revitalisation of the old PACE
Programme networks. Strictly speaking, PACE activities were mainly focused on the
building, support, strengthening of national epidemiological surveillance systems.
However, the regional PACE coordination for Western and Central Africa based in Bamako
and Eastern Africa based at IBAR in Nairobi tended to act as de facto networks. Therefore
the networks that are now being established by FAO can be viewed as the next step after
the national systems that were set by PACE.

From the outset, we would recommend that the ALive Consortium consider addressing
the following underlying issues in supporting the new networks:

   i.   The evolving role of animal health requires addressing the goals for of animal
        health as being beyond just animal agriculture. Animal health should assure:
            Animal agriculture
            Safe trade in animal commodities
            Animal welfare
            Animal biodiversity
            Food safety
            Human health (>51% all human infections; >75% emerging human
                infections are of animal origin)
   ii. With respect to infectious diseases, Afric an veterinary services also need to
        reposition themselves as:
            Health (animal and human) protection agencies,
            Instead of just animal disease control agencies
   iii. Experience with rinderpest has shown that single disease surveillance is difficult to
        sustain when disease incidence has declined to low or unapparent levels. Under
        such circumstances it is important to include surrogate surveillance for diseases
        that communities can readily relate with their immediate needs;



                                                                                          35
   iv. Trans-REC surveillance networks are difficult to sustain in the absence of a
       programme for regionally coordinated progressive disease control
   v. Give epidemiological surveillance a point of reference, a driver and a long -term
       roll out plan
             A clear roadmap for the REC to assume PRIMARY responsibility f or
               coordinating passive epidemiological surveillance and response - guided
               and assisted by FAO or the relevant Regional Animal Health Centre.
             10-year roll-out strategy for mainstreaming/institutionalisation of the
               network in the RECs, with an enabling project and phased technical
               assistance by FAO for the initial stages. The networks that FAO is setting
               up could be the beginning of such a roadmap, if the concept is included in
               the project design.
             National governments to accord a regulatory framework for ep idemiological
               surveillance and some budgetary provision for participation in the REC-
               associated regional epidemiological surveillance networks
             A defined and commonly agreed disease risk management strategy as a
               key driver for the regional network
             Wide stakeholder involvement in the network including tapping into the
               technical expertise of institutions outside the immediate jurisdiction of the
               ministry responsible for the network e.g. academia, research, public health
               and wildlife sectors, representation of the faming and livestock trading
               communities and the private veterinary sector.

   vi. They should include targeting innovations which will make a difference to the
        surveillance strategy such as by
             Introducing technology for point of disease event data capture a t field level
                plus participatory epidemiology with community and private veterinary
                sector involvement
             Introducing Field Epidemiology Training similar to WHO
             Developing veterinary integrated disease surveillance and response (IDSR)
                system similar to WHO
   vii. Make HPAI preparedness sustainable and relevant to African development by
             Stimulating biosecurity-based production and marketing of poultry
             Targeting control of infectious poultry killers

   viii. Ensure animal health and epidemiological surveillance programmes in Africa are
         underpinned by in situ research through
             Promoting competitive partnership research projects, requiring African
               consortia to partner with centres of science in industrialised countries (and
               not the easy option of the other way round)
             Ensuring the centre of gravity for such funding is tilted in favour of African
               institutions

We note that FAO shares a similar perspective as most of the above points have now
been incorporated into the guidelines for regional epidemiological surveillance networks
which were developed by the FAO regional networks focal points (from East, Central and
West Asia as well as Northern, West & Central, Eastern and Southern Af rica) meeting
held in Rome in October 2008 and which was attended by the ALive Epidemiology Team
Leader (see Annex 4).

   5.2. Enhanc ing Competence in F ield Epidemiology

In view of the expanding role of animal health and its impact on society and the disease
burden in Africa (Annex 2), it is imperative that epidemiological surveillance for TADs and
zoonoses in Af rica be under-pinned by w idespread competence in Field Epidemiology at
the national and regional levels. While many countries boasted of national
epidemiologists trained to MSc or even PhD level, it was evident that the national and
even regional systems in place were not fully geared up to the challenges of the future.


                                                                                         36
The sustainability of veterinary epidemiological surveillance networks will also depend on
their credibility and relevance of the future needs of society.

It is important to learn from t he experience of HPAI and RVF to review both the
structures and staff competence in epidemiological skills. Our assessment is that
competence in f ield epidemiology is an area where there is severe shortage, which is not
readily acknow ledged.

The WHO IDSR epidemiological surveillance has been underpinned by a cadre of
personnel with training in field epidemiology based on a 2-year postgraduate programme
that was originally devised by the CDC in the USA. This programme is now w idely used in
many parts of the world. There does not seem to be a comparable programme on the
veterinary side. In South-East Asia the need for such a programme has been highlighted
by the avian influenza epidemic. In Thailand, for example, steps are being taken to start
a veterinary va riant of the Field Epidemiology Training Programme. The need for such a
programme has been identified at least in East Africa, Southern Africa and Ghana. A
solution that is being sought in Africa so far has been to place a few veterinary
candidates in the public health FEPT programme. We recomme nd that a specific
assessment be made as to whether such an approach will satisfy demand or w hether
there is need to develop a specific strand of FETP-veterinary based on the CDC platform.

In view of the recently enhanced collaboration between USA-CDC with both the OIE and
FAO, we recommend that FAO and OIE use this opportunity to develop a dialogue with
CDC on promoting a training programme on veterinary Field Epidemiology to underpin
the surveillance for GF-TADs. Such a system would not be simply a matter of copying the
CDC-WHO FETP curriculum. It may need to be developed as a specific field veterinary
epidemiology training programme which is driven by the need to enhance the capacity
for the risk management of TADs and zoonoses by the veterinary services systems. We
also recomme nd that such a programme be specifically developed for developing
countries (or more specifically Africa), in Africa by African institutions in smart
partnership with OIE-FAO reference centres or academic institutions of the industrialised
countries, rather than a curriculum developed in industrialised countries for translocation
to Africa. We realise that this recommendation is new in veterinary risk management of
TADs and zoonoses. It is therefore best developed directly at the point of need, i.e.
within the endemic settings of Africa (and Asia).

The USAID is supporting a short -term training programme in field epidemiology and risk
analysis through a contract with the STOP-AI agency. The ALive Team has not been able
to make contact with STOP-AI to get a clear picture of what is intended. What is clear,
however, is that it is highly recommended that the ALive consortium look into the
feasibility of supporting a structured programme for field epidemiology training along the
lines of the WHO Field Epidemiology Training Programme, preferably under the umbrella
of FAO-OIE-WHO, but run by competent consortia of universities with veterinary faculties
in Africa in partnership with external technical input. This would help to progressively
convert the current epidemiological surveillance networks into integrated disease
surveillance and response networks. We believe that it is important to take advantage of
the current experience with HPAI to install a new vigour and direction in field veterinary
epidemiology in view of the increasing relevance of veterinary epidemiological
surveillance to both animal agriculture and human health. Whether such courses should
be stand alone or be part of the current WHO FETP should be a matter for specific
feasibility assessment. Our own preference would be for a specifically designed
curriculum for field veterinary epidemiology which will underpin GF -TADs.


   5.3. Organisation of Ne tworks at the National Level


PACE helped to establish epidemiological surveillance networks in Africa whose objective
was to set up and maintain a sustainable cost efficient livestock information management

                                                                                        37
system to back up policy and strategy development, and risk assessment and
management. Taking Tanzania as an example, the national network included the National
Epidemiology Section of the Directorate of Veterinary Services, the Central Veterinary
Laboratory, Veterinary Investigation Centres, Sokoine University of Agriculture, District
Veterinary Officers, Veterinary Service Providers and Wildlife management and research
establishments. But this appears to have been based on an informal working
arrangement for project delivery without a clear governance structure. This structure also
focused a lot on information flow without clear commit ment to feed-back or response.
Accordingly, we recommend an organisation structure and information flow as
summarised in F igure 3 below. Implied in this chart are the following underlying
principles:
    At each stage there should be a built-in feed-back mechanism (hence 2-way
     arrows) so that at the national level, the epidemiological surveillance network
     should address surveillance and response. It is not expected that the
     epidemiologists will always be the responders but they will be required to provide
     information and advice to those who have responsibility for response.
    The new network should progressively become an integrated epidemiological
     surveillance and response system conceptually similar to the IDSR system of
     WHO-AFRO but adapted to veterinary requirements.
    At all stages the epidemiological surveillance network will involve other sectors
     beyond the immediate jurisdiction of the national veterinary services.
     Consequently, there should be specific MoU with such s ectors defining roles and
     responsibilities and there should also be appropriate financial arrangements for
     such involvement. It is important to have formal collaboration with the Public
     Health and Wildlife Sectors as well as participation by the relevant a cademic and
     research institutions. An example of an emerging arrangement in SADC is that
     being promoted by the AfDB funded SADC TADs project which will be piloting
     cross-sectoral and inter-institutional collaboration through the formation of
     National Virtual Centres for infectious diseases. Also SACIDS, which is the One
     Health network in the SADC region, is based on such a model at both the national
     and regional settings.
    The national steering committee of the network, with representation of all players
     in the network, will be chaired by the National Chief Veterinary Officer.
    External official reporting to regional organisations, the OIE and FAO will be
     exercised through the National Chief Veterinary Officer.
    Early Warning to the responsible Minister and to the National Disaster
     Management Committee and def inition of the requisite national response to
     disease outbreaks w ill be the responsibility of the National Chief Veterinary
     Officer. Thanks to HPAI, outbreaks of RVF in Eastern and Southern Africa and the
     apparent upsurge in the incidence of rabies in Africa, several countries in Africa
     now accept the involvement of the National Disaster Management Committee in
     dealing w ith human and animal disease epidemics.




                                                                                       38
Figure 3:         Gene ric   structure     for    a   national      epidemiologica l       surveillance
network

               National Epidemiological Surveillance Network Structure

 Livestock Farmers /
 village                                                                  Regnal/Intnl Report
                                     Wildlife                                                        Generic
                                                                                                     livestock
                                                                                Ntnl CVO             & related
            Private vet                                                                              data
                                                                                          Report
                                           Province /State
                                                                            National Vet Services
    Field staff                           Surveillance and                   Epidemiology Unit
                                                                                                     Natnl
                                                                                                     Steering
                                          Disease investigation                 Data input/          Comittee
   Abattoir/           DVO                team;Provincial/State                 storage/Analysis     Chaired
   S/slab                                 database                                                   by Natnl
                                                                                                     CVO
                                                                                         Early
    Surveys                                                                              Warning
                                         Laboratory and Research
                                                                                Ntnl CVO
                                                 services
                                          CVL, Provincial labs & Ref
     Livestock projects                              Labs                Management/Planning
                                           Academia (Vet Faculty),              •Action
                                               Wildlife research,         •Strategy & Policy
                                         Medical Diagnostic & Research    Natnl Disaster Mngt Comm
                       Public
                       Health                                                 Chief Med
                       Services                                               Officer /Public
                                                                              Health




   5.4. Enhanc ing Governance and Susta inability of Re gional Epidemiological
       Surveillance Networks

Having studied past experiences with PACE and the structures of the current animal
health networks in Africa as well as FAO associated networks elsewhere in the world, we
have concluded that the sustainability of such networks is not simply a financial issue.
Credibility and overt reference to national and regional development aspirations must
also be an important consideration in the design of epidemiological surveillance networks.

Therefore, we recommend that elements for the institutional set up and governance of
the network as a national or regional FORUM should not be mixed up with the associated
projects for implementation of activities identified by the network.

We recommend that:
    The regional epidemiological network should have defined terms of reference and
      arrangements for meetings at least once a year. The network should be linked to
      a REC. The Chair and Deputy Chair for the Network should be from Member
      States while the Secretariat can be provided by the animal health desk of the
      REC. The network should report to a committee of Directors responsible for animal
      health and/or livestock development. This would be akin to the arrangements for
      the SADC networks and for the European Commission for the Control of FMD, two
      examples of networks that have been sustained. It should be able to develop a

                                                                                                       39
       project for setting up such a network w ith clearly defined phasing out of donor
       input and phasing in Member State contribution.

The programme of work for such a network that is sustainable, credible and responsive
to development objectives could be grouped into three categories:

Category A – which should focus on t he core functions of the network. This is the
category that should be targeted for sustainability largely through internally generated
funds. The functions and associated elements for this category are elaborated in Section
5 of this report.

    The core functions should be to act as a forum for national epidemiologists and
     experts; to share information in Member Countries and those which pose highest
     risk to the region even if foreign to the region; to review disease national
     surveillance, response and control programmes;            analyse regional and
     international disease trends and provide early warning to National CVOs and
     policy makers; to define disease control, preparedness and response strategies as
     well as identification of areas for project intervention.

Category B – which would encompass enabling project interventions to facilitate the
work of the networks And thereby their credibility. Examples of such project enablers
are given in Section 6. These comprise:

    A set of enabling projects for enhancing the effectiveness of the networks but
     whose management and sustainability would not be linked to that of the networks
     themselves. Such enabling projects would need to be be developed by the RECs
     with the support of FAO, AU-IBAR and other development partners (see Section
     6).


Category C – which would comprise development programmes whose realiation
require effective epidemiological surveillance. Examples are given in Section 7


   5.5. Linking Re gional Epidemiological Surveilla nce Networks to the RECs

We believe that the regional networks established under PACE were an interim
arrangement as the primary concern was to establish the principle or proof of concept.
The quality of the national submissions to the OIE for rinderpest freedom and the
response to the HPAI outbreaks and threats bear testimony to the value of the system
that was introduced by PACE.

We recommend that FAO and IBAR take steps to link the emerging epidemiological
networks to the Regional Economic Communities as shown in Figure 4, as is already the
case in the SADC. From the perspective of sustainability, this process needs to be
initiated in the early stages of setting up the networks, a lthough the te chnica l
assistance would be e xpe cted to continue for a numbe r of years. The ea rly
active involvement of the RECs not only signals owne rship but is also a crucia l
element of capacity building. Accordingly, we further recommend that these be
linked to the EAC, IGAD, ECOWAS and ECCAS, which are geographical entities and
thereby provide epidemiological c ontinuity. Participation in such networks should be
inclusive of other relevant economic, monetary or cultural organisations (e.g. COMESA,
UEMOA) which, although not epidemiological or geographical e entities, have animal
health programmes that benefit Member Countries in the epidemiological surveillance
network. Participation in the networks should also include representation of the wildlife
and Public Health Sectors, farmers associations, relevant private sector and NGOs,
especially those that operate in areas of impaired government access.



                                                                                      40
From the point of view of epidemiological surveillance and risk management of TADs, we
consider the over-lapping country membership of RECs to hve potential benefits, which
can lead to linked disease cont rol programmes across RECs, e.g. between SADC and EAC
with Tanzania as the link country and between EAC and IGAD w ith Kenya and Uganda as
the link countries.

Our recommendation for linking the new networks to the RECs should be viewed as a
progression towards sust ainable and stable structures with the following advantages:

   •   Visible linkage to the development aspirations of RECs which include regional
       economic integration as free trade regions, the desire for export of livestock
       commodities (to the Maghreb for ECOWAS; the GCC countries for Eastern Africa;
       Middle East, East Asia and Europe for Southern Africa), as the realisation of such
       objectives will demand sanitary assurance;
   •   Political leadership which is necessary for sustainable financing mechanism
   •   Being in line with, on the one hand, the policy of the AU Commission for
       strengthening the role of RECs and working through them towards the goal of
       continental integration and on the other hand, the policy of the FAO for
       strengthening the capacity of the REC;
   •   Enhancing a sense of ownership and linkage to geographical and geo -political
       coverage
   •   Keeping the number of countries within a network to a manageable level. FAO‟s
       experience is that the number should ideally not exceed 15 countries so as to
       ensure effective coordination. We endorse this guiding principle.

NB: Our re comme ndation for linking the regiona l epidemiological surveillance
networks to the RECs, should not be interpreted as signa lling the expansion of
the pe rsonnel establishment of the REC Se creta riat. W hat is critical is to put in
place a coordination mechanism which involves both the Se cretariat a nd
Member States and which the reby may require no more than 1 to 3 officers
located in the REC Se cretariat. Such a model exists in the SADC and European
Commission for the Control of FMD.

   5.6. The role of the AU Inte r-African Bureau for Animal Resources (AU- IBAR)
        in coordinating re gional epidemiologica l surveilla nce network

The primary role of IBAR, either alone or supported by FAO, will be to act as the
Continental Coordinator, providing inter-REC linkage and an over-sight for
epidemiological surveillance in shared ecological systems between RECs. Furthermore we
envisage the following functions for AU-IBAR as enabling the effectiveness or relevance
of the regional epidemiological surveillance networks. They include the following:

   •   Coordination of disease control programmes w hich require harmonised action
       across RECs.
   •   Gathering and analysing basic livestock data in Africa, in partnership w ith the
       global systems of FAO and others.
   •   Advocacy for the livestock sector of Africa. This should focus, particularly, on the
       role of livestock in wealth generation and/or poverty reduction strategies, sanitary
       standards in market access and international trade as well as the increas ing
       impact of infectious diseases of animal origin on human health.
   •   Galvanised opinion of national veterinary and livestock services in issues of
       standards and global strategies for risk management of TADs and zoonoses and
       for relevant emerging trends.
   •   Championing the role of African scientific institutions in specialised training,
       research and policy analysis relevant to enhancing the capacity for epidemiological
       surveillance, risk management of TADs and zoonoses and market oriented
       livestock development in general.



                                                                                        41
Accordingly, AU-IBAR should develop its capacity for acting as the continental forum for
the regional networks not only for epidemiology but also for other REC based networks as
well as for the National Directors of Veterinary Services and ultimately the AU Ministers
Responsible for Animal Industries.


   5.7. The role of the Regiona l Animal Health Centres (RAHCs) a nd the
        inte rnational partne rs in setting up the Regional Epidemiological
        Surveillance Networks

The Role of the RAHCs will be crucial in providing the necessary guidance and
establishing the standard operating procedures for the networks. This will be particularly
important for FAO as the Lead Technical Agency for risk management driven surveillance
and management of TADs and zoonoses. We c onsider the guidelines that were developed
by the FAO meeting of ECTAD managers for regional networks during October 2008
(Annex 4) provide a sound basis for the logical framework for the regional
epidemiological surveillance networks. Table 2 summarises aspects which we recommend
should be incorporated as Performance Indicators for the networks.

We appreciate and endorse the steps that are being taken by FAO to establish such
networks. However, we recommend that from the outset the networks should be
associated with and be labelled as REC networks even though the FAO-ECTAD w ill be the
executing agency for the initial phase.

We believe that our recommendation for REC based regional epidemiological surveillance
networks, developed with the support of FAO, is in line with FAO‟s own strategy for
assisting FAO Member Countries and RECs to develop their own        “Animal Health
National Medium Te rm Priority Pla n (AH-NMTPP)”.            We appreciate the MTP
approach and hope that FAO will take into account our recommendations regarding the
disease framework (Section 5.2 and Annex 2) during the elaboration of the MTP at
national and regional levels. We commend the approach to members of the ALive
consortium for their support.

Accordingly, as the networks evolve it can be expected that the role of RAHCs will
progressively shift towards back-stopping of the REC networks and of bringing value-add
activities or projects to enhance the effectiveness of the REC epidemiology networks. Fig
4 summarises the relationships between REC-based networks, AU-IBAR and the technical
support of the RAHCs to the networks.




                                                                                       42
        Fig 4: Linkages for African Epidemiologica l Surveillance Networks


                  RAHC
                Gaborone                    SADC




                          EAC                              ECOWAS
                                         AU-IBAR
                                          African                        RAHC
         RAHC                             Epidem
                                         Networks


         Nairobi                                                         Bamako

                                IGAD                 ECCAS




An important role for IBAR (supported by its partners, especially FAO and OIE) will be to
enhance the interaction between the different REC-based regional epidemiological
networks within Africa. The IBAR‟s partners, especially FAO, will be to bring global
experience to bear on the modernisation of African regional networks. It would be
expected that IBAR could play a leading role here in re-establishing a continental forum.


   Table 2: Suggested Performance Indicators for Susta inable Regiona l a nd
   National Epidemiological Surveillance Networks



   Objective                                   Performance              Ta rget

                                               Measure



   1. governance

                                               Coordination

                                               Office available

   a) Set up Regional Coordination office      Within RECs              SADC1,EAC1

    Within RECs                                Coordinator              ECOWAS1

                                               Appointed                IGAD1

   b)Recruit ment of Regional Coordinator                               One in each

     by RECs                                   Regional    Epi-Surv.    REC
                                               Established


                                                                                        43
Objective                                     Performance                Ta rget

                                              Measure



c)Establishment       of      Regional                                   One in Each
Epidemiological surveillance Networks
with appropriate linkage to laboratory                                   REC
and research services for TADs and
zoonoses
                                              Linkages established


d) Establish effective interface with the
wildlife and public health systems for                                   One in Each
surveillance of infectious diseases of
animals including zoonoses                                               REC

                                              Chairpersons

d) Appoint ment of       Chairpersons   of    Appointed
Regional networks

                                              Strategy     Document      One in each
e)Development of Strategy Document for        Produced
                                                                         REC
Regional Operations to be approved by

 Ministers of various RECs
                                                                         First Year of

                                                                         Network

                                                                         Establishment
                                              Database      platfor m
                                              agreed             and
                                              established at RECs
 f) Establishment of Regional Database(s)
for generic livestock information, official
reporting and risk management of TADs         Quality and f requency
and zoonoses
                                              of official reporting by
                                              Member Countries to
                                              the OIE.



                                              Quality and f requency
                                              of early warning for       An appropriate
                                              TADs and zoonoses          system for each
                                                                         REC


                                              Impact on design of
                                              regional programmes
                                              for the prevention and
                                              control of TADs and
                                              zoonoses




                                                                                         44
Objective                                       Performance               Ta rget

                                                Measure



2. Operations of Networks

   a)Preparations    of   Regional        and   Work Plans Produced       One per REC
   National
                                                Budgets Produced          And Country
   work Plans
                                                Training Plans
  -Preparation of budgets for network
                                                Produced                  One for Each

                                                                          REC            and
  -Training Needs Assessment Survey                                       country
                                                Meeting Program

                                                Produced
                                                                          One program

  -Preparation for network Meetings                                       For Each REC
                                                Priority List Produced
                                                                          And Country

                                                                          One        List
                                                                          Produced     for
  -Identification of Priority Focus for                                   each REC and
                                                Committees
    networks                                                              Country
                                                Established   in   each
                                                country                   One Committee
    Initiation of National Disaster                                       in Each Country

    Committees (in Countries)

3. Sustainability of Networks (What
   Should be Present)



      a) Regional networks Established
         and Aligned to RECs                    REC Networks              One network

                                                Established               For each

                                                                          Region
      b) National Networks established
         and aligned to RECs and DVS            National      networks    One Epi-Surv
                                                established
                                                                          Network
      c) RAHCs Enabling networks                                          Established in

                                                                          Each country
      d) Partners Supporting Enabling
         Projects for Networks                  RAHCs working
                                                                          At least one
                                                With networks
                                                                          RAHC      working
      e) Farmers     Assoc iations     and                                with
         Private    Sector      (including
         private veterinary practitioners       Network projects          Each network
         and other service providers)

                                                                                           45
    Objective                                             Performance                    Ta rget

                                                          Measure



                 Streamlined        into     Network      Funded                         75% f unding of
                 Activities                                                              network

                                                                                         projects
                                                          Participation of
             f)Regional and National Budgets                                             Percentage of
             for Network Activities established           Farmers and private
                                                          sector in                      Farmers
                                                                                         participating in
                                                          Network activities
                                                                                         Network
                                                                                         activities




                                                          Network Budgets                50% f unding of
                                                          available                      network
                                                                                         activities



The above Performance Indicators are given as a guide for the networks themselves.
Indicators for the operations of the networks at the national level would need to be
developed. An example of such indicators 5 was published by AU-IBAR as part of the PACE
programme.


6. RECOMMENDATIONS                  FOR  PROJEC T   ENABLERS  TO                        ENHANCE   THE
   CREDIBILITY OF                   REGIONALL    EPIDEMIOLOGICAL                         SURVEILLANCE
   NETWORKING

For Africa, it is important that the epidemiological surveillance networks are not seen as
simply systems for information exchange or just disease intelligence. Epidemiological
surveillance networks should be driven by the goal of the livestock contribution to food
security, poverty reduction and market access through effective prevention and control
(i.e. risk management) of TADs and zoonoses. Experience in FAO indicates that
know ledge exchange networks like the Veterinary Public Health or the Family Poultry or
even the Pan African Tsetse and Trypanosomosis (PAAT) networks tend to be dominated
by academic groups whereas the epidemiological surveillance networks should be linked
to and driven by the public sector. Therefore, it is important that there be
complementary projects which will enhance the effectiveness of the networks and their
relevance to development needs and thereby their sustainability. We propose below a
basket of project elements for consideration by the ALive consortium and which can be
elaborated as either a set of linked projects or a comprehensive programme of support
for animal health in Africa.

    6.1. Collaborating with the AU- IBAR and Regiona l Organisations to Esta blish
         Re gional Databases for Early Wa rnin g a nd Response to TADs a nd
         Zoonoses Linked to the FAO-OIE-WHO GLEWS


5
 Bidjeh Kebkiba (2004). Gu idelines for the development of performance indicators to assess national epidemio -
surveillance systems or netwoks. A U-IBA R, Nairobi
                                                                                                            46
IBAR and SADC Secretariat have developed independently two livestock information
systems based on a common principle of collecting baseline data for livestock production,
diseases, trade and marketing. The IBAR system is called ARIS = Animal Resource
Information System and that for the SADC Secretariat is called LIMS = Livestock
Information Management System. The latter is intended to be part of a wider Agricultural
Information Management System (AIMS). The primary objective of both ARIS and LIMS
is to set up a reference database on livestock issues for the region. These functions are
core to the mandates of both IBAR and the SADC Secretariats. It should be noted that
Member States value t he resultant reports that have been generated by IBAR and the
SADC Secretariats.

The ALive Feasibility Mission considers that the availability of such reference databases
will be invaluable for development planning, trade, research and historical trend
analyses. Also they have the potential to contribute to programmes for vulnerability
assessment, risk mapping and early warning. These databases are conceptually similar to
the reference agricultural databases of FAO, although they have not been developed on a
programming platform similar to that of FAO.

Therefore, the only key issue for examination has been the strategy adopted for the
development of the database.

ARIS and LIMS have not been developed on a common programming platform. Each has
been developed through contracts with commercial companies. Originally ARIS was
based on the Oracle platform. Follow ing the termination of the PACE project, ARIS nearly
collapsed at both IBAR and in the countries that had adopted system.            The Final
Evaluation Mission for the PACE programme indicated the possibility of such post project
collapse in its report by observing that it had teething problems and appeared to be an
unfinished product which needed continuing support and development.

IBAR is currently reviving ARIS with support from the USAID using open-source based
programming instead of the Oracle platform used before and involving some African
universities for programming.

With respect to LIMS, the SADC Epidemiology and Informatics Subcommittee (EIS) has
recently (November 2008) expressed its concern about the future management of animal
health data at regional level after the end of the PRINT project and therefore has urged
the LTC to look into the sustainability of LIMS.

ARIS and LIMS have been developed by projects, apparently without a phased transfer to
a suitably resourced data management entity within the core structures of IBAR or the
SADC Secretariat respectively. ARIS was launched within the final stages of the PACE
project. Similarly, LIMS is being launched within the final stages of the SADC PRINT
project.

Another observation is that there appears to have been an exaggerated expectation at
both IBAR and the SADC Secretariat that such databases in themselves could serve as
the sole instrument for vulnerability assessment, risk mapping and early warning for
natural disasters including transboundary animal diseases. In the past both IBAR and the
SADC Secretariat have tended to persuade firmly National Epidemiology Units to adopt
exclusively ARIS in PACE countries and LIMS in SADC countries. In our view such
entrenched views might have diverted attention from the core objective of having robust
and sustainable regional livestock databases on which there is unanimity. Unfortunately,
it seems that the project personnel advisers to IBAR and SADC might not have been fully
aware of either the cost benefit and sustainability potential for starting developing
ARIS/LIMS from the open-source platform of such FAO programmes as TADInfo in order
to extend to wider requirements of the generic livestock databases or the feasibility of
entering into a formal arrangement with FAO for access to software source codes.


                                                                                      47
This has meant that inadvertently IBAR and the SADC Secretariats were taking on the
responsibility for further development and back-stopping of ARIS and LIMS respectively
at the national level w ithout assured resources for such a continuing task. It also meant
that any fragility in ARIS or LIMS at the regional nodes would be reflected (and perhaps
even exaggerated) at the country level.

Recently, both IBAR and the SADC Secretariat (advised by the EIS) have disaggregated
the two sets of responsibilities. So now the requirement is that Member States are only
required to submit data in a format that is commonly agreed and that is compatible with
LIMS at the SADC Secretariat or ARIS at IBAR (i.e. as an Excel sheet). Member countries
can select whatever programme suits their needs for risk management of diseases
whether it is LIMS, TADInfo or own national progra mme.


IBAR is beginning to realise that its ARIS programme, while appropriate as the regional
database, may not be totally appropriate for at least certain forms of early warning. The
experience of shortcomings in early response to the FAO early warning to the risk of RVF
outbreaks in Eastern Af rica during 2006 has reinforced this view. Therefore, IBAR is keen
to collaborate at the regional level with the FAO-OIE-WHO GLEWS system in order to
enhance IBAR‟s role in early warning and encouragement of countries to have structured
preparedness plans and capacity for early response credible to early warning.

Accordingly, we be lieve that now is a propitious opportunity for a fruitful
dialogue between IBAR, SADC- Se creta riat and FAO on a way forward for robust
and sustainable systems in support of risk ma nagement of TADs a nd Zoonoses
in Africa. We believe that the current compa rtmenta lisation is ne ithe r cost -
effe ctive nor conducive to the kind of acce lerated mode rnisation of disease risk
management systems that the development aspirations of a nd the disease
constraint in Africa re quire.

Recommendation:
   ONE: The examples of IBAR and SADC show that neither IBAR nor the Secretariats of
   the RECs are likely to have adequate internal IT programming capacity in the short -
   term. Therefore they are likely to continue to rely on out -sourcing to local IT
   companies. It is recommended that IBAR and the RECs include a financial provision in
   projects for developing regional databases that will allow FAO with its vast IT capacity
   to oversee the design, programming and quality assurance of such products. Such an
   arrangement will assure both IBAR and the RECs that the contracted programming
   companies will use programming platforms that are fit for the purpose and that are
   contemporary. It will also ensure that at the end of the contract such companies will
   be required to surrender the source code to the custody of either FAO or IBAR or the
   concerned REC.

   Such an arrangement is likely to benefit also the African IT companies that are
   involved in such contracts as it will open up contractual opportunities for such
   companies to be involved in the global networks of programmers that FAO, WHO and
   OIE use.

   TWO: The ALive consortium should consider launching a project by which the
   partners in GLEWS (FAO, OIE, WHO) and others such as ILRI, Google Predict and
   Prevent could assist in setting up robust regional early warning platforms for
   transboundary animal diseases, zoonoses and emerging diseases and w hich would be
   linked to GLEWS. Such platforms could be housed either in IBAR plus RECs or be one
   of the value-add functions of the FAO-OIE-IBAR Regional Animal Health Centres




                                                                                        48
   6.2. Supporting sustainable National Disease Information Systems                     for
       Offic ial Reporting and Risk Ma nagement of TADs a nd Zoonoses

Most national epidemiologists interviewed by the ALive Team were happy with the recent
version of WAHIS. The only issue that arose was that several countries would have
wished also to have had an off-line version of WAHIS in view of problems with
connectivity and internet stability of networks in Africa.

The major issue regarding animal health information systems seems to have related to
confusion between the requirements for disease reporting to regional organisations and
the use of animal health information for risk management of TADs and zoonoses. The
need to distinguish between a baseline, fairly static livestock information database in
which incidence of disease is a component from dynamic systems for disease risk
management does not seem to have been readily appreciated by support projects at both
IBAR and SADC. As a result there was strong persuasion to ensure and sometimes insist
that all project participating countries had to immediately adopt the regional database.
This led to software being rushed for adoption by all countries w ithout adequate piloting
and field testing for robustness. Additionally it meant that both SADC and IBAR suddenly
placed themselves in a situation of assuming responsibility for the maintenance and
upgrading of nationa l systems without ensuring that resources required for such a
responsibility were available. This placed IBAR in particular in a vulnerable situation from
the perspective of sustainability.

The recent decision by both IBAR and SADC Secretariat to concentrate on developing a
regional database and only asking the countries to submit reports in a specific format
that is compatible with the regional database at the hub should reduce that vulnerability.

Another emerging recognition is that both ARIS and LIMS c apture the sort of data that
are generally required by the livestock planning depart ments in which disease data are
only a component. These are akin to the FAOstat databases at the global level. Disease
risk management often requires a specialised system w hich can still export the static
data on disease incidence that feed into the baseline database either in the national
livestock planning units or the regional hub.

By realising such a distinction and the complementarity between reporting and disease
risk management the arguments in Africa regarding the adoption of ARIS, LIMS, TADInfo
or other systems developed by or used by national veterinary services, become
redundant. Curiously this does not seem to have been such an acute issue in West and
Central Africa, where follow ing the collapse of ARIS after PACE the needs have been
defined by the countries as focusing first and foremost on official reporting to the OIE via
WAHIS and on the efficiency of veterinary services in risk management of diseases using
TADInfo or any other software that can fulfil such a need and be supported in a
sustainable way.

Many of the National epidemiologists interviewed seem to appreciate the value of a
system like TADInfo that is dedicated to assisting national veterinary services in the risk
management of TADs and zoonoses, while also appreciating the need for a broader
baseline database as part of the livestock planning units or the regional database to
which they would report.

Recommendation:
   • Because of internet instabilit y several countries would greatly appreciate the
     availability of an off-line WAHIS that they can use for primary assembly of data
     and only connect on line for final transmission to the OIE. If OIE could
     accommodate such a requirement without compromising t he quality of data input,
     it would be a service that many countries in Africa would appreciate.
   • The recommendation under Section 6.1 for supporting IBAR and the RECs to have
     robust and sustainable databases also applies for national


                                                                                         49
   •   For the risk manageme nt of TADs and zoonoses there is a strong case for
       deploying at the national level a dedicated program such as TADInfo. Of the
       partners in ALive consortium or the Regional Animal Health Centre, FAO is best
       placed to sustain such a system at the national level in view of FAO‟s country
       based presence in Africa as well as Asia.
   •   However for such a standardised system to be readily and comfortably accepted
       by countries in Africa, many of the National Epidemiologists interviewed were
       strongly of the opinion that they required readily accessible back-stopping.
       Accordingly, we recommend that FAO seeks resources that will enable it to
       decentralise the primary back-stopping of TADInfo from Rome to the FAO-OIE-
       IBAR Regional Animal Health Centres, with Rome maintaining the responsibility
       for constant updating, training and secondary back-stopping. Thus, it will be
       necessary to recruit and/or train one epidemiologist from each RAHC in all aspects
       of TADInfo in order to enable this cadre of personnel to assume the responsi bility
       for deployment and back-stopping of the system in those countries that wish to
       adopt the system. We further recommend that from the perspective of
       sustainability and the sensitivity of national epidemiologists, it would be highly
       desirable, for this task, to employ and train personnel derived from the region.
   •   We recommend also that each National Epidemiology Network seek to establish a
       “maintenance” outsourcing arrangement with e.g. the local university IT, or a
       local IT company for routine trouble shooting and maintenance of the software.
   •   The above arrangement would also place risk management of TADs and zoonoses
       on a more sustainable footing than now when support animal health information
       systems have tended to be linked to short -term projects. However as the current
       version of the Java based TADInfo has been programmed in an open-source
       platform, it will allow national veterinary services or enabling projects to add
       modules for peculiar needs, evidently subject to agreement with FAO on software
       safeguards.

   6.3. Supporting technologies a nd surveillance systems that e nha nce the
       capture of disease alerts or information at point-of-outbrea k by sub-
       professional, veterinary personne l

One of the major bottlenecks in the national surveillance chain is the early detection of
disease events at the local level. Under PACE several countries developed participatory
disease search. However programmes which enhance the role of veterinary auxiliaries
(be they community animal health workers or veterinary scouts) in a veterinary
surveillance chain have been show n to be effective instruments for detection of disease
events in remote areas. Recently limited trials by FAO in some Southern Af rican countries
(especially Namibia, Tanzania, Zambia, Malaw i and Mozambique) with a combination of
mobile telephony and digital pen technologies have shown that technology could add
value to the effectiveness of sub-professional field staff in alerts to disease events and
thereby mobilisation of prompt responses. However these have been relatively small-
scale field trials without a coherent and consistent programme. Yet the future for
surveillance and the ability to detect unusual disease events in the field in Africa will
require the application of point of outbreak devices.

Thus a programme which enhances the ability of sub-professional cadres in the early
detection of unusual disease events in rural areas through appropriate technology and
training in participatory epidemiology approaches will enhance the capacity for
preparedness against HPAI and emerging diseases, provided such interventions are
associated with a feed-back or response system.




   6.4. Supporting Public-Private Pa rtne rships for Epidemiologica l Surveillance



                                                                                       50
The private sector can contribute immensely to the effectiveness o f national and regional
epidemiological surveillance networks. Accordingly, we recommend that every project
support to the networks should have a specific aspect of promoting effective public -
private partnerships as part of the continuing process for respo nsible and balanced
national veterinary service reform, which started during PARC/PACE and championed by
AU-IBAR. Examples for such considerations could include the follow ing:

   •   Mobilisation of communities and leadership in advocacy for animal health and
       disease control programmes, which also emphasise the relevance of such measure
       to community‟s economic and social interest and welfare.
   •   Supporting farmers associations, livestock traders and livestock commodity
       processors to train their members in disease aw areness, recognition and bio-
       security measures for prevention of disease spread, including community
       supported quarantines and animal movement management.
   •   Mobilisation of farmers associations, livestock traders and livestock commodity
       processors for f inanc ial contribution towards the cost of epidemiological
       surveillance and disease control measures as a contribution to the
       industry/community good, e.g. through a levy fund which should be ring-fenced
       for supporting the activity agreed by the parties.
   •   Promoting the participation of licensed, private veterinary practitioners and para -
       veterinarians in epidemiological surveillance, animal inspections and disease
       control on equitable contract with the public sector. We note that in some
       countries this may need a review of the current legislation governing the
       administration of veterinary services.
   •   Promoting the role of national or regional commercial enterprises in providing
       services or provisions in support of either diagnostics or surveillance. An example
       is that of the Botswana Vaccine Institute which also uses its technical expertise to
       provide referral diagnosis (with OIE accreditation) and supply of sampling kits.
   •   Involvement of African training institutions (especially universities) or private
       enterprises to design and/or undertake continuing education programmes in such
       key areas as field epidemiology, risk analysis, Hazard Analysis and Critical Control
       Points (HACCP).
   •    Involvement of local or regional ICT companies in either design (under
       supervision by e.g. FAO) or quality assured back-stopping ICT aspects of national
       or regional epidemiological surveillance networks.
   •   Regional experts for periodic technical auditing the programme of work of the
       national and regional epidemiological networks in order to enhance accountability
       and transparency.
   •   Promoting licensed private diagnostic laboratories to undertake quality assured
       testing either for the private sector (e.g. farmers or villages) or the public sector
       where such work would supplement the national veterinary laboratory network in
       order to widen the scope of laboratory supported epidemiological surveillance.

   6.5. Supporting Enabling       Resea rch    on   Infectious    Diseases    by   African
        Institutions

One of the reflections from the Pan-African Veterinary Conference to celebrate the
centenary of the Onderstepoort veterinary complex has been that the greatest advances
in animal disease control in Africa have been through research conducted in situ in Africa.
Research by expeditionary teams from Europe or USA has added value but cannot be an
adequate substitute to problem based research conducted in Africa. Yet the capacity for
such research has tended to decline in the mainstream Af rican institutions during the last
20 to 30 years. An assessment of the human resource base in 5 SADC countries the
main contributing factor is no longer just lack of trained human resource. Furthermore
studies like the Foresight project on infectious diseases indicate that African scientists
tend to be over-compart mentalised in institutional, sect oral and administrative silos.




                                                                                         51
There is now a growing tendency to form theme based research networks across
administrative lines. Such a principle has been built into the SADC TADs project that is
funded by the African Development Bank and is at the core of the recently formed
Southern African Centre for Infectious Disease Surveillance (SACIDS). A recent AU
meeting of experts has also recommended the formation networks as virtual centres to
be a positive way forward for developing Africa‟s capacity for surveillance driven research
on infectious diseases.

We recommend that the ALive consortium consider stimulating Africa based research
capacity to underpin the epidemiological surveillance programme through a system of
competitive research bidding by African research consortia in partnership with institutions
from industrialised countries but where the centre of gravity for funding is tilted in favour
of Africa.




7. RECOMMENDATIONS FOR PROJEC T INTERVENTIONS                        ASSOCIATED WITH
   REGIONAL DEVELOPMENT

This category of project intervention would be those regional initiatives whose
realisations require the support of effective epidemiological surveillance. The following
are examples, whose selection would depend on regional needs.


   7.1. Regional Programmes for Progressive Control of TADs or Zoonoses

Experience with rinderpest eradication in Tropical Africa and FMD control in Southern
Africa have demonstrated the value of regionally coordinated programmes for disease
control on stimulating effective epidemiological survei llance. As already remarked the
systems that was in place for either rinderpest or FMD has formed the backbone for the
surveillance and preparedness for HPAI inSub-Saharan Africa. In the post rinderpest
period all regions of Africa seem to have ambitions f or export trade in animal
commodities.

Accordingly we recommend that :

   •   Each of the regional networks should strive to identify a limited set of diseases
       (no more than 3) for targeted, progressive control on a phased scheme similar to
       that which has been suggested for FMD and CBPP in the SADC region and for a
       global strategy for FMD. Such a programme would form the back-borne of a
       sustained and broad-based epidemiological surveillance network w hich would
       maintain the interest of the national governments and the livestock dependent
       communities. In selecting such a disease exemplar attention must be paid to
       identifying one that will catalyse and set standard operating procedures for a
       broad-based surveillance and response, that will facilitate improving livest ock
       dependent livelihoods, market access or human health protection. The objective
       should not be to institute an exclusive vertical system of surveillance that is
       dedicated to only one disease but rather a bench mark for measurable
       performance outcomes.
   •   Any such programme should always start with surveillance and a socio -economic
       assessment of disease control strategy options. However the type of surveillance
       to be promoted should be one that is risk-based and driven by targeted disease
       risk management strategies to promote market access for livestock commodities.
       Therefore the driving force would be livestock dependent livelihoods. Improving
       official reporting would be the inevitable consequential benefit, which in fact can
       be used as a performance indicator for the effectiveness of the surveillance
       system.



                                                                                          52
   •   It is unlikely that the next coordinated disease control strategy will start with
       mass vaccination of the national herd as happened w ith rinderpest. This is likely
       to be targeted in response to market needs, epidemiological determinants and the
       objective of reducing the risk of specified infectious agents in the traded livestock
       commodities. Thus the targeting is likely to be for compart ments or health
       assured zones and for perceived disease hotspots and/or persistent endemicity or
       infection/disease source. It is also likely to involve inf rastructure and inspections
       designed to assure minimum risk of livestock traded commodities transmitting
       infections, especially when such commodities originate from area s that may not
       have been certified as free from specified infections in accordance with the OIE
       norms and standards. It will be essential, therefore, to involve the private
       veterinary practitioners in undertaking passive surveillance, livestock inspections
       and disease control measures like vaccination on contract to the public sector.
       New programmes should therefore extend the privatisation of veterinary service
       delivery started under PARC and PACE to mainstreaming the process of sanitary
       mandate by which private veterinary practitioners can be contracted to undertake
       public good duties under the supervision and quality assurance control of the
       public sector national veterinary services.
   •   The new phase of epidemiological surveillance and coordinated disease c ontrol
       should be associated with some form of livestock marketing levy building on the
       groundwork of PACE.
   •   It would be unrealistic to expect that such a levy could cover all the cost for an
       epidemiological surveillance system. So there will be need for a public sector and
       international donor contribution as epidemiological surveillance for TADs and
       zoonoses is part of the contribution to the national and international public goods.
       It is imperative, therefore, that the new epidemiological surveillance netw orks be
       seen to be credible in terms of enhancing the efficiency of official disease
       reporting, the transparency and credibility of disease information, the promptness
       of response to disease events at community level, their contribution to early
       warning and response to disease outbreaks, the prevention of livestock losses, the
       protection of human health and the design of effective disease control strategies.
   •   In view of the increasing importance of animal health to food security, livestock
       dependent livelihoods and human health, it is recommended that FAO, OIE and
       AU use the RAHC system to develop a programme for integrated disease
       surveillance and response along the lines of the WHO IDSR but adapted to
       veterinary systems. Such a scheme will require international donor funding but in
       the end will be more readily integrated into national and regional funding streams
       than a system which is solely driven by disease information exchange.


   7.2. Supporting Re gional Forums (or Commissions) for the Control of TADs
        and Zoonoses

As outlined above coordination of passive surveillance stands the best chance for
sustainability if it is associated with RECs and their institutional set ups.

We would strongly recommend that RECs be encouraged to examine the model that has
evolved within SADC over the last 20 years as they seek to develop their own REC
associated animal health coordination mechanisms.

Experience from IBAR, SADC, EAC, ECOWAS and the emerging tendency in Central Africa
is that countries in Africa appreciate the need for forums to facilitate harmonised policies
and strategies for animal health management. This is particularly appreciated for the risk
management of TADs and zoonoses. Countries can make their ow n contribution to such
meetings.

Nevertheless externa l support is essential for the effectiveness of such forums.



                                                                                          53
We recommend that external support could take the form of:
    • Supporting the participation of national experts in such meetings while national
       governments would meet the cost of participation at t he policy level i.e. Directors
       and Ministers.
    • Support the participation of external speakers or experts invited by the regional
       organisation to add value by contribution of new ideas;
    • Support commissioned studies that will periodically focus attention on needs,
       gaps and possible solutions.


   7.3. Supporting    the FAO-OIE- IBAR Regional Animal Hea lth Centres to
        collaborate with Others in promoting the One World One Health Goa ls in
        Africa

There is widespread support for the Regional Animal Health Centre concept tha t was set
up initially to deal with the emerging problem of H5N1 highly pathogenic avian influenza.

The ALive Team found that almost invariably Countries would wish to have the mandate
of the RAHC to be extended to dealing with other TADs and zoonoses ra ther than be
restricted to HPAI. They are increasingly regarded as the portal for GF -TADs
implementation.

The following issues were raised which we would recommend for consideration by the
partners in the RAHC set up:

   i.     A review of the MoU to broaden the mandate to cover major TADs as
          envisaged in the GF-TADs. This will require both additional resources for the
          RAHCs and a review of the requisite expertise for the new tasks implicit in this
          and other recommendations, bearing in mind that the initial focus o f the
          RAHCs, so far, has been to coordinate emergency actions for HPAI while the
          new thrust will require established experience in infectious diseases and
          animal health management as well as expertise in normative and leadership
          skills that will be required to guide RECs and national systems. Thus the
          expertise or competence complement that will be required, especially in the
          FAO-IBAR axis of the RAHCs, should include established animal health (or
          veterinary service) management competence, epidemiology, GIS and database
          management, wildlife health (especially for southern and Eastern Africa),
          disease emergency preparedness/contingency planning and response or
          control strategies, laboratory coordination, socio-economics coordination,
          communication (including advocacy) plus ICT (including webmaster design and
          management) which could be shared between RAHCs or outsourced. The
          above assumes the continuing availability of the in situ and HQ support of
          FAO‟s expertise in project operations and financial management . It also
          assumes the continuing in situ and HQ role of the OIE expertise in veterinary
          governance, standards and official disease reporting information systems.
   ii.    To extend such mandate to include cooperation with the RECs and WHO offices
          for the type of inter-sectoral collaboration that has been fostered by HPAI to
          form a platform for promoting the One World One Health in Africa.
   iii.   For IBAR there could be an institutional problem as the RAHCs do not seem to
          align with the AU policy which requires IBAR to operate through the RECs.
          However we believe that the current RAHCs can still work with the RECs
          without themselves becoming part of the Secretariats of the RECs.
   iv.    For the RAHC in Nairobi there is need for it to be aligned at two levels, i.e. to
          both the continental mandate of IBAR and the two Eastern African RECs (EAC
          and IGAD).
   v.     At IBAR, SADC and ECOWAS Secretariats, there was a desire to see FAO
          playing an increasing normative role w ithin the RAHCs as part of agreed
          mandate rather than simply through persona l initiatives.


                                                                                        54
   vi.      To support IBAR to revive the biennial meetings of AU Ministers Responsible
            for Animal Industries preceded by meetings of Directors and experts, which
            were a component of both PARC and PACE. However, in the new format there
            would need to be cost-sharing between AUC, National Governments and donor
            support built into the programme from the outset.

   7.4. Supporting biosecurity-based poultry production and risk mana gement
        of Ne wcastle disease and othe r poultry infectious killers of village
        chic kens as a poverty reduction instrument and surrogate for sustaina ble
        surveillance/preparedness for HPAI in rural Africa

There are three compelling reasons for a bold programme to boost the small-scale
production and marketing of poultry in Sub-Saharan Africa as an integral part of a
sustained programme for surveillance and preparedness against HPAI even in the few
countries that have experienced outbreaks of HPAI. The first is the sheer problem of
sustaining the interest of the community in constant surveillance for HPAI unless they
can associate that activity with their own intrinsic socio-economic interest. Secondly the
threat of avian influenza provides an opportunity for a bold programme for enhancing
protein food security, enhancing wealth creation by the vulnerable members of
community and introducing bio-security based poultry husbandry systems. Thirdly,
several countries, including Mozambique, Malaw i, Tanzania, Ethiopia, Mali, Burkina Faso
and Senegal have been trying to develop programmes for village chicken poultry without
a consistent programme.

We therefore recommend that the ALive consortium consider launching a programme in
Africa, especially in those rural areas considered to be at risk from the incursion of HPAI,
which incorporates principles of bio-security based small-scale production, utilisation and
marketing of poultry and poultry products underpinned by a veterinary programme for
risk management of infectious killers of poultry, especially the control of Newcastle
disease.

Such a programme would lay emphasis on those farming practices and veterinary
interventions which minimise the risk of introduction of infection, dissemination of
infection/disease and the escape of infection from infected premises. Accordingly, these
interventions will be driven by the need for economic performance and asset protection
through the biosecurity principles of reducing the risk of disease/infection spread through
appropriate bio-exclusion and bio-containment.

Emphasis would also be laid on the risk of infect ion transmission f rom poultry to humans.
Thus there would be attention to housing, hygiene, community awareness and
community vigilance for the enforcement of veterinary quarantine measures with
community cooperation. Surveillance and preparedness systems would be introduced
with the same biosecurity objective and where vaccination is indicated (e.g. Newcastle
disease control) it would be essential to use quality assured vaccines as prescribed by the
vaccine manufacturers and in accordance with the OIE standards, as far as possible
verif ied by PANVAC.

Key activities would include:
    Promoting small scale livestock production with improved management
    training of farmers in low-cost improvements to village poultry husbandry
    training of local extension workers and others such as community vaccinators
       Newcastle Disease vaccination techniques
    promotion of Newcastle disease vaccination campaigns
    promotion of low-cost poultry housing or kraals
        promotion of improved and balanced feeds for the animals
        promotion of marketing chain



                                                                                         55
Overall the above scheme should strength economic development especially of the
vulnerable community members and will serve as a sustained mechanism for surveillance
preparedness against HPAI, while promoting good faming practices that are appropriate
to rural areas in Africa.


8. TARGETING PROJEC T INTERVENTIONS TO SUPPORT EPIDEMIOLOGICAL
   SURVEILLANCE NETWORKS IN SOUTHERN, EASTERN AND WESTERN-
   CENTRAL AF RIC A

As already described the current 3 epidemiological surveillance networks differ in
character although they all correspond in geographical coverage to that of the 3 Regional
Animal Health Centres in Sub-Saharan Africa. In all three, there is need for project
intervention to set up or strengthen the regional epidemiological networks. Such ne w
intervention, however, should incorporate sustainability elements from the outset.

Accordingly, a clear roadmap to technical and financial sustainability should be part of
the project design f rom the outset. Such a roadmap could start with an initial p hase with
full technical assistance by FAO, which dovetails with an over-watch phase during which
FAO would not have resident technical assistance expertise but could continue supporting
the network with short-term consultants to the phase of full unsuperv ised technical
operation by REC but with only a back-stopping role for FAO. Donor or extra-budgetary
financial support should also progressively decrease from the initial phase as the RECs
progressively assume f inancial responsibility. The speed of technic al and f inancial
phasing-out phasing-in will vary from REC to REC. A similar roadmap is recommended for
IBAR‟s responsibility for Continental coordination.


   8.1. Recommendations for West a nd Centra l Africa

The West and Central African network, which is being set up, is coherently organised and
already has a website. It is closely linked to the work of the RAHC. However it does not
yet have a clear link with institutional systems of the two RECs that it serves.

The project intervention for West and Central Africa should focus on the following:

   i.     The overriding objective would be to focus on designed progressive
          mainstreaming of epidemiological surveillance networking w ithin the
          normative functions of the two RECs, supported and technically guided by the
          FAO set up in the RAHC, Bamako.
   ii.    For long term sustainability, the epidemiological surveillance network w ill need
          to link its passive surveillance and reporting as well as forum activities to the
          institutional set ups of the two RECs. The RAHC can act as the over-arching
          coordinating body but specific sub-sets for West Africa and Central Africa
          which are linked to ECOWAS and ECCAS guided and assisted by FAO-ECTAD.
          The DRC could serve as an epidemiological link country between the SADC and
          Central Af rican networks.
   iii.   A programme for the coordinated tactical control of PPR or CBPP or FMD (as
          may be determined by regional needs) and elimination of HPAI in West and
          Central Af rica which would also underpin the epidemiological surveillance
          network. Such a programme should be linked to the development of a
          livestock marketing chain system to reinforce the policies of the two RECs.
          Without such a disease control programme the network could readily drift into
          being just a disease information exchange, with little impact on the sanitary
          status of Member Countries. This could affect its long-term sustainability.
   iv.    Supporting the two RECs to develop their own baseline livestock database.
          However the early warning elements which reflect the platform of the FAO-
          OIE-WHO GLEWS would not be an immediate priority.


                                                                                        56
   v.       Supporting the RECs and national veterinary services to mainstream
            structured preparedness against TADs building on the experience of the HPAI.
            The two RECs to develop specific regional preparedness plans which include an
            agreed mechanism for mobilising funds for disease emergency response.

   8.2. Recommendations for Eastern Africa

   The Eastern African epidemiological surveillance network should take account of the
   disparity between IGAD and EAC in supporting institutions at the REC lev el and the
   mandate of IBAR as the continental body for animal health. For the EAC an
   intervention should encourage close contact between the emerging systems of the
   EAC with those of SADC. This will encourage exchange of epidemiological information
   and sha ring experience for network governance and functioning.

   Therefore a project intervention for the Eastern Africa region should encompass the
   follow ing 5 elements:
    (i)     Supporting the emerging institutions of the EAC so that they can have
            institutional settings similar to those of the SADC and can sustain a system
            for passive and risk-based epidemiological surveillance and emergency
            preparedness against outbreaks of TADs and zoonoses (especially RVF, HPAI)
            in the EAC. Such an initiative should be aligned to the EAC Agriculture and
            Rural Development Strategy for the East African Community (2005 - 2030) as
            well as the Regional Plan of Action for the Prevention and Control of Human
            and Animal Transboundary Diseases in East Africa. This support should serve
            to consolidate the emerging collaboration, within the EAC, between human,
            livestock and wildlife health sectors with respect to infectious diseases, i.e. a
            platform for One Health.

    (ii)    Exploring further mechanism for linking the pro-poor livestock policy initiative
            in IGAD and market access driven epidemiological surveillance network for
            the IGAD, taking into account the results of the on-going study by ILRI-based
            consultants which has been commissioned by FAO and Af DB.

    (iii)   Supporting IBAR and FAO-ECTAD (Eastern Af rica) to coordinate a regional
            programme for the progressive, but targeted, control of PPR, CBPP and FMD
            from Eastern Af rica which should be underpinned by an epidemiological
            surveillance network for TADs and Zoonoses in Eastern Africa and an animal
            disease information system based at IBAR. This could serve as the regional
            node for the FAO-OIE GF-TADs for Eastern Africa

    (iv)    Supporting IBAR and FAO-ECTAD (Eastern Africa) to mainstream structured
            preparedness against TADs building on the experience of the HPAI. But IGAD
            and EAC would need to develop REC specific preparedness plans which include
            an agreed mechanism for mobilising funds for disease emergency response.

    (v)     Setting up a regional early warning system between IBAR and the FAO-ECTAD
            (Eastern Africa) located in IBAR but which links with the FAO-OIE-WHO
            GLEWS, recognised as complementary to but distinct from the baseline
            generic ARIS system of IBAR.

   8.3. Recommendations for SADC

A project intervention for this region should be seen as being aligned to the strategy f or
regional economic integration to create a SADC Free Trade Area and should focus on four
issues, namely:
    i. strengthening the existing institutions to align them to the goals of GF -TADs
        through support for regular meetings of the LTC, its relevant sub-committees and
        the emerging Southern African Commission for the Control of TADs and Zoonoses;


                                                                                          57
      Support in this area should also serve to consolidate the emerging inter-sectoral
      and inter-institutional collaboration, within the SADC, between human, livestock
      and wildlife health sectors with respect to infectious diseases, i.e. a platform for
      One Health. A mechanism for linking the global objectives of One World – One
      Health and GF-TADs with those of the SADC Livestock sector is summarised in F ig
      5 below:


              Fig 5: A proposal for linking Regional with Global Objectives
                     in SADC: targeting credibility and sustainability


            RAHC & One
            Health Collabtn        SADC                 SADC - LTC
                                 Secretariat
            AU-FAO-OIE
            {SADC-WHO}
                                                            SACCT as hub for
                                                            GF-TADs


               AI & TADs
               Preparedness                                   Surveillance network



                        SACIDS & Other One Health            LTC Lab & Epidem
                        surveillance related networks         Sub-committees




             (NB: The text in the orange background represents new initiatives in SADC
              while that against the blue background represents established structures.
                              Similarly the text in red for the RAHC represents desirable
                extension collaborative elements for the RAHC associated with SADC)

ii.  A phased coordinated programme for the progressive, but targeted, control of
     FMD and CBPP, which should build on the outcome of the current SADC TADs and
     the SADC FMD projects and should take into account the baseline elements
     outlined in the 20 -30 year strategy arising from the recommendations of the
     FAO-SADC-OIE regional meeting of CVOs in 2003 and taking into account the risk
     management driven approach for commodity-based trading in livestock products;
     such a programme is what will drive a sustained and structured epidemiological
     surveillance network encompassing all the SADC Member States, but where
     external donor support could focus on the needs of the less resourced countries,
     especially in the northern band in order to accelerate market access for livestock
     commodities from such countries as well;
iii. mainstreaming structured preparedness against TADs building on the experience
     of the HPAI, again especially in the northern band countries of SADC and at the
     SADC regional level. A pilot is being tested in Tanzania under the One UN
     Programme and the SADC TADs project includes some seed funding for a regional
     approach. In themselves these two initiatives could fall short of expectation unless
     they are reinforced by a structured programme of institutionalisation through a
     financial provision by SADC Member States and top-up by donor support; such an
     enabling project would need to focus on the need for preparedness against SADC
     exotic and international emerging diseases as well as on those diseases for which
     the SADC CVOs have described as requiring tactical intervention when incidence
     threatens to rise above an acceptable risk level and on local control of zoonoses
     and food security threatening diseases;

                                                                                       58
   iv. Setting up a regional early warning and response system between the SADC
       Secretariat and the RAHC which links with the FAO-OIE-WHO GLEWS, recognised
       as complementary to but distinct from the baseline generic LIMS -AIMS system.
       We found that the current SADC TADs project, which is funded by the Af DB, has
       some provision for initiating such a process, but we could not ascertain when such
       a process might start as the operations of the project are only starting. In any
       case such a programme will need to be further develo ped with additional
       resources.


   8.4. Recommendations for IBAR

Project intervention for IBAR should strengthen its role as a continental forum and
coordinator of disease programmes which need harmonisation across RECs.

IBAR will also require support to be able to act as the Continental early warning agency
for TADs and Zoonoses in close collaboration and coordination w ith the FAO -OIE-WHO
GLEWS.

We strongly recommend that IBAR seek technical support from FAO for strengthening
IBAR‟s own normative and policy functions. Such support, which should be distinct from
IBAR‟s participation in the RAHC or operational projects, will also serve to strengthen
mutual confidence between IBAR and FAO and w ill enable IBAR to have direct access to
the enormous knowledge base of FAO in the agricultural and livestock sectors as well as
such support technologies as ICT.




9. CONCLUSION

This study has recommended that the Governa nce (a nd the reby sustainability) of
regional epidemiological surveillance networks be associated from the outset with the 5
geographical RECs (i.e. SADC, EAC, IGAD, ECOWAS and ECCAS), although the technical
support from FAO is expected to continue for several years.

We recommend that the activities of these networks be grouped under three categories
in order to reflect the objectives of sustainability and credibility.

Category A – which should focus on the core functions of the network, i.e. to act as a
forum for national epidemiologists and experts; to review disease national surveillance,
response and control programmes; analyse regional and international disease trends
and provide early warning to National CVOs and policy makers; to define disease control,
preparedness and response strategies as well as identification of areas for project
intervention. This category should be the target for sustainability primarily with funding
from Member States of the relevant REC. This will constitute the core budget of the
network

Category B – which would encompass enabling project interventions to facilitat e the
objectives of the networks. This category of activities enhances the effectiveness and
credibility of the networks and w ill be expected to be funded through extra -budgetary
sources (e.g. donors), i.e. as additional to the core budget.

Category C – which would comprise development objectives or programmes which
require or enhance epidemiological surveillance. Activities of this category are also
expected to be funded from extra-budgetary sources.



                                                                                       59
10. OBSERVATION


We had expected the team to consist of 5 experienced members. In the end only 3 were
appointed. Of these one (Dr Seck) who was still in the experience gaining ended up
visiting 5 countries on his own as the 4th epidemiologist was not recruited after the
schedule had been approved. This phase of the study was undertaken without an
economist/financial analyst and therefore the report does not cover economic analysis or
costing.

We were unable to hold the consultative regional workshops as required in the Terms of
Reference and included in our Inception Report, as these were cancelled. Consequently
we were unable to interact effectively with some of the stakeholders, especially the
private sector and farmer organisations.

The team had to spend a considerable amount of time on logistics issues , such as travel
arrangements.


11. AC KNOWLEDGEMENT

The team was impressed with the quality of programme on avian influenza and other major TADs
being implemented in Africa with the technical assistance of FAO, OIE and IBAR through the
Regional Animal Health Centres. This is underpinned by an authoritative, multi-disciplinary strategy
and a clear collaboration with human health systems of Member Countries and WHO.

The staff of the FAO Animal Health Service in Rome was helpful throughout the study
period. We are particularly thankf ul to Drs Domenech, Lubroth, Le Brun, Dauphin, Idrissi,
Akiko Kamata, New man, Stephane de la Rocque and Ms Agnieszka Bakowska. We
appreciate the invitation that was extended to the Team Leader to participate actively in
the workshop of the FAO Focal Points for regional epidemiology and laboratory
surveillance networks 21 – 23 October 2008, which included participants from East,
Central and West Asia as well as f rom Northern, West & Central, Eastern and Southern
Africa.

During the field missions the Team was helped tremendously by the FAO-ECTAD Regional
Managers and staff in Bamako, Gaborone and Nairobi, by the OIE Regional
Representative and Sub- Regional Representative respectively in Bamako and Gaborone,
by the Director AU-IBAR and key IBAR staff, by the FAO Representatives and FAO
Livestock personnel in Addis Ababa, Kampala and Nigeria.

We note our appreciation of the effort made by FAO-ECTAD Managers to reschedule their
own regional workshops to coincide with our travel schedule. This made it possible for
the Team to interact with more national epidemiologists and experts than would have
been possible only through country visits.

Above all we acknowledge the assistance and readiness to discuss in detail by the
Directors of Veterinary Services of the Ministries responsible for animal health and the
Directors of Public Health senior officials in the Ministries of Health of the countries
visited.


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                                                                                                 60
2. Anon (2004). Update: Integrated Diseases Surveillance and Response
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                                                                                     64
Annex 1
Te rms of Refe rence

Feasibility study for establishing epidemiology networks for HPAI in Africa

1. Bac kground

The spread of the highly pathogenic avian inf luenza (HPAI) from Asia to Europe in 2005 -
2006 posed a threat to create an endemic situation with the entry of the virus into the
African continent. This is where there are weak veterinary services, especially
inadequate diagnostic laboratory capacity as well as lack of well trained manpower in
HPAI. In addition, more than 80% of the poultry in Africa are backyard chicken. It was
very essential to establish capacity to facilitate early detection and control of the disease
and the linkage between veterinary and public workers.

A multi-faceted approach to avian inf luenza prevention and management is undergoing
to counter this spread. Among the set of principles of such approach, timely early
warning and disease intelligence, based on consistent and transparent information
sharing, are central to detecting and reporting outbreaks before they become
widespread, and tracking potentially dangerous changes in the virus. Lessons learned
from a disease experience in one country are a valuable tool for other countries‟
preparedness and response to the same disease. This can only be accomplished when
there is a transparent exchange of disease information among countries and a
collaboration of efforts across areas. This requires networking at many levels including
field and central/national level, veterinary diagnostic laboratories and epidemiology
teams.

Regional coordination and networking are an essential component of the FAO/OIE Global
Strategy for control and eradication of HPAI and of the overall coordinating mechanism
being established to support its effective implementation.

The GF-TADs (Global Framework for the Progressive Control of Transboundary Diseases)
is a joint initiative of FAO and the OIE which combines both organisations in the fight
against transboundary animal diseases (TADs) world wide. The Regional Steering
committee of GF-TADs for Africa has as an essential mandate to support the activities
relating to animal health in Africa and includes representatives of the OIE, FAO, UA -
IBAR, elected members of the Bureau of the OIE Regional Commission and
representatives of the regional economic communities involved in the support of animal
health policies. The OIE host and manage the secretariat of the regional GF -TADs
steering committee as well as the Secretariat of the Regional Animal Health Center of
Bamako.

In April 2005, the OIE and FAO created and endorsed a joint network of expertise on
Avian influenza for the benefit of Member Countries: the OIE/FAO OFFLU network on
avian influenza. The objectives of OFFLU are: (i) To exchange scientific data and
biological materials (including virus strains) w ithin the network, and to share such
information with the wider scientific community; (ii) To offer technical advice and
veterinary expertise to Member Countries to assist in the diagnosis, surveillance and
control of avian influenza; (iii) To collaborate with the WHO influenza network on issues
relating to the animal-human interface and (iv) To highlight avian influenza research
needs, promote their development and ensure co-ordination.

In the Geneva meeting in 2005, OIE, FAO and WHO also expressed the need for regions
to develop epidemiology networks w hich would facilitate epidemiological surveillance and
intelligence of the virus and thus improve prevention and control activities.         This
approach harmonizes natio nal priorities in disease prevention and control efforts and
builds synergy and efficiency in terms epidemiological expertise and consequently global
efficacy of the overall disease prevention and control.


                                                                                           65
Regional networks are needed to support countries and national institutions to create a
dynamic/synergistic approach for interaction between countries and break the isolation
of national teams in developing countries. They will have a co-ordinating and technical
backstopping function that will promote c onsistency and rigour in methodology, enable
local national institutions to share ideas and information, and build trust for enhanced
transparency and mutual confidence in disease information exchange.

Since the beginning of HPAI crisis in early 2004, numerous sub-regional epidemiology
and laboratory networks have been established in Asia, Middle East, Eastern Europe and
Caucasus, Africa and Latin America to coordinate HPAI disease surveillance and
diagnostic capacity of participating countries. These netw orks were set up and promoted
by FAO in close collaboration with OIE and regional organizations under the FAO/OIE GF-
TADs initiative. The sub-regional networks are designed to improve the quality of
disease surveillance and disease diagnosis by putting in place harmonized
epidemiological surveillance and diagnostic tools and methods, and by providing training
and technical support to national staff engaged in this work in each country. These
networks support coordination and harmonization of regional appro aches for early
warning, efficient detection and early response to HPAI.

Networking of epidemiology teams has been used and proved to be successful in the
cases of rinderpest, new world screw worm, classical swine fever and food and mouth
diseases. The epidemiology networks set up in Af rica by AU-IBAR/PACE and SADC, as
well as epidemiological surveillance networks established through FAO-RADISCON 6 in
North Africa and Near East have been instrumental in establishing regional reporting
systems and promoting disease information sharing between countries of these
networks.

Follow ing consultations between many partners 7 , it has become evident that the process
in building up prof iciency in AI surveillance (and any other emerging or re -emerging
disease) needs to be further strengthened through regional coordination and networking.
This approach has been adopted by FAO through its Technical Cooperation Programme to
assist member countries and set up epidemiological surveillance networks in North Africa,
Western and Central Af rica, Eastern Africa and Southern Af rica. These subregional
networks and those established by AU-IBAR/PACE and SADC for other transboundary
animal diseases have to be continued and strengthened for surveillance and early
warning of HPAI outbreaks. They support coordination and harmonization of regional
approaches for early warning, efficient detection and early response to HPAI. This w ill
enable rapid reduction in the number of outbreaks and spread of disease, progressively
leading to eradication or longer term disease containment and prevention so that
regional economies and individual family livelihoods and food security are protected and
the risk to human health is minimized.

In support of the epidemiological surveillance and laboratory work the OIE in 2006
further elaborated its concept and arrangements for twinning between laboratories
introduced already in 2002. Developing and in-transition countries are also in urgent
need of easier access to scientific expertise to scient ifically justify and formulate animal
health control strategies and to develop their own veterinary scientif ic communities so as
to assist more in the standard-setting process of the OIE and to implement these
standards at national level. The aim of the OIE twinning concept is to ensure eventually
an even geographical distribution of expertise and Reference Laboratories allow ing easier
access to experts and for the rapid detection and diagnosis of disease.




1
 Regional Animal Disease Surveillance and Control Network
2
 FAO, OIE, AU-IBA R, AIEA, ARC-OVI, ILRI, IZSVe, CDC Kenya, SA DC, PRINT, LA NADA, PANVA C,
DEBRE-ZEIT, USDA, APHIS, etc...
                                                                                              66
The enhanced regional capacity and cross boundary collaboration will also enable more
effective responses to other transboundary and emerging diseases in addition to HPAI,
which may threaten public health.

2- Objectives of the study

The objective of the feasibility study is to evaluate the technical a nd operational
feasibility, investment and benefits related to the establishment and adoption of
epidemiology networks in Africa for control and prevention of HPAI and other
Transbounday Animal Diseases.

The epidemiology sub-regional networks will improve control and prevention of HPAI
through strengthened and coordinated surveillance activities and through a better
understanding of the epidemiology of the disease.

Spe cifically, the networks will
  Develop robust, comprehensive, and fully coordinated officia l surveillance and
     monitoring systems through sustainable epidemiology networks,
     Increase implementation of OIE International Standards to improve the notif ication
     to OIE of diseases and epidemiological information
  Build regional and national capacity in disease surveillance and epidemiology
     through technical meetings and targeted training;
  Facilitate resource mobilization (human and financial) through close interaction with
     international programmes/agencies/organizations
  Exchange information on HPAI and other transboundary animal diseases and
     harmonize epidemiological surveillance protocols and disease detection to prevent
     and control potential outbreaks
  Develop data analysis, disease intelligence and risk mapping capacity within the
     region
  Facilitate the emergence of subregional epidemiology leading groups and develop a
     cadre of regional experts for mutual support

3. Guiding principles for the study

Guiding principles for the feasibility study that need to be taken into account while
conducting the study include:

   -   Clear vision and objectives of the study: It is critical that discussions and
       agreements reached while conducting the study be based on common
       understanding and objectives as set in the concept note and section 2 of these
       ToRs.
   -   Well focused issues for analysis.
   -   Adequate scope: the feasibility study to be thorough enough to allow
       discussions and consultations w ith all stockholders involved in prevention and
       control of TADs at national, regional and international levels including potential
       partners f rom the public and private sectors (see suggested list of potential
       stakeholders attached to these ToRs).
   -   Information sharing: make methods and data collected during the study
       accessible to all concerned stakeholders.
   -   Reference to and use of OIE international standards.
   -   Ensure full integration of epidemiology networks w ith laboratory networks

 4. Issues to be addressed in the feasibility study

4.1. Review of what exists, what has been achieved, constraints and failures

      Implementation and usage of       OIE International Standards (Notif ication of
       diseases and epidemiological information; Evaluation of Veterinary Services and

                                                                                      67
       Guidelines for the evaluation of Veterinary Services; General Guidelines and
       Surveillance for Specific Diseases and Guidelines for the surveillance of avian
       influenza)
      Information systems already in place WHAHIS/WHAHID; GLEWS and OFFLU
      An overview of selected national surveillance and disease information systems
      Lessons learned from epidemiology networking initiatives in ot her regions e.g. in
       Asia (FAO Technical Cooperation Programme projects)
      An overview of existing networks in Africa, e.g.:
           - OIE/FAO/AU-IBAR Regional Animal Health Centers
           - Networks established through PARC & PACE programmes
           - Networks established in Africa through the FAO Technical Cooperation
              Programme
           - RADISCON (North Africa)
           - Other networks existing in Af rica (SADC)
      Collect official ToR‟s of existing laboratory networks and analyse their legal roots
       sources

4.2. Organization of the networks

      Def ine the strategic framework and priorities for networks
      Def ine the management structure and institutional arrangements,
      Characterize leadership (e.g. chairing system, etc...) and coordination
       arrangements (facilitation)
      Def ine the role of each partner to the network:
           - National teams
           - Regional leader
           - International Reference Centres (world and regional levels)
           - Regional, sub-regional and international organizations
      Def ine number of countries per network, geographic coverage, number of sub -
       regional leading epidemiology teams/centres per network;
      Def ine modus operandi meetings, training (type of activities)
      Def ine implementation mechanisms
      Monitoring and evaluation / performance indicators
      Status of interaction with public health surveillance networks part icularly relevant
       in HPAI, and other zoonoses
      Status of interaction      and integration of the      epidemiology networks with
       laboratory networks (idem national level)

4.3. Principles, methods and tools

      Capacity: Human resources / skills / current situation of data capture storage and
       analysis (risk analysis, time and spatial series analysis)
      Information systems in place (epidemiology units. connectivity, electronic
       networks, field data capture storage)
      Use of OIE International Standards on Veterinary Servic es, Surveillance, of the
       OIE “Performance Vision and Strategy” (PVS) instrument for the Evaluation of
       Veterinary Services
      Connection with systems in place WHAHIS/WHAHID; GLEWS; OFFLU

4.4. Public – private partnerships

      Key tripod for surveillance (official veterinarians, private veterinarians and
       farmers) and private public partnership.
      Role of producers / Processors : commercial farms, rural holders (backyard
       systems at village level) given level and type of vertical integration in commodity
       chains (c ommercial sector / backyard)
      Participatory approaches for village level surveillance



                                                                                         68
4.5. Cost assessment

      Cost assessment of national surveillance systems and sub regional networks.
      Relative Participation of private sector in financing the surveillance, hence
       managing risk: relates to Public/Private partnerships cf. 4.4

4.6. Impacts and cost-benefit analysis

      Impact: Identify Elements (criteria) of Effectiveness improvement due to the
       networking modus operandi as compared to a stand alone type of epidemiological
       surveillance activity: e.g. reduction of disease notification time, avoidance of
       delays in result dissemination, better quality and accuracy of results.

      Cost / Advantage: How epidemiology networks bring added value to activity,
       efficiency & efficacy of national epidemiology units / systems: economy of scales
       expected or actual thanks to the networks in place. Participation of epidemiology
       networks in the Costs and Benefits of disease prevention (epidemiology and
       information part)

4.7. Long term sustainability

      Source of funding for epidemiology networks including all aspects: (i) financing of
       networks setting-up, including coordination between official networks and
       participatory disease surveillance networks; (ii) financing of training of all partners
       of the tripod for surveillance (official veterinarians / private veterinarians and
       farmers); (iii) f inancing of sample collection and shipment and (iv) financing of
       sample analysis
      Who is contributing to the funding of networks? (e.g. public funds/ private funds
       / public or parastatal projects)
      Cost sharing according to justifications through “public good” and “private good”
       outputs.
      Level of participation to international projects and programmes

5. Methodology

The commissioned consulting team is expected to conduct enquiries, collect information,
form opinions and prepare project proposals by:

   •   Documentary and electronic research
   •   Desk studies
   •   Visits to countries
   •   Meetings with international, regional, sub-regional       and national organisations
       involved
   •   One stakeholder workshop per sub-region
   •   E-conferences

Guidance and contacts will be made available on key stakeholders to be interviewed,
within regional organisations, national governments, national and regional epidemiology
and disease surveillance systems, NGOs and other relevant institutions

A review panel consisting of five panel members, including participants in this
consultation will have be nominated by the executive committee of Alive.


6. Team composition, location an d duration of the assignme nt

The team of consultants commissioned for the feasibility study will be composed of 5
experts as follows:


                                                                                           69
         An epidemiology expert, team leader, having an experience in the management
          and coordination of equivalent regional epidemiology networks;
         An epidemiology expert preferably from the OIE-FAO OFFLU network and
          collaborating centers;
         An epidemiologist experimented in the management of national surveillance
          systems, in terms of methods, organization and costing;
         An economist that will assess the cost of national and regional surveillance
          systems/networks, as well as cost effectiveness and sustainable funding
         Expert on animal health information systems

Location and duration of the assignment:

         FAO headquarters in Rome c an host the team
         The Team w ill make visits and/or arrange videoconferences with international and
          regional organisations
         The team will carry out country missions as needed after their first findings about
          the sub-regional partitioning w ith a number of 3 to 4 countries per sub-region
         The study will be implemented within 2 months

7. Required Outputs

The outputs of the study will be as follows:
    A report of approximately 10,000 word (main text) plus annexes as needed, in MS
      Word format, provided as print ed and electronic copies. It should include a
   section   covering each of the subjects described under 4.1 to 4.7 including a logical
      framework and major            conclusions, recommendations
    A workshop for each sub-region, with brief proceedings
    An electronic database of organisations/institutions engaged in activities
   appropriate       to thenetwork with names and contacts.

The outputs will be delivered in English (except where workshops are held in French, in
which case the proceedings will be documented in that language), with an executive
summary in French.

The draft report and database will be produced by [dates].
A review panel consisting of five panel members, including participants in this
consultation will have 2 weeks to comment on the draft.

The final version will be provided within 4 weeks of receiving written comments from the
review panel.


8. Working documents

         Concept note for laboratory networks

         FAO/OIE Global Strategy for Prevention and Control of H5N1 HPAI        available at
          http://www.fao.org/docs/eims/upload//228807/a1145e.pdf

         FAO/OIE Global framework for the progressive control of transboundary animal
          diseases (GF-TADs)
          http://www.fao.org/ag/againfo/subjects/en/health/diseasescards/cd/documents/G
          F-      TADs24May2004.pdf

         HPAI Manual (Preparing for Highly Pathogenic Avian Inf luenza)
          http://www.fao.org/docs/eims/upload/200354/HPAI_manual_en.pdf



                                                                                          70
   FAO recommendations on the Prevention, Control and Eradication of Highly
    Pathogenic Avian Influenza (HPAI) in Asia. September, 2004.
    http://www.fao.org/docs/eims/upload/165186/FAOrecommendationsonHPAI.pdf

   Guiding principles for highly pathogenic avian inf luenza surveillance and diagnostic
    networks in Asia. FAO Expert Meeting on surveillance and diagnosis of avian
    influenza in Asia. Bangkok 21-23 July, 2004.
    http://www.fao.org/ag/againfo/subjects/en/health/diseases-
    cards/Guiding%20principles.pdf

   Avian Influenza Prevention and Control and Human Influenza Pandemic
    Preparedness in Africa: Assessment of Financial Needs and Gaps December 2006
    http://www.avianinf luenzaconference4.org/index.php?id=23

   OIE/FAO Network of expertise on avian influenza (OFFLU)
    http://www.fao.org/docs/eims/upload//217790/leaf let_offlu_en.pdf

   The Global Early Warning and Response System (GLEWS) for major animal
    diseases including zoonoses
    http://www.fao.org/docs/eims/upload//217837/agre_glews_en.pdf

   OIE related documents




                                                                                       71
Annex 2


     THE ANIMAL DISEASE IMPERATIVE FOR EPIDEMIOLOGICAL SURVEILLANCE
                           NETWORKS IN AF RIC A

                                           By

                         Mark Rweyemamu and Musa Fanikiso
                         Consultants, ALive Feasibility Study on
          Regional Epidemiological Surveillance Networks in Sub-Saharan Africa
                          Mark.rweyemamu@btinternet.com;
                             Mfanikiso@orangemail.co.bw




1.   Context

Animal diseases that result in emergencies, which are generally described by national
laws as notifiable and which require immediate official reporting to the OIE are of three
categories: the transboundary animal diseases (TADs), zoonoses and emerging or
previously unknown diseases.

Transboundary animal diseases have been defined by FAO and OIE as “t hose animal
diseases that are of signif icant economic, trade and/or food security importance for a
considerable number of countries; which can easily spread to other countries and reach
epidemic proportions; and w here control/management, including exclusion, requires
cooperation between several countries”.

Zoonoses have been defined by WHO as “Diseases or infections which are naturally
transmitted between vertebrate animals and humans”. Like TADs, zoonoses can be an
important technical barrier to international trade. Furthermore in recent years zoonoses
have become of increasing importance to human health as the majority of emerging
human diseases have been shown to have originated from animals. This importance is
because zoonoses:
    • Constitute about 51% of all human infectious diseases;
    • Constitute a technical barrier to international trade;
    • Some 70 to 80% of new or emerging diseases of humans over the last 30 years
       originated from animals;
    • Include some of the most feared human diseases e.g.
           – AIDS
           – Ebola,
           – SARS
           – Avian influenza
           – Rabies

According to the OIE Terrestrial Animal Health Code, the term Eme rging disease means
a new infection resulting from the evolution or change of an existing pathogenic agent, a
know n infection spreading to a new geographic area or population, or a previously
unrecognized pathogenic agent or disease diagnosed for the first time and which has a
significant impact on animal or public health.

This term was originally introduced by the USA Centre for Disease Cont rol and Prevention
(CDC) in 1994 who described emerging diseases as: “Diseases of infectious origin whose
incidence in humans has increased within the past two decades or threatens to increase
in the near future”.




                                                                                      72
As remarked above the majority of emerging human diseases are of a zoonotic nature.
Accordingly, animal health is increasingly becoming relevant not only to the traditional
areas of animal welfare (to stop suffering) and safeguarding animal agriculture and trade
in animal commodities but also to t he protection of human health. In Africa this has
recently been brought into sharp focus by the outbreaks of highly pathogenic H5N1 avian
influenza and the recent (2006/7 and 2008) outbreaks of Rift Valley fever in Eastern and
Southern Af rica.

Therefore by nature, the risk management of TADs and zoonoses (including emerging
diseases) entails having in place the capacity to detect disease event s at the grassroots
level, ensuring inter-District coordination and collaboration for both surveillance and risk
management of such diseases. All this has to be over and above the cooperation with
other countries, especially the neighbouring countries.

The risk management of TADs and major zoonoses is guided by the precepts of the
EMPRES programme, which first became a major priority programme of FAO in 1994 and
has been outlined:

Early Warning: identified as all disease initiatives based predominantly on
epidemiological surveillance, which would lead to improved awareness and know ledge of
the distribution of disease or infection and which might permit forecasting the further
evolution of an outbreak.

Early Reaction: identif ied as all actions that would be targeted at rapid and effective
containment of, and leading to, the elimination of a disease outbreak, thus preventin g it
from turning into a serious epidemic. This includes contingency planning and emergency
preparedness.

Co-ordination: involves either co-ordination of global eradication of an identified animal
disease such as rinderpest e.g. through the Global Rinderpe st Eradication Programme,
or encouraging regional initiatives for eradication of a given transboundary disease.

Enabling Research: identified as prime element of EMPRES to emphasize the
collaboration between FAO and scientific centres of excellence in dire cting research
efforts towards problem solving.

These prime elements of EMPRES have now been embedded into the Joint FAO-OIE-WHO
Global Framework for the progressive control of transboundary animal diseases and
zoonoses (GF-TADs) and form a reference point for animal disease risk management (i.e.
prevention and control).

Fig 1 summarises some of the key elements that lead up to Early Warning (which is a
product of epidemiological analysis of disease or infection surveillance data) and Early
Reaction (which is a product of a practiced emergency preparedness plan) and the two
dovetail to lead to an effective response and disease control strategy.




                                                                                         73
                    Fig 1: Risk management of TADs and zoonoses

             Clinical                                            Define
             observation                                         acceptable risk
                                                                 Dis. Monitoring
             Presumptive
             diagnosis                                           Contingency plan
             (CAHWs/Vet                                          Stakeholders
             Assist/Veterinarian)
                                                                 Simulation
                                     Early           Early
             Lab diagnosis &                                     Contingency
             identification /       Warning         Reaction
                                                                 resources
             Investigation/                                      Outbreak
             Surveys/data                                        investigation &
                                         Cost-effective          surveillance
             Wildlife surveys
             Other data/info
                                                                 Emergency
                                         Science based
                                                                 interventions
             Epidemio-               TADs Risk management        Parameters for
             analysES                   (Disease control)        emergency end

              Underpinned by                                    Underpinned by
             SURVEILLANCE                                       PREPAREDNESS




It is apparent from the above that Surveilla nce a nd pre paredness require access to:
effective laboratory diagnosis and a structured animal disease information systems which
encompass both disease reporting and early warning (a product of epidemiological
analysis).

2. Conjectured Status of Major TADs a nd Zoonoses in Sub-Saha ran Africa

In recent years Africa has reported 1.25 crises per year according to results from a
questionnaire analysed by the OIE from member countries. Most of the crises were as a
result of FMD outbreaks. But recently other TADs have also shown an increasing trend.
For example the epidemic of Rift Valley Fever (RVF) in Eastern Africa (Ethiopia, Somalia,
Kenya and Tanzania) resulted in many abortions and mortality in ruminants and over 500
human deaths.

In February 2006 Highly Pathogenic Avian Influenza (HPAI) was first reported in Africa
when it entered Nigeria. Subsequently the disease has been detected in Niger,
Cameroun, Burkina Faso Togo, Cote d‟Ivoire, Ghana, Egypt, Southern Sudan and
Djibouti. Although there have been a relatively low number of human deaths due to
H5N1 infection (50 in Egypt and 1in Nigeria), high mortalities in poultry were recorded
and the threat to human health continues to be of great concern. The resources of
national authorities in the affected and at risk countries were stretched to the limit. The
response by many donors and the establishment of the FAO country/regional ECTAD
offices was of tremendous help in assisting with the response and control measures.

In 2007 Mauritius experienced an outbreak of African Swine Fever (ASF) which caused
deaths of 13 000 pigs out of a national heard of 17 000. This was serious disaster to the
emerging Mauritian pig industry.

In Botswana periodic outbreaks of FMD have been experienced since 2002 and a recent
(October 2008) outbreak of the disease in the FMD free without vaccination zone resulted
in the destruction of close to 2000 head of cattle in a stamping-out operation. In
Namibia, Malaw i, Zimbabwe and Zambia FMD outbreaks continue to be experienced and
the disease does not seem to respond to vaccination which is usually t he preferred



                                                                                        74
strategy in areas of high diseases challenge. All this is apart from the endemic incidents
of FMD in much of Tropical Africa.

 Major Outbreaks of Animal Diseases in Africa notified to the OIE during 2008 are as
follows:
      Namibia- African Swine Fever                              29/10/2008
      Botswana- Foot and Mouth Disease                          20/10/2008
      Malaw i- Foot and Mouth Disease                           29/09/2008
      Ethiopia- African Horse Sickness                          19/09/2008
      Togo- Highly Pathogenic Avian Influenza                   18/09/2008
      Benin- Highly Pathogenic Avian Inf luenza-                26/08/2008
      Nigeria- Rabies-                                          08/08/2008
      Botswana - Foot and Mouth Disease-                        05/08/2008
      Namibia- Foot and Mouth Disease                           04/08/2008
      Egypt- Equine Influenza                                   31/07/2008
      Swaziland- Rift Valley Fever                               28/07/2008
      Nigeria- Highly Pathogenic Avian Influenza                 25/07/2008

The above scenario might only represent the tip of an ice-berg as most African countries
do not notify the OIE of outbreaks of diseases considered to be endemic in the country
nor do they report repeat outbreaks which show the behaviour of the disease in the
country.

Follow ing the elimination of rinderpest, there is an increasing demand for livestock trade
in most countries in Africa either as part of regional economic integration or export or
through increased demand by the urban population. There is also an increasing
realisation that the expected economic benefit might not be optimally realised unless
improved sanitary conditions are in place.

We found therefore that there is an increasing demand for public veterinary services,
which are underpinned by an effective epidemiological surv eillance. One indication is that
there is an increasing number of countries now with distinct ministries for livestock or
livestock and fisheries or animal industries.


3. Emerging Drivers of TADs and Zoonoses in Sub-Saha ran Africa

During the last 2 decades there have been incidents of high profile epidemics of human
and animal diseases. These reflect trends in the global distribution of the major infectious
diseases. Several risk assessment studies lead to a conclusion that major infectious
diseases are normally absent from highly industrialised countries while they remain
endemic in developing countries. The pattern of disease spread is no longer limited to
episodic spread in localities or to neighbouring countries but has also led to wider global
dissemination. Thus the recent patterns of international spread of foot-and-mouth
disease, classical swine fever, avian inf luenza and bluetongue have illustrated the
importance of transboundary animal diseases to the global livestock industry and to trade
in livestock commodities beyond their endemic settings. Another trend has been the
association of the majority of emerging human diseases w ith the animal source. Most
such diseases have also originated from developing countries. Considerations of this
nature have propelled the FAO, OIE and WHO to place at the heart of their renewed
agreement and collaboration a programme know n as the Global Framework for the
progressive control of Transboundary Animal Diseases and Zoonoses (GF -TADs). The
core strategy of GF-TADs is to promote epidemiological surveillance and control of
infectious diseases at source, geographically in developing countries (especially of Africa
and Asia) where these diseases are generally endemic and zoologically in animals (wild
and domesticated) from the perspective of animal and public health.




                                                                                         75
The UK coordinated Foresight global study on infectious diseases of humans, animals and
plants identified common underlying risk drivers as (i) Culture and governance, including
legislation and systems of government; (ii) Technology and innovation; (iii) Conflict and
law; (iv) Human activity and social pressures, including urbanisation, animal agriculture
intensif ication and human-livestock-wildlife interface; (v) Economic factors – including
globalisation; and (vi) Climate change. Probably the most acute human activity and
social pressure w ith respect to animal agriculture is that which the study by FAO, IFPRI
and ILRI had termed the livestock revolution. This is characterised by an unprecedented
demand for livestock products, a rapid growth in the livestock sector and an increased
risk for animal disease epidemics. Animal agriculture now represents the fastest growing
component of agriculture. An aspect of social pressures is the increasing human
settlement encroachment on previously separated wildlife habitats resulting in an
increasing human-livestock-wildlife interface. The overall conclusion of the Foresight
study was that:
    • Many existing diseases will remain important, but new diseases w ill emerge in the
        future – noting that in the last 25 to 30 years some 80% of new/emerging
        infectious diseases of humans had originated from animals;
    • Major infectious diseases are endemic in Africa and Asia;
    • Substantial advances in infectious disease prevention and manageme nt will be
        made through integration of research across sectors (human, animal, plant) and
        disciplines (natural and social science);
    • New technological systems for early detection, identif ication and monitoring of
        infectious diseases have the potential to transform our capabilities in managing
        future disease risks, especially if challenges of international development are met;
    • Societal contexts will be crucial in realising the benefits of the new technological
        systems.

Therefore, the design and management of the new epidemiological surveillance networks
do need to take account of these tends in infectious diseases and their drivers in Africa if
the work of these networks is to contribute to the goal of effective prevention and control
of animal infectious diseases in order to stimulate economic animal agriculture, creation
of livestock dependent wealth, promote safe trade in livestock products and protect
human health.

Some recent examples of how these drivers are affecting animal health in Africa can be
summarised as follows:


    3.1. Globalisation
The introduction of H5N1 avian influenza into Africa has probably been more due to
economic factors than inter-continental bird migration. In recent years there have also
been outbreaks of diseases which had been foreign to Africa which most probably are a
consequence of globalisation. Examples include outbreaks of Pan-Asian Type O in 2000 in
Kwa-Zulu Natal of South Africa; Porcine Reproductive and Respiratory Syndrome (PRRS)
in Western Cape Province of South Africa and more recently 2005 – 2006 classical swine
fever in Western and Eastern Cape Provinces of South Africa. A common factor seems to
have been the feeding of swill from ships originating from outside Africa. The fact that
these episodes have all been detected in South Africa seems to reflect two lessons for the
rest of Africa. One is that South Africa is the most active country in international
commerce and therefore carries a higher risk of foreign disease introduction through
globalised commercial activities than other countries in the region. The second is that
South Africa has the best capacity for detection and identification of such exotic diseases.
Therefore the impact of globalisation on infectious disease incidence in Africa might be
under estimated.

   3.2. Climate Change
The association between climate change and disease outbreaks is now w idely accepted
and is a subject of further scientific investigation using powerful models. Most of the


                                                                                         76
current climate models indicate that the overall scenario is one of rising temperatures
and changes in rainfall patterns, with more prolonged and frequent drought and flooding.
Mean temperatures over land areas are expected to increase by an average of around
1–2°C by 2020 (relative to the 1961–1990 baseline), with the largest increases
occurring in southern Africa. By 2080, mean temperatures are expected to increase by
about 1.7–6ºC in southern Africa, 1.3–4.5ºC in eastern Africa and 1.7–5.5ºC in western
Africa. Several models also predict a decrease in rainfall for southern Africa of
approximately 5% by 2020 and 10% by 2050. Similar decreases are also anticipated in
parts of the Horn of Africa, with some areas in eastern Africa likely to receive a
significant increase in rainfall.

The prediction of future disease distribution might change depending on moisture
dependence. For example, certain species of tsetse flies might disappear from the
predicted drier parts of south-eastern Southern Africa. By contrast the combination of
drought and rainfall, brought by ENSO, has also been linked to large epidemics of African
horse sickness in the Republic of South Africa and might also have been account for a
similar episode in Senegal. Some global climate models predict that ENSO will occur
more frequently in future; it is also widely predicted that climate extremes (e.g.,
drought, floods) will become more frequent. It is possible, therefore, that significant
epizootics of certain vector-borne diseases, such as Rift Valley fever, could become more
common in parts of Africa.

Examples in Africa of possibly climate change associated disease outbreaks include the
2006/7 epidemic of Rift Valley fever in Eastern Africa. During Zambezi River flooding
destroyed disease control fences in Botswana and Zimbabwe resulting in the spread of
foot and mouth disease. Drying up of watering points for wildlife in Botswana, Zimbabwe
and elsew here is alleged to be one of the factors for spreading FMD in that region as
buffalo and cattle mix at watering points during the dry season.

    3.3. Governance/Political and Economic Change
Several Af rican countries are under-going political and economic instability resulting in
massive movements of people and animal and animal products. Some of the movements
involve cross border movements into neighbouring countries with animals of different
health status and hence disease outbreaks. Because of conflicts, disease surveillance and
control programmes are difficult to implement resulting in undesired endemic status
which keeps on f laring-up when conditions become favourable. Conf licts in Somalia and
the DRC have complicated epidemiological surveillance.

Also improved political stability and enhanced economic activity has sometimes resulted
in disease spreading along the new economic gradients. Outbreaks of certain strains of
FMD in the Maghreb and PPR could well have been associated with such economic activity
as the outbreak of CBPP in Botswana in 1995 after more than 50 years.

Overall several countries in Tropical Africa experienced upsurges of animal disease
epidemics during the 1980‟s and 1990‟s and a deteriorated animal health status which
several authors have attributed to the following governance issues:

   •   weaknesses in the national budget
   •   constant policy and structural changes
   •   donor-driven structural adjust ment policies which initially appeared to brigade all
       animal health activities together as primarily a private agricultural technical
       service to the farming community
   •   consequential weakness in the national veterinary services
   •   even weaker capacity for sustained laborat ory diagnostic services for infectious
       diseases
   •   weak livestock farming industry with little political inf luence and thereby no
       bargaining power in lobbying for an efficient animal health service



                                                                                          77
   •   grossly inadequate private service providers for the livestoc k sector, especially for
       animal health
   •   inadequate incentives for access to formal livestock markets
   •   uncontrolled animal movement.


    3.4. Re gional Integration
While regional integration has been observed to yield positive results by creating mega
markets for goods and services and increased trade, there are also negative effects it
brings. For instance the Southern African Development Community (SADC), in an effort
to promote better utilisation w ildlife resources through tourism, the political leadership of
the organisation has agreed to create mega trans-frontier conservation areas (TFCA)
cutting across many countries and this was done without the consultation of Veterinary
Depart ments. Free movements of wildlife across these frontier parks has created a
serious disease risk across countries as fences which usually form formidable barriers are
supposed to be removed to allow free movements of wildlife.

Diseases such as foot and mouth and tuberculosis are known to have been spread
through these trans-frontier parks. The preparations in terms of establishing multi-
sectoral epidemiological surveillance networks to manage the process have been
overlooked. While trans-frontier parks are supposed to improve resource utilisation in a
regional economic block, the approach adopted in their establishments could result in
long term negative impact in the spread of animal and zoonotic diseases unless
appropriate disease risk mitigation measures are put into place to ensure that previous
gains in animal disease control in the region are not jeopardised. This, now, is the
subject of intense discussion in the region driven by the SADC Secretariat and the
Livestock Technical Committee in order to define an inter-sectoral, science based disease
risk mitigation strategy.

   3.5. African Farming Systems and Land Use Pattern
Animal movement is a major factor in the spread of diseases and has features that are
peculiar to sub-Saharan Africa, driven by farming systems, trade, culture and social
habits. It can occur in several forms, including:
   • trade – regulated and unregulated
   • communal grazing – agro-pastoralists
   • transhumance – pastoralists
   • human migrations
   • wild animal migrations
   • family gifts and dowries – live animals.

In many countries there are no specific legal rights for pastoral grazing o r the regulation
of pastoral grazing. By contrast there are often tight laws for wildlife conservation.
Accordingly there is extensive human-livestock-wildlife interaction in the interface areas.

Peri-urban small-scale faming has been grow ing in many countries such as around
Bamako, Nairobi and Kampala. This together with multiple informal slaughter points also
has tended to drive disease spread.

In some countries, population pressures have lead to hasty land redistribution
programmes and the resultant un regulated animal movements to new settlements
resulting in upsurges of disease spread, as happened in Zimbabwe during the 2002 -4
FMD outbreaks. Such movements also disrupt disease control programmes in place as
animals may skip vaccinations or inspections and quarantines. The estimation of animal
populations for purposes of planning disease control programmes and surveillance
becomes extremely difficult.




                                                                                           78
4. The Disease           F rame work        Impe rative       for    Surveilla nce       Strategy      by     the
   Networks

So far the epidemiological surveillance networks in Africa have been pre-occupied more
with disease reporting than with the role of surveillance in the risk management of TADs
and zoonoses. Except for the SADC region, we found that the concept of categorising or
clustering TADs and zoonoses according to disease risk management strategies was not
part of the epidemiological surveillance network routine strategy. Nevertheless, it was
impressive that thanks to both the PACE programme and the FAO interventions through
EMPRES, many national veterinary services were aware of disease emergency
preparedness planning. So the response to either the outbreak or the threat of HPAI had
built on this prior experience. The challenge now is to build on the experience of
progressive control of rinderpest which has led to eradication and the current multi-
faceted programme for HPAI preparedness as well as the RVF experience in Eastern and
Southern Africa to work towards mainstreaming disease surveillance as a key component
of risk management of TADs.

The scheme that has been agreed by SADC CVOs seems to be appropriate and in line
with both the EMPRES advice and the practice of the WHO-AFRO Integrated Disease
Surveillance and Response (IDSR) strategy. This was first recommended in 2003 by the
regional workshop of National Chief Veterinary Officers, which was convened by FAO with
the participation of the OIE and the SADC Secretariat 8 in Pretoria. This categorisation
was revised by another FAO convened regional workshop of National Chief Veterinary
Officers plus experts in 2007 at Ngurdoto, Arusha. This scheme requires surveillance and
disease risk management strategies to align themselves to the following guidelines:

    •    Strategic diseases, i.e. diseases ta rgeted for progressive control
            – Nationally and regionally coordinated progressive control to elimination
               from the livestock population
            – A 20 year strategy agreed at SADC level
            – Conformity to OIE standards of zonal/compart ment or national disease
               freedom
            – Conformity to FAO-OIE Guidelines for Good Emergency Management
               Practices (GEMP) to protect freed areas

    •    Tactical diseases, i.e. epidemic diseases to be contained below accepta ble
         levels of risk
            – Require a preparedness programme
            – Surveillance (clinical and laboratory) to define acceptable risk level
            – Preparedness and contingency plan to be triggered when disease
                occurrence threatens to exceed acceptable risk level
            – Emphasis on capacity for early detection/ early warning and for rapid
                reaction in case of an outbreak
            – Disease control response to contain disease occurrence within acceptable
                risk limits

    •    Exotic or Emerging Diseases
            – Require a constant and high level of alert,
            – A practiced preparedness and contingency plan
            – An early warning system beyond national or regional borders
            – Capacity for disease intelligence
            – Laboratories within the region w ith a practical capacity and capability for
                early detection and identif ication of such diseases
            – Laboratory capacity to detect the unexpected or the unknown


8
 M usisi, F.L. (2003). FAO Regional Workshop of National Chief Veterinary Officers on FMD and Other Tran sboundary
Animal Diseases in Southern Africa, Pretoria 21 -22 July 2003- organized by FAO through project TCP/RAF/2809. pp
129.

                                                                                                               79
          –   Standing arrangements for access to a high security laboratory (BSL-3 or
              BSL-4), preferably within the region

   •   Inter-species diseases
          – Inter-sectoral collaboration in detection, identif ication and monitoring
          – Require attention to biosafety in laboratory operations (level depends on
              agent)
          – Medical and veterinary collaboration in disease control
          – Reference to WHO International Health Regulations and to OIE Animal
              Health Codes for zoonoses


Through literature study and discussions with the WHO-AFRO in Brazzaville and national
public health systems in Tanzania, Botswana, Kenya and Uganda we have found that the
IDSR system for human health follows similar principles, as shown in Table 1 below:


   Table 1: Contrasting systems for infectious disease categorization system by SADC
                        animal health sector and by WHO-AFRO

SADC Categorisation of TA Ds and Zoonoses            WHO-AFRO Categorisation of
                                                    Infectious Diseases of Humans
                                                             for the IDSR



                                                    Diseases which a re targeted
                                                     for elimination/eradication
 Strategic Diseases

=Targeted for regional progressive      control/
elimination from livestock population



                                                      Epidemic prone disease

 Tactical Diseases

= requiring tactical intervention when incidence
above pre-determined risk level; OR targeted
for local control




 Inter-species Diseases                              Diseases of Public Health
                                                       Importance




 SADC Exotic and Emerging Diseases                   ???




                                                                                       80
Table 2 below summarises the SADC system for the clustering of TADs and zoonoses
from the perspective of risk management strategies. The corresponding IDS clustering
system for one SADC Member State (Tanzania) is shown in Table 3. The two systems are
based on similar conceptual systems, although the IDSR system for human diseases has
been more vigorously and systematically applied than on the veterinary side.




Table 2: The SADC categorisation of TADs and Zoonoses


                                             FMD
       Strategic Diseases = i.e.
                                             CBPP
       Targeted for progressive regional
       control

                                             RVF; ASF ; LSD
       Tactical = intervention limited
       to tactical intervention to contain
                                             ND/IBD/ Fowl pox/ poultry
       epidemics or to local control
                                             Salmonellosis


                                             CCPP ; ruminant Salmonellosis


                                             Rabies


                                             Bovine TB

                                             Brucellosis
       Inter-species requiring
       concerted regional actions
                                             Rabies


                                             HPAI


                                             Rinderpest; PPR
       SADC Exotic or
       inte rnationally emerging
                                             BSE


                                             etc




Table 3: IDS Categorisation of infectious diseases of humans in Tanzania ( NB: This
excludes HIV/AIDS as this disease is covered by a specific vertically coordinated
programme)


       Diseases which are targeted           Acute Flaccid Paralysis
       for elimination/eradication
                                             Neonatal Tetanus
       Epidemic prone disease                Cholera
                                             Bacillary dysentery



                                                                                 81
                                             Plague
                                             Measles
                                             Yellow fever
                                             Cerebral Spinal Meningitis
                                             Rabies/animal bite
         Diseases of      Public    Health   Diarrhoea in Children < 5 years
         Importance:
                                             Pneumonia in Children < 5 years
                                             Malaria
                                             Typhoid




The other two regions (Eastern Africa; West and Central Africa) have not yet defined
such a clustering. However our probing of probable actions for the diseases identified as
priority for the region, there was indication that Eastern Africa considers the diseases
requiring progressive control prog rammes as PPR, CBPP and FMD. For West and Central
Africa there was not such a clearly identified vision although several individuals referred
to either CBPP or PPR with FMD as a possibility.

5.   Future trends for the control of TADs and Zoonoses in Africa as drive rs for
     Epidemiological Surveillance Networks

The Foresight study has observed that Africa is likely to continue to bear a heavy burden
of today‟s major infectious diseases over the next decade and to experience additional
challenges of new emerging diseases, the re-emergence of old diseases with enhanced
virulence, and the threat of diseases from other parts of the world. Against this
background, the management and control of infectious diseases are likely to be major
pre-occupations of the public sector in Africa in both the human and animal health
sectors.

Future control strategies for animal disease are likely to be influenced by the following
trends:

     a. The movement of animals and of animal derived commodities within and between
        countries and RECs as well as between Africa and the rest of the world.

     b. The linkage of controlling of infectious diseases to the wider development goals of
        poverty reduction, food security and market access, bearing in mind the evolving
        consensus that livestock and the c ontrol of animal diseases can be a key pathway
        out of poverty for rural SS-Africa.

     c. Focusing on disease control strategies which are driven by reducing the risk of
        traded commodities from containing specified infectious agents, including the
        incorporation of HACCP principles.

     d. The intensification of animal agriculture, including aquaculture, which could lead
        to an increasing importance of otherwise low pathogenicity diseases either as
        productivity limiting diseases or even as epidemic diseases. This too will be
        associated with an increasing number of emerging or re-emerging diseases.

     e. The relatively higher human-livestock-wildlife interaction in Af rica compared to
        other continents, the risk of inter-species spread of infectious agents and the

                                                                                          82
         incidence of zoonoses and occurrence of emerging or re-emerging diseases all of
         which are likely to demand better focused epidemiological surveillance and
         disease control strategies than in the past, reflecting an increasing demand from
         society for the control of zoonoses (old and new)

   f.    The increasing importance of environment dependent, vector-borne diseases as a
         result of climate change, such development programmes as the construction of
         new large dams or agricultural and/or urban developments which encroach
         excessively on wildlife animal habitats or large human settlements into rain
         forests.

Therefore, the public sector role in infectious animal disease control in SS -Africa is likely
to be dominated by three thrusts, namely: the control of epidemic or transboundary
animal diseases; tactical control of zoonoses, and the control of vector-borne diseases
within farming systems.

The control of transboundary animal diseases is likely to be driven by two parallel
objectives: firstly, the boosting of household income and local trade, which will focus
primarily on epidemic diseases of short -cycle stocks such as Newcastle disease in village
chicken, African swine fever, peste des petits ruminants (PPR) and caprine
pleuropneumonia (CCP) and secondly, by the need to promote acc ess to the export
market, which will focus on epidemic diseases of cattle and small ruminants, such as
FMD, contagious bovine pleuropneumonia (CBPP), Rift Valley fever, PPR and CCP.

The first objective is likely to focus on tactical interventions, area -wide at the level of
village clusters. By contrast the second objective is likely to incorporate a range of
strategic and tactical approaches driven by the desire to contain disease or infection to
acceptable levels of risk in accordance with international norms. The surveillance and
control of strategic diseases is likely to be based on agreements among clusters of
countries, irrespective of whether control is to focus on zones within a country or across
neighbouring countries. Accordingly, such approaches are likely to be better coordinated
at the level of the RECs than as continental programmes as happened with rinderpest.
Such surveillance and disease control strategies will need to target the dominant
livestock farming system in Africa, namely agro-pastoral and pastoral systems, which are
marked by transhumance and communal grazing. They will also need to address the
interaction between wild animals, livestock and humans.

All this w ill require novel epidemiological research approaches to underpin the
epidemiological surveillance and disease control strategies, which are fit -for-the-purpose
in Africa, rather than simply translocation of systems that have been established
primarily for European farming systems.

Similarly the control of zoonoses w ill require better targeted research approaches than in
the past including the assessment of the factors that seem to be fuelling an upsurge of
rabies in many parts of Africa and the role of such traditional zoonoses as bovine
tuberculosis, brucellosis and cysticerc osis as a complication in the HIV/AIDS complex
among the agro-pastoral and pastoral communities.

Therefore in many countries the starting point for addressing zoonoses could be:

        a) Targeted surveys to establish the level of prevalence/risk of animal infections
           which threaten the health of agro-pastoral and pastoral communities, i.e. risk
           assessment.
        b) To promote community-based preventive measures e.g., tactical vaccinations of
           at-risk animals or culling of infected animals – i.e. risk management.
        c) To promote pro-poor processes for the preservation of animal products and
           thereby reduce the risk of food-borne infections among livestock dependent
           communities – i.e. risk m itigation.

                                                                                           83
     d) To develop, in collaboration with Community Public Health Programmes, an
        active awareness campaign for livestock dependent communities on issues of
        public health including HIV/AIDS, infectious human diseases, zoonoses and
        food-borne infections/ diseases – i.e. risk communication.

There is also a high risk of the emergence of drug-resistant infectious agents as a result
of extensive usage of antimicrobials. It will be important that the new surveillance
systems are able to monitor such agents.

The control of Vector-borne or tra nsmitte d diseases, whether viral (e.g. the vector-
borne diseases bluetongue, Rift Valley fever, African horse sickness and African swine
fever or the insect-transmitted lumpy skin diseases) or tsetse and trypanosomosis, or
ticks and tick-borne diseases, will increasingly require to be underpinned by predictive
mode ls based on remotely-sensed environmental and epidemiological data in order to
generate spatio-temporal risk maps that will be used to target surveillance as well as
implement pre-emptive control measures.




                                                                                       84
Annex 3




               SADC LIVESTOC K TECHNICAL COMMITTEE MEETING


Re port to the SADC Livestock Technica l Committee of the Epidemiology and
Informatics Sub-committee


Recommendations to the LTC:

The subcommittee met at the Gaborone Sun Hotel from 7 to 8 November 2008
and recommended the following


   1. Noting the need to export livestock disease data from LIMS to WAHIS, the OIE
      should still consider availing the offline module.

   2. The EIS is concerned about future management of animal health data at regional
      level after the end of the PRINT project and therefore urges the LTC to look at
      sustainability of LIMS.

   3. Inclusion of wildlife health experts in EIS be considered

   4. Ensure veterinary epidemiological representation (membership) in TFCA national
      committee to advise on TADs and zoonosis.

   5. EIS noted that some MS a re adding private standards as part of their import
      requirements. MS are urged to confine themselves to SPS guidelines.

   6. The EIS noted the problem of controlling FMD particularly SAT 2 and that more
      information and a systematic approach to more effective vaccine development is
      required. The EIS recommends that research into the factors that affect
      immunogenicity and antigenic variability of SAT serotypes particularly SAT -2 is
      urgently needed.

      Noting that this will require high level technology to address this problem
      satisfactorily, it is proposed that local scientific institutions seek to form
      partnerships with appropriate institutions in other parts of the world to carry out
      the research. The LTC is thus urged to investigate ways to fund this urgently
      needed research.

   7. The EIS recommend that commercial providers of biologicals (Vaccine and
      reagents) avail External quality assurance certificates for their products




                                                                                      85
RESOLUTIONS (for noting by the LTC)

The SC resolved the following:

   1. Implementation of FMD consultancy recommendations particularly pre and post
      vaccination sero- monitoring as part of the vaccination programme

   2. In addition to surveillance on TADs and zoonosis emphasis must also be placed on
      food-borne diseases in liaison with VPH subcommittee.

   3. EIS members are encouraged to publish their work for visibility purposes.

   4. Working group to be formed to formulate terms of reference for a consultancy on

          a. BSE pathway to freedom
          b. Private standards for food products of animal origin

   5. MS to develop contingency plans encompassing strategies for early warning and
      reaction to RVF threats/risks.
Annex 4:

  RECOMMENDATION OF WORKSHOP FAO REGIONAL EPIDEMIOLOGY AND LABORATORY SURVEILLANCE NETWORKS 21 – 23
                                            OCTOBER 2008

                                       Contribute to economic growth, food security, animal welfare and human health through
Global objectives
                                       coordinated prevention and control of HPAI, TADs and zoonoses.
                                       To improve the capacity for prevention and control of TADs and zoonoses through
                                       strengthened and coordinated regional surveillance networks so as to get a better
Purpose Epi
                                       understanding of disease epidemiology which leads to preparedness, early warning, rapid
                                       response and design of disease control strategies
                                       Upgrade and maintain laboratory capacity for diagnosis and surveillance of HPAI, TADs
Purpose Lab
                                       and zoonoses in the region through effective and efficient regional laboratory networks.


                                                                                   Time
                 Outputs               Activities                                                                                 Cost
                                                                                   2008   2009              2010           2011
                 Result            1   1.1 Nominate country focal point
                 Enhanced
                                       1.2 Assess current status of national
                 national strategic
                                       disease surveillance and information
                 surveillance
                                       systems, capacities for preparedness
                 plans for both
                                       and response
                 livestock      and
                                       a)      Questionnaire distributed to all
                 wildlife diseases,
                                       countries to assess existing capacities,
                 which
                                       constraints and needs
                 encompass both
                                       b)        Analyse data and identify
                 field         and
                                       priorities, strengths, weakness and
                 laboratory
                                       needs to improve knowledge on
                 components       in
                                       existing systems and to develop a
                 order to improve
                                       regional classif ication and sub regional
  EPIDEMIOLOGY




                 preparedness,
                                       clusters of national networks
                 early     warning
                 and      response     c)       Potential    epidemiological
                 mechanisms,           assessment    mission   to    improve
                 thus setting the      national   epidemiological    network
                 basis for regional    competences following results survey
networks   d)       Facilitate the identification of
           subregional       epidemiology    leading
           groups and develop a cadre of
           regional experts for mutual support
           and     collaborations    w ith  regional
           organizations (economic / political),
           follow ing survey results
           1.3 Ensure proper implementation of
           the national strategic surveillance plan
           a) Ensure that epidemiology principles
           (e.g. proper sample sizes based on
           estimated prevalence) are applied to
           TADs     and   zoonoses   surveillance
           activities with coordination among
           epidemiologist     and     laboratory
           specialists
           1.4 Harmonized information system
           as a basis for information sharing
           a)    Assess the use of animal health
           information systems
           b)    Promote the use of harmonized
           national animal health databases (e.g.
           TADinfo)
           1.5 Strategic and targeted annual
           network meeting bringing together
           nominated focal point and decision
           makers on animal health issues to
           share information and know ledge on
           subregional priorities
           a)      Evaluate means for sharing
           information involving national and
           regional counterparts
           b)     Setting up a work plan for
           regional network implementation



                                                       88
                   1.6 Promote through various tools
                   (Website,     newsletters,   emails)
                   network activities and liaise with
                   laboratory networks
                   1.7 Trainings
                   a) Assist in training field staff for
                   epidemiological        surveillance     and
                   participatory methods for disease
                   recognition,      search,    and    disease
                   mapping with support of OIE/FAO
                   reference centres
                   b) Organize and conduct specific
                   technical      trainings    for    national
                   technical staff        and    partners   in
                   surveillance activities with regional
                   experts in disease information system,
                   analysis,            computer           and
                   epidemiological tools or any other
                   technical needs identified follow ing
                   assessment survey.
                   c)        Provide       upon        request
                   epidemiological expertise to national
                   authorities      to    plan    surveillance
                   activities
                   1.8 Facilitate the development and /
                   or      review/revision      of    national
                   preparedness and response plans,
                   when         necessitated,       combining
                   information from previous and current
                   initiatives and       incorporating new
                   information related to TADs and
                   zoonoses
Result    2    :   2.1      Networking      mechanism and
Credible           monitoring
subregional        a)        Identify regional coordination
epidemiology       mechanisms



                                                                 89
networks able to     b)          Develop    /     strengthen
strengthen    the    institutional       mechanisms        of
capacity       for   networking
epidemiological      c)         Exchange    animal    health
activities,          information on TADs and zoonoses
sharing         of   d)       Identify and share regional
information in a     epidemiology expertise
transparent          e)          Strengthen    links    w ith
manner       and     governmental and non governmental
regional resource    agencies in the human and wildlife
mobilization         sectors, on TADs and zoonoses
and/or sharing       f)         Strengthen links between
                     national Laboratories and national
                     epidemiology units for improved TADs
                     and zoonoses surveillance, diagnosis
                     and control
                     g)    Pledge for fund raising
                     2.2    Identify the mechanisms to
                     mobilize    regional   resources   for
                     response,     jointly with  laboratory
                     network
                     2.3 Network evaluation
                     a)       Facilitate  monitoring    and
                     evaluation of the quality of networks
                     through the use of performance
                     indicators and matrix quantification of
                     functionality
                     b)      Evaluate the sustainability of
                     network activities so as to address
                     gaps
For result 3 :       3.1 Annual inter-regional meeting w ith
Effective linkage    regional focal points at continental
with         other   level




                                                                90
regional      and         3.2 Evaluate the use of new
international        technologies for early detection and
epidemiological      reporting such as mobile technologies
surveillance         for the transfer of data from field to
networks,            central level
academic      and    3.3 Identify partners (including but
research             not limited to national agencies as well
institutions    to   as academic and research institutions)
exchange             to perform strategic studies on TADs
surveillance         and zoonoses issues of regional
data, to promote     importance (data analysis, disease
scientific           trends and risk mapping)
approach,     new    3.3     Link   with    other    thematic
technologies and     networks, as socio-economic networks
epidemiologic        3.4 Improve liaison between national,
vigilance            regional and international levels for
                     effective information and expertise
                     exchange
                     a)       Develop subregional website
                     and/or establish links to existing
                     websites which contain databases and
                     serve as venue to share sanitary,
                     socio-economic, epidemiological and
                     production systems information
                     b)    Review     existing    subregional
                     databases faciltiies and identify t he
                     needs     for either developing       or
                     updating in collaboration with regional
                     economic organisations
                     c)       Organize a forum among
                     concerned     partners    to   exchange
                     experience and information on TADs
                     and zoonoses




                                                                91
                      d)       Develop linkages with national
                      animal health organizations, as well as
                      regional        and          international
                      organisations involved in TADs and
                      zoonoses prevention and control
                      3.5 Feed discussion on regional
                      databases
                      4.1    Foster disease reporting to
For result 4 :        international organizations
International         a)       encourage official reporting
norms,                through       advocacy         (meetings,
recommendation        websites, notifications)
s for reporting       b)     encourage reporting of unofficial
are promoted          epidemiological      information      and
                      surveillance data (GLEWS, Empres-i)
                      5.1 Highlight epidemiological findings
                      related to important risk factors
                      associated with TADs and zoonoses
                      (e.g. participatory approach, cross
                      borders surveillance, trans-national
                      ecosystems) taking into account the
For    Result     5   socio-economic and production factors
Recommendation        5.2     Communicate       epidemiological
s for science-        analyses to support the effective
evidence based,       implementation of TADs and zoonoses
cost     effective,   control    programs,       focusing    on
regional control      strengthening early detection and
strategies            response activities
defined               5.3   Organize expert consultations
                      based on scientific findings to come up
                      with recommendations
                      5.4 Provide technical support to
                      regional organizations to promote the
                      use of recommendations for regional
                      control strategies.




                                                                   92
                               1.1 Identify Terms of Reference
                               governing the role and mechanism of
                               the network
                               1.2 Designate focal points and ensure
                               animation of the network
                               1.3 Organize at least one annual
                               regional network meeting and assess
             Established
                               network activities
             regional
                               1.4 Identify priority diseases and
             laboratory
                               target capacity of the region for
             network
                               diagnosis and surveillance
                               1.5 Ensure laboratory preparedness
                               for emergenc y response to high risk
                               diseases in the region
                               1.6 Advocate for national government
                               commit ment and regional economic
                               communities commit ments
                               2.1    Assess    current    capacity of
                               laboratories
                               2.2 Identify needs to upgrade national
                               laboratories
                               2.3 Identify regional laboratories and
             Upgraded          their roles and responsibilities
             laboratory        2.4 Identify needs to upgrade regional
             diagnostic        laboratories
             capacity          2.5 Facilitate to fulfill the needs for
                               upgrading based on network priorities,
                               needs assessments and available
                               resources
                               2.6 Carry out trainings for laboratories
LABORATORY




                               3.1 Assess current capacity of disease
             Enhanced
                               surveillance and identify needs
             synergy between
             epi   and   lab
                               3.2 Strenghen and bridge field and
             networks
                               laboratory disease surveillance teams



                                                                          93
                     3.3 Carry out trainings for field and
                     laboratory disease surveillance teams
                     4.1 Support data collection and
                     processing and information sharing
                     mechanisms
                     4.2     Promote   quality  assurance
                     implementation       and     develop
                     standardized      procedures     and
                     guidelines for adoption at regional
                     level
Maintained           4.3 Develop laboratory information
diagnostic   and     system for use by the network with
surveillance         interface to the epi surveillance
network capacity     information system
                     4.4 Organize and implement regular
                     proficiency tests
                     4.5 Carry out additional trainings
                     4.6 Promote exchange of technical
                     information, materials and promote
                     research
                     4.7 Mobilize financial resources to
                     sustain the network
                     5.1 Share information and experience
Linkages      with
                     with other regional networks
international and
                     5.2 Facilitate access to information,
regional
                     training and technology transfer f ro m
networks
                     OIE and FAO reference laboratories
                     5.3. Facilitate collaborations with
                     research and academic insitutes




                                                               94
Annex 5: List of Persons consulted/inte rvie wed during fie ld mis sions

             NAME                  ORGANIZATION                  COUNTRY
Dr Hamadou Saidou            CVO( MINEPIA)                       Cameroon
Dr Louis Banipe              MINEPIA                             Cameroon
Dr Baschirou Moussa
Demsa                        MINEPIA                             Cameroon
Dr Mindjie Mewoand
Georges                      MINEPIA                             Cameroon
Dr Alexandre François
Ngatchou                     MINEPIA                             Cameroon
                             Ministère de l'Elevage et
Dr Leon Tati                 Pêche                           Congo Brazzaville

                             WHO Country
Dr Molamou                   Representative                  Congo Brazzaville

Dr William Olaho-Mukani      CVO                                  Uganda

                             Deputy Director
Dr Chris Rutebarika          Commissioner Disease                 Uganda
                             Control

                             Sanitary Information
Dr Sserugga                  System Manager Min of                Uganda
                             livestock

                             Principal Veterinary Officer
Dr Noelina Nantima           EPIDEMICS                            Uganda

                             Communication Officer
Dr Mubiru Emmanuel           Epidemiology Unit                    Uganda

Dr Percy W. Misika           FAO Representative                   Uganda

                             FAO National Consultant
Dr Charles Musinguzi         Avian Influenza                      Uganda

                             FAO National Consultant
                             Avian Influenza
Dr Denis K. Byarugaba        Prevention and Control               Uganda
                             Programme

                             Wildlife Authority
Dr Patrick Atimnedi                                               Uganda
                             Chairman Veterinary
                             Association                          Uganda

Dr Ahmed El Sawalhy          Ag Director AU-IBAR                   Kenya

Dr Nesru Hussein             AU-IBAR                               Kenya

                             FAO Consultant and Former
Dr. Jotham Musiime           Acting Director-IBAR                  Kenya

Dr. Walter     Masiga        AU-IBAR former Director               Kenya
             NAME               ORGANIZATION              COUNTRY
                           FAO (ECTAD) Regional
Dr William Amanfu          Manager Eastern Africa          Kenya

Dr Joseph Litamoi          FAO (ECTAD)                     Kenya
Dr Sam Okuthe              FAO (ECTAD)                     Kenya
Mme Tabitha Kimani         FAO (ECTAD)                     Kenya
Prof. Uswege Msinga        FAO ECTAD Office Nairobi        Kenya
                           Director of Vet Services,
                           Ministry of Livestock and       Kenya
Dr. Peter Ithondeka        Fisheries Development

                           Director of Public Health,
Dr. Sharif                 Ministry of Health              Kenya

Dr. Nzioka                 Direction of Public Health      Kenya
Dr Phillip M. Muthoka      Direction of Public Health      Kenya
                           CTA, Somali Animal Health
Dr. Henry Wanwayi          Surveillance Programme          Kenya
                           (SAHSP)

Dr. Germain Bobo           ALive Secretariat AU-IBAR       Kenya

                           SERECU Coordinator AU-
Dr Dickens Chiben          IBAR
                                                           Kenya
Dr Samuel Muriuki          AU-IBAR                         Kenya
Dr Vittorio Cagnolati      AU-IBAR                         Kenya
Dr Annie Lewa              AU-IBAR                         Kenya
Dr Dodji Tagodoe           AU-IBAR                         Kenya
                           Epidemiologist, Directorate
Dr Catherine Wanjohi       of Veterinary Services          Kenya
                           Head, Epidemiology Unit,
                           Directorate of Veterinary
Dr Murithi R. Mbabu        Sservices                       Kenya
                           Chief Veterinary Officer,
Dr Francis Gakuya          Kenya Wildlife Services         Kenya

                           FAO Livestock National
Pr Guetachev Abede         Consultant                     Ethiopia
                           CVO Min Agric and Rural
Dr Berhe Gebreegziabher    Development                    Ethiopia
                           Epidemiology and Disease
                           Control Expert
Dr Amsalu Demissre         Min Agric and Rural Dev        Ethiopia
                           FAO International
Dr Gijs Van't Klooster     Consultant Livestock           Ethiopia
                           Director National Animal
Dr Mesfin Sahle Forsa      Health Research Centre         Ethiopia
                            Directeur d‟ Elevage (Chief
Dr Khassimou DIAKITE            Veterinary Officer)
                                                            Mali
Dr Mamadou Racine Ndiaye   Coordinator Epivet Mali          Mali
                           DNSV (Directorate, National
Dr Lassina Doumbia         Veterinary Services)             Mali
Mahmoudou Diall            Epivet Mali                      Mali

                                                                     96
           NAME                  ORGANIZATION              COUNTRY
                            FAO-ECTAD Regional
                            Manager West/Central
Dr Frederic Poudevigne      Africa
                                                             Mali
                            FAO-ECTAD Coordinator of
Dr Boubacar Seck            the Laboratory Network           Mali

                            OIE Representative for
Dr Abdoulaye Bouna Niang    Africa                           Mali

                            ECOWAS focal person in the
Dr Samba Sidibe             RAHC West & Central              Mali
                            Africa and Former OIE
                            Representative for Africa

                            AU-IBAR Rep RAHC West
Dr Oumou Sangare            Africa                           Mali

Dr.Nicolas De Normandie     OIE Programme Officer
                                                             Mali
Dr. Daouda Sylla            Former Director PANVAC           Mali

                            Senior Program officer
                            Livestock(SADC)
Mr. B. D.Hulman                                            Botswana
                            OIE Sub-Regional
                            Representative Southern
Dr. Bonaventure Mtei        Africa                         Botswana

                            FAO-ECTAD Regional
Dr. Susanne Munstermann     Manager                        Botswana

                            SADC TADs Project
Dr. Misheck Mulumba         Coordinator                    Botswana
                            PRINT Project Coordinator
Dr. Welbourne Madzima       SADC                           Botswana
Dr. Mokganedi Mokopasetso   FAO ECTAD Epidemiologist
                                                           Botswana
                            Director of Veterinary
Dr. M. Letshwenyo           Services                       Botswana

                            Chief Vet. Officer National
Dr. Kekgonne Baipoledi      Vet Lab                        Botswana

Ms Thulie C Losho           Chief Scientific Officer
                            National Vet. Lab              Botswana
Dr. Chandapiwa Marobela-    Principal Vet Off National
Rabo-rokgwe                 Vet Lab                        Botswana

                            Principal Scientist National
Mr Gregory Ndlovu           Vet. Lab                       Botswana

                            Principal Vet Off. National
Dr. K. Tlotleng             Vet Lab                        Botswana

Dr. Gavin Thomson           SADC FMD Proj.                 Botswana


                                                                      97
          NAME                  ORGANIZATION             COUNTRY
Dr. Andrea Masseralli      SADC FMD Proj.                Botswana

                           PRINT Project Information
Dr.Berhano Bedane          Specialist                     Botswana

                           IBAR Regional Coordinator
Dr.Baboucarr Jaw           in RAHC                        Botswana

                           SPINAP Regional Proj.
Dr. Elzein Ali             Coordinator                    Botswana

Dr. Patrick Bastiaensen    OIE Programme officer          Botswana

                           Chief Technical Advisor
Dr. Francis Sudi           SADC TAD Project               Botswana

                           Federal Governemnt Chief
Dr. Junaidu A. Maina       Veterinary Officer              Nigeria
Dr I. Gashash Ahmed        Chief F DL- Epid Unit           Nigeria
                           National Consultant
Dr.Garba Maina Ahmed       Epidemiology, FAO-ECTAD         Nigeria
                           National Project
Dr. Dooshima Kwange        Coordinator FAO-ECTAD           Nigeria
                           Fed. Dept of Livestock and
Dr. J. Nyager              Pest Control Services
                                                           Nigeria
                           Principal Programme
                           Officer, ECOWAS Dept of
Dr. Vivian N. Iwar         Agric. and Rura l
                           Development                     Nigeria

Dr Khalil Timamy           Director AU-STRC, Lagos         Nigeria
Dr Nathaniel Yebuah        Epidemiologist, Vet Dept        Ghana
                           Director of Livestock
Dr. Morosi Molomo          Services                        Lesotho
                           Epidemiologist, Directorate
Dr. Thembo Mumba           of Veterinary Services          Lesotho
                           Deputy Director, National
Dr. A. Mavale              Veterinary Services           Mozambique

                           President OIE Af rica
Dr. Robert S. Thwala       Commission and Permanent       Swaziland
                           Secretary

                           Chief Director Dept. of
Dr. Bothle Mike Modisane   Agriculture                   South Africa
                           Deputy Director of Vet.
Dr. M.P.C. Mangani         Services                        Zambia
Dr C. Chisembele           Head Epidemiology Unit          Zambia
                           Deputy Director Vet.
                           Services, Epidemiology and
Dr. Cleopas Bamhare        Coordinator SADC               Namibia
                           Epidemiology and
                           Informatics Sub-Committee



                                                                        98
           NAME              ORGANIZATION            COUNTRY


Dr. Alexander Toto      Proj. Coord. Anim. ID and    Namibia
                        Traceability

                        Deputy Director, Dept Of
                        Anim. Health and Livestock    Malaw i
Dr. Patrick Chikungwa   Serv.

                        Head Epidemiology Unit,
                        Directorate of Veterinary
                        Services, Ministry of
Dr Fredrick Kivaria     Livestock Development and
                        Fisheries
                                                     Tanzania

                        EAC Livestock Sector,
                        Arusha                       Tanzania
Dr Timothy Wesonga




                                                                99
LIST OF PARTICIPANTS FOR THE SADC EPIDEMIOLOGY & INFORMATICS
MEETING 07-08 NOVEMBER 2008, GABORONE-BOTSWANA


ANGOLA

Dr Norberto J.S. Pinto
Chief Epidemiology
Ministry of Agriculture
P O Box 10578
Luanda
Angola

Tel/Fax: +244 222 324067                            PHYSICAL ADDRESS
Mobile: +244 923523966                              Largo A. Jacinto Edificio
Email: eubeto2002@yahoo.com                         55/56 4◦Andar D.
                                                    Luanda, Angola


DRC

Yuma Amundala Jean Marie Olenga
Chef de Bureau “Grandes Endemies”
Ministry of Agriculture, Fisheries and Liveswtock
Cropisement des Avenue BATETELA el
Boulevard du 30 Juin
Kinshasa-Gombe
DRC

Tel : +243 1510 2941                                10,rue Wamba
Mobile : +243 998 867155                            Kinjabwa/Limete
Email: jm-olga@yahoo.fr                             Kinshasa, DRC



LESOTHO

Dr Tembo Mumba
Veterinary epidemiologist
Ministry of Agriculture
P/Bag 82 A
Maseru 100
Lesotho

Tel: +266 2231 7284                                 Department of Livestock
Mobile: +266 5808 0832                              Opposite LDF Wing
Fax: +266 223 11500                                 Moshoeshoe II, Maseru
Email: mtembo001@yahoo.com




                                                                                100
MADAGASCAR

Dr. Lanto Tiana Razafimanantsoa
Director of Veterinary Services
Ministry of Agriculture, Livestock and Fisheries
Anory, Antananarivo
101 Madagascar
                                                   PHYSICAL ADDRESS
Mobile: +261 3202 35534                            Lot VF77 I meniutsiatosika
Email: tianarazalabo@yahoo.fr                      Arivonimamo 112, Madagascar


MALAWI

Dr. Patrick Benson Chikungwa
Deputy Director (Epidemiology)
Ministry of Agriculture and Food Security
Department of Animal Health
P O Box 2096
Lilongwe

Tel: +265 175 3038                                 Kamuzu Procession Road
Mobile: +265 837 1509                              Opposite Old Town Hall
Fax: +265 175 1349
Email: pchikungwa@yahoo.com


MAURITIUS

Dr. Siddick Khemil Isham Ibrahim Timol
Veterinary Officer
Agroindustry and Fisheries
Department of Veterinary Services
Port Louis
Mauritius

Mobile: +230 7912 814                              Gobin Road Angrais Martial
Email: sidtimol@yahoo.co.uk                        Curepipe Road, Mauritius


MOZAMBIQUE

Dr. Zacarias Elias Massicame
Head of Veterinary Epidemiology Department
Direccao Nacional Dos Servicos De Veterinacia
Praca Dos Herois
Mocambicanos

Tel : +258 2146 0494                               C.P. 1406
Mobile : +258 8276 28800                           Maputo, Mozambique

                                                                                 101
Fax : +258 2146 0479
Email : zmassicame@yahoo.co.uk


NAMIBIA

Dr Cleopas Bamhare
Deputy Chief Veterinary Officer
Ministry of Agriculture, Water and Forestry
Directorate of Veterinary Services
P/Bag 12022
Namibia
                                                              PHYSICAL ADDRESS
Tel: +264 61 2087 505                                         Government Office Park
Mobile: + 264 128 9251                                        Luther Street
Fax: +264 61 208 7779                                         Windhoek
Email: bamharec@hotmail.com
Or : bamharec@mawf.gov.na


SWAZILAND

Dr. Sihle Mdluli
Veterinary Officer(Epidemiology Unit)
Department of Veterinary Services
P O Box 4192
Manzini
Swaziland

Tel: +268 505 6443/ 2113                                      Corner Mancishane and Sandlane
Street
Mobile: +268 6085 133                                         Manzini
Fax: +268 505 6443
Email: epiunit@africaonline.co.sz


TANZANIA

Dr. Fredrick Mathias Kivaria
National epidemiologist, Directorate of Veterinary Services
Ministry of Livestock Development and Fisheries
P O Box 9152
Dar Es Salaam
Tanzania

Mobile: +255 754 086 860                            Nelson Mandela Express Highway
Email: fredkiv@yahoo.com




                                                                                         102
ZAMBIA

Dr Christina Chisembele
Chief Epidemiologist
Ministry of Agriculture
Department of Veterinary
P O Box 50060
Mulungushi House
Lusaka
Zambia
                                                 PHYSICAL ADDRESS
Tel: +260 211 229 470                            No 3323 Kabelenga Road
Mobile: +260 977 604365                          Lusaka
Fax: +260 211 229 470
Email: cchisembele@naleicdvld.gov.zm



ZIMBABWE

Dr. Unesu Hildah Ushewokunze-Obatolu
Director
Ministry of Agriculture/Veterinary Field
Box CY56
Causeway
Zimbabwe

Tel: +263 47 38645                               18 Borrowdale Road
Mobile: +263 912 219763                          Opposite St Georges College
Fax: +263 4700 327                               Harare
Email: dvfs@mweb.co.zw


OBSERVERS

   1. Dr Musa Fanikiso
      Private Consultant
      Midzi Agricultural Development (Pty) Ltd
      P O Box 82364
      Gaborone

       Tel : +267 395 2917                              BOCCIM House
       Mobile : +267 7170 9345                          Old Lobatse Road
       Email : mfanikiso@orangemail.co.bw               Gaborone

   2. Mr. Ernest B.L. Bagopi
      Sales & Markerting Manager
      Botswana Vaccine Institute
      P/Bag 0031
      Gaborone
                                                        PHYSICAL ADDRESS

                                                                               103
     Mobile: +267 7137 3747                  Plot 6385/90 Lejara Road
     Fax : +267 395 6798                     Broadhurst Industrial
     Email : ebagopi@bvi.co.bw               Gaborone

  3. Dr Mokganedi Mokopasetso
     National Project Officer
     FAO
     P O Box 80598
     Gaborone

     Tel : +267 395 3100                     BK House
     Mobile : +267 7279 9190                 Old Lobatse Road
     Fax : +267 395 3104                     Gaborone
     Email : mokganedi.mokopasetso@fao.org

  4. Dr Francis F. Sudi
     CTA-SADC/ADB TADs Project
     SADC Secretariat
     Private Bag 0095
     Gaborone

     Tel: +267 395 1863                      Plot 116 Millineum Park
     Mobile: +267 71354511                   Kgale View
     Email: fsudi@sadc.int                   Gaborone
     Or: sudifrancis@yahoo.com

  5. Prof. Mark Rweyemamu
     C/o Alive Secretariat
     Executive Director SACIDS
     Sokoine University of Agriculture
     Morogoro
     Tanzania
     Tel : +44 1483 473774
     Email : mark.rweyemamu@btinternet.com


SADC SECRETARIAT

  1. Ms Onalenna Kethaetswe
     PRINT Livestock Project
     SADC Secretariat
     P/Bag 0095
     Gaborone
     Botswana


                                             PHYSICAL ADDRESS
     Tel: +267 3951863 x 5125                Plot 116 Millineum Park
     Mobile: +267 7271 7589                  Kgale View
     Fax: +267 3959834                       Gaborone
     Email: okethaetswe@sadc.int

                                                                  104
2. Dr. Welbourne Madzima
   PRINT Livestock Project
   SADC Secretariat
   P/Bag 0095
   Gaborone
   Botswana

   Tel: +267 3951863 x 5113   Plot 116 Millineum Park
   Mobile: +267 71563253      Kgale View
   Fax: +267 3959834          Gaborone
   Email: wmadzima@sadc.int

3. Dr Gift Wanda
   PRINT Livestock Project
   SADC Secretariat
   P/Bag 0095
   Gaborone
   Botswana

   Tel: +267 3951863 x 5061   Plot 116 Millineum Park
   Mobile: +267 72174797      Kgale View
   Fax: +267 3959834          Gaborone
   Email: gwanda@sadc.int

4. Dr Berhanu Bedane
   PRINT Livestock Project
   SADC Secretariat
   P/Bag 0095
   Gaborone
   Botswana

   Tel: +267 3951863 x 5125   Plot 116 Millineum Park
   Mobile: +267 72148939      Kgale View
   Fax: +267 3959834          Gaborone
   Email: bbedane@sadc.int




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