Support to Increase Sustainable Livestock Production:

Development of Technical Framework for the Progressive Control of Foot &

Mouth Disease in Pakistan

GCP/PAK/123/USA

January 2015

Project Outputs

• Output 1: Capacity to diagnose FMD at disease, serotype and genotype level enhanced at districts, provincial and reference laboratories in Pakistan

• Output 2: Surveillance of and response to FMD outbreaks in the country improved

• Output 3: Benefits of early and consistent immunization practices demonstrated for effective control of FMD

Project Activities Sites Map

Afghanistan

Iran

China

Disputed Territory

India

Arabian Sea

Output 1: Capacity to diagnose FMD at disease, serotype and genotype level enhanced in districts, provincial and reference laboratories in Pakistan

Activities1. Strengthening of Lab capacity for FMD

diagnosis

2. Capacity building of field and laboratory staff

3. Proficiency testing of diagnostic labs

4. Development of an harmonized (central and provincial) Laboratory Information and Management System

Output 1: Improvement of FMD diagnosisActivity 1: Strengthening of lab capacity for FMD diagnosis

• Remodelled / refurbished existing labs to accommodate ELISA diagnostic work at Karachi, Lahore and Mirpur

• 8 of 9 intended labs fully functional for undertaking serotyping of FMD (NVL, Peshawar, Lahore, Tandojam, Karachi, Quetta, Gilgit, Mirpur). Equipment and consumable provided

• FMD diagnosis (serotyping) undertaken at these labs• Antibody titres against SP and NSP done at NVL• Molecular diagnostics (rtPCR – conventional and real time)

and virus isolation working at NVL• Nucleic acid sequencing started at NVL• Technical back-stopping regularly being provided

Output 1: Improvement of FMD diagnosisActivity 2: Capacity building of field and laboratory staff

• Two persons from each provincial / regional Lab provided extensive training (15 days) in antigen and antibody ELISA for FMD diagnosis. Refresher training on ELISA for provincial lab staff in 11/2012, 12/2013 and 12/2014

• 47 district laboratory vets trained in collection and despatch of samples from field outbreaks of FMD

• Eight veterinarians (two from NVL, two scientists from Animal Health Program, NARC and one person from each leading 4 provincial lab staff provided training at NVL in virus isolation of FMD from field samples by USDA experts from Plum Island Foreign Animal Disease Lab, New York

• 5 vets /scientists trained in molecular diagnostics at NIBGE• 5 vets / scientists trained in nucleic acid sequencing

Output 1: Improvement of FMD diagnosisActivity 3: Proficiency testing of diagnostic labs

• Two teleconferences held with USDA team on the subject with help from Dr. Jeff Hamer of USDA

• 5 persons trained in a specially designed practical course in Laboratory Quality Management for Pakistan senior lab practitioners from 21 July, 2012 at Ames, Iowa (USDA special funding)

• NVL completed proficiency test 2012 & 2013 of FMD World Reference Lab, Pirbright. Practically able to correctly identify A,O and Asia-1 antigens and antibodies

• NVL invited to Proficiency testing program 2014 of WRL• Proficiency testing of provincial labs started in 2015

Output 1: Improvement of FMD diagnosisActivity 4: Development of an harmonized LIMS

• Initial discussions for the development of LIMS held with NUST• During Project Coordinator visit to US Animal Health Association in

Buffalo (October, 2011), contacts made with private sector LIMS suppliers and Texas A & M University professionals. Video conference held with a LIMS supplier from USA. Did not suit our requirements

• USDA provided additional support to FAZD (IIAD), Texas A & M University for developing LIMS for Pakistan

• Texas A & M scientists visited Pakistan to assess ground situation and start work on LIMS. Three days workshop (7-9 May 2012 ) held with lab workers / directors from federal and provincial / regional governments

• MOU signed between FAZD, Texas A & M University and NUST for development and maintenance of LIMS for veterinary labs in Pakistan

• Project signed LOA with NUST for technical backstopping of LIMS• PK-LIMS being tested in all functional FMD labs now• IT equipment provided to 8 FMD ELISA labs• PK-LIMS expanded to 13 veterinary diagnostic labs across Pakistan

Output 2: Surveillance of and response to FMD outbreaks in the country improved

Activities1. Awareness of livestock farmers2. Capacity building of field staff and policy makers3. Outbreak reporting, epidemiological investigation and

submission of samples4. Sero-monitoring for determining the level of virus

circulation in different farming systems 5. Creation of a rapid response mechanism for FMD

outbreaks6. Creation of a National FMD Epidemiology and Information

System7. Strengthening of FMD monitoring program in Landhi

Dairy Colony Karachi

Output 2: Improved surveillance and response to FMD outbreaks

Activity 1: Awareness raising of livestock farmers • Awareness material for the farmers including posters (English and

Urdu) and brochure (Urdu) prepared and printed• 4000+ Posters distributed. Posters now visible at most of the

veterinary institutions through out the country• 18500+ copies of brochure highlighting prevention and control of

FMD distributed among farmers• A documentary on FMD is prepared in collaboration with US

Embassy in Islamabad. Launched in June 2014• 124 farmers’ awareness seminars / workshops held involving 5232

livestock keepers• Regular participation in livestock exhibitions, radio and TV

programs to highlight control of FMD

Output 2: Improved surveillence and response to FMD outbreaks

Activity 1: Awareness raising of livestock farmers

Province / Area Seminars # Farmers trained #

Punjab 33 960

Sindh 12 730

Khyber Pakhtunkhwa 31 1979

Baluchistan 9 236

FATA 7 268

Gilgit – Baltistan 7 195

Azad Jammu & Kashmir 24 817

Islamabad 1 47

Total 124 5232

Output 2: Improved surveillance and response to FMD outbreaks

Activity 2: Capacity building of field staff and policy makers • 47 training workshops for field and laboratory vets held; 1378 vets

trained in FMD epidemiology, disease control and prevention• Sample collection and dispatch kits provided to 967 vets• 7 Trainings provided to 262 veterinarians from private sector

(practitioners, ENGRO vets, DRDF staff) on demand; 170 kits distributed• USDA scientists from PIADC, New York and UC, Davis imparted two days

training in Epidemiology to senior provincial veterinarians and scientists of Project and NARC

• Two days training in Bioportal software (for epidemiological studies of livestock diseases like FMD ) given by UC, Davis scientists. Federal officers and provincial TAD Officers participated

• Senior management of livestock departments (Secretaries and DGs) visited Turkey from 23 to 29/9/12 and practically saw FMD control activities under different production systems. Vaccine production Facility was also visited

Output 1: Improvement of FMD diagnosisActivity 2: Capacity building of field and laboratory staff

Province / Area Workshops # Vets trained # Kits provide #

Punjab 17 470 324

Sindh 10 317 259

Khyber Pakhtunkhwa 6 200 91

Balochistan 5 147 123

FATA 3 77 50

Gilgit-Baltistan 2 38 34

Azad Jammu & Kashmir 3 100 66

Islamabad 1 29 20

Total 47 1378 967

Output 2: Improved surveillance and response to FMD outbreaks

Activity 3: Outbreak reporting, epidemiological investigation and submission of samples

Surveillance for FMD

Field Vet(Sample Collection & Treatment kits provided)

Diagnostic Lab TAD Officer

Epidemiology node

Chief Veterinary Officer

Lab Result

FMD Samples Re-filling of Kits

Outbreak Report

Outbre

ak report

&

Lab re

sults

Lab results

Confirm sample receipt

Lab results

Awareness of field staff and dairy farmers Training of veterinary staff

Provision of sample collection and dispatch material

Cover expenditure of sample collection and dispatch

Respond back with outbreak handling Report back to field staff on lab findings

Essentials

FMD Virus Serotypes (Jan - Dec 2012)Province Total FMD

outbreaksOutbreak (#) due to serotype ELISA

Negative Outbreaks

O A Asia-I O+ Asia-I

O+A A+Asia-1

Punjab 164 72 19 28 14 2 1 27(+1)

Sindh 686 394 51 97 21 8 4 111

Khyber Pakhtunkhwa

120 24 6 15 15 5 - 55

Balochistan 19 7 3 - - 2 - 7

Gilgit-Baltistan

7 - 1 2 - 1 - 3

FATA 4 3 - - - - - 1

AJK 60 22 18 - - 1 - 19

Islamabad 28 11 5 5 - - - 7

Total 1088 533 103 147 50 19 5 230(+1)

Regional/Provincial Distribution of FMD outbreaks in Pakistan (2012)

Sindh

FMD Virus Serotypes (January-December 2013)

Province Total FMD outbreaks

Outbreaks (#) due to serotype ELISA Negative

OutbreaksO A Asia-I Mixed

Punjab 177 65 47 21 3 41

Sindh 2364 991 959 80 22 312

Khyber Pakhtunkhwa

171 61 44 2 17 47

Balochistan 42 15 3 - 1 23

Gilgit-Baltistan 7 2 - - 5 -

FATA 18 - 11 - - 7

AJK 89 31 25 5 - 28

Islamabad 6 1 2 2 - 1

Total 2874 1166 1091 110 48 459

FMD Virus Serotypes (January-December 2014)Province Total FMD

outbreaksOutbreaks (#) due to serotype ELISA

Negative Outbreaks

O A Asia-I Mixed

Punjab 417 291 37 19 2 68Sindh 1168 679 92 115 111 171*Khyber Pakhtunkhwa 407 187 24 38 0 158Balochistan

193 107 15 16 0 55Gilgit-Baltistan

10 7 3 0 0 0FATA 29 17 0 0 0 12AJK 534 310 6 5 6 207Islamabad 55 31 11 3 0 10Total 2813 1629 188 196 119 681*

*includes 2 NYT samples

Genotypes of FMD virus (2012 – 14)

Serotype Genotype Reporting Lab

O PanAsia-2ANT-10

UnnamedWRL, Pirbright

PIADRC, New York

A Iran-05FAR-11

Iran-05FAR-09

Iran-05SIS-12

WRL, PirbrightPIADRC, New York

Asia-1 Sindh 08 WRL, PirbrightPIADRC, New York

Sero-monitoring of FMD virus circulation (AJK)

Dairy Production System Samples Tested (#)

NSP Antibodies

Positive (#) % Positive

Mirpur- Dairy Farms 323 160 49.5

Mirpur-Smallholder Rural Production

309 73 23.6

Muzzaffarabad- Smallholder Rural Production

254 9 3.5

Rawalakot- Smallholder Rural Production

270 23 8.5

Sero-monitoring of FMD virus circulation (Punjab)

Dairy Production System Samples Tested (#)

NSP Antibodies

Positive (#) % Positive

Lahore - Dairy Colony 317 247 78

Attock - Smallholder Rural Production

153 45 29

Jhang - Smallholder Rural Production

263 97 37

Rahim Yar Khan - Smallholder Rural Production

275 52 19

FMD Virus circulation in Desert Cattle Farming

• Sero-monitoring showed wide spread FMD virus circulation in animals in desert areas also

Area Tobas # Blood samples #

NSP antibody positive #

% Positive

Greater Cholistan

5 110 65 59.1

Lesser Cholistan 7 263 167 63.5

Total 12 373 232 62.2

Output 2: Improved surveillance and response to FMD outbreaks

Activity 5: Creation of a rapid response mechanism for FMD outbreaks• Meeting on development of Standard Operating Procedure

for FMD outbreak held on 22-8-2011 at Faculty of Veterinary Sciences, University of Agriculture, Faisalabad. LDDD Punjab Vets, UVAS representative and FVS teachers and clinicians participated

• 1378 Trained field veterinary officers have already started responding to the FMD clinical outbreaks as per SOP prepared by the project management

• Treatment provided to sick animals in all outbreaks• Ring vaccination done in most of the outbreaks• Positive response from the livestock farmers• Vaccine banks functional at Islamabad, Peshawar, Lahore,

Karachi, Hyderabad, Quetta, Gilgit

Output 2: Improved surveillance and response to FMD outbreaks

Activity 6: Creation of a national FMD epidemiology and information system

• A formal request made to the federal government (AHC) on 9 Dec 2011 to establish federal epidemiology node

• Ministry nominated Dr. Syed M. Jamal from NVL as focal point for the activity. However, he changed the job

• Federal Government then nominated Dr. Amanullah (Ph.D. Epid) of Animal Health Group, NARC as focal point for the federal epi node

• Project is working with the focal point / Incharge of the node to equip and facilitate the node

• Quarterly Pakistan FMD Bulletin regularly printed and circulated (10 issues covering January 2012 to June 2014)

• Pakistan FMD Bulletin also on FAO-PK website

Output 2: Improved surveillance and response to FMD outbreaks

Activity 7: Strengthening of FMD monitoring program in Landhi Dairy Colony Karachi• Two laboratory staff from Landhi cattle colony Diagnostic

Lab of the Sindh Government already trained in ELISA• Vets and Paravets posted in Karachi trained in sample

collection and outbreak handling• Workshop for private sector vets working in Karachi held.

32 Vets / Paravets trained• ELISA lab has been refurbished and formally inaugurated.

Equipment installed. Technical back stopping missions on various occasions. Fully functional lab now

• Project National Field Officer already started work in Landhi cattle colony

• > 70 % of reported FMD outbreaks have been documented from Karachi alone

Output 3: Benefits of early and consistent immunization practices demonstrated for effective

control of FMDActivities1. Identification of appropriate vaccine for field use2. Strengthening NVL capacity for evaluation of FMD

vaccines3. Effective vaccination in dairy colony production

system4. Early immunization in market oriented rural dairy

production system5. Evaluation of FMD vaccination effects on productivity

in different dairy production systems

Output 3: Control of FMD through immunization Activity 1: Identification of appropriate vaccine for field use

• Experts Committee meeting of relevant Pakistani scientists held on 25 August, 2011. Animal Husbandry Commissioner chaired the meeting

• Data generated by GTFS project and other studies shared with the participants

• Vaccine for use in Pakistan recommended to be trivalent having O, A and Asia-1 serotypes

• Sub-serotypes to be included in the appropriate vaccine for 2012 were O PanAsia-II, A Iran05/Tur06 and Asia-1 Shamir (higher dose). Recommendations shared with Dr. Giancarlo Ferrari, Dr. Samia Metwally at the FAO (HQ) and WRL scientists who endorsed the proposal

• Many viruses of Pakistan sequenced in 2012, 2013 and 2014. Vaccine matching done at WRL Weybridge and PIADC NY. Vaccine for 2013 contains O PanAsia-II, A Tur/06 and Asia-1 Sindh08, also endorsed by FAO (Hq) and WRL and regional scientists

• Virus sequencing and vaccine matching studies suggest same vaccine strains for 2014

Vaccine used in Pakistan

Vaccine 2012• Serotype O – PanAsia-2• Serotype A – Iran 05• Serotype Asia-1 – Shamir• Concentration of all

strains in the vaccine

> 6 PD50

Vaccine 2013 – 2014•Serotype O - PanAsia-2•Serotype A - Turkey 06•Serotype Asia-1 - Sind 08•Concentration of all strains in the vaccine > 6 PD50

Output 3: Control of FMD through immunization Activity 2: Strengthening NVL capacity for evaluation of FMD

vaccines• Equipment and expendables have been identified and

purchased to strengthen lab• An international expert was recruited to train the NVL and

provincial staff for properly analyzing the quality of vaccine in 2012. However, he declined to come due to security issues

• Two international experts were identified in 2013. TOR were finalized and conveyed to them. Unfortunately, both declined due to security concerns

• Advertisement by FAO regional office in Bangkok did not yield any positive outcome

• An expert in quality control of FMD vaccine from Turkey has been identified. TOR conveyed to him. Promised to come in March 2015. Recruitment in process

• Training of Pakistani scientists after recruitment of consultant

Output 3: Control of FMD through immunization Activity 3: Effective vaccination in dairy colony production system

• Dairy colonies where vaccination is being carried out are:– Khalsa area Peshawar dairy colony – Landhi Dairy colony and Nagori Dairy Colony, Karachi – Rakh Chandra Gwala Colony, Lahore – Eastern bypass and Quary Road, Quetta – Livestock farms, Mirpur– Suhan, Tarlai, Sihala & Golra Dairy Farms, Islamabad

• Tagging carried out in all vaccinated animals• Primary and booster dose completed• New entrants in the dairy colonies also being tagged and

vaccinated • Regular monitoring (clinical and serological) for FMD

infection

Vaccination in dairy coloniesDairy Colony Farms # Animals #

Initial New Total

Khalsa area Peshawar 330 10000 2382 12382

Landhi, Karachi 27 6761 9819 16580

Nagori Society, Karachi 28 4839 6777 11616

Rakh Chandra Rai Lahore 183 7014 3336 10350

Eastern bypass, Quetta 16 3927 873 4234

Quary Road, Quetta 33 7567 4750 11963

Livestock farms, Mirpur 30 945 34 979

Dairy Farms, Islamabad 309 6529 - 6529

Total 956 47582 27971 75553

No evidence of clinical disease in vaccinated animals

Immunization in rural smallholder dairy production system

• Selection of villages for vaccine trial undertaken in consultation with respective livestock departments

• Each livestock department identified 3 areas in their province / region

• Baseline survey for all villages was undertaken• Vaccination (primary , booster and six monthly) done• Tagging done in young animals (< 1 year age)• Calves reaching 4 months age also being tagged and

vaccinated• Regular monitoring (clinical and serological) for FMD

infection being undertaken• No evidence of clinical disease in vaccinated animals.

Sera being analyzed

Vaccination in Smallholders Rural Production System

District Villages # Farmers # Animals #

Initial New Total

Rahim Yar Khan 5 810 7014 612 7626

Jhang 4 704 4189 250 4439

Attock 3 910 5000 - 5000

Nausheroferoz 24 722 3314 - 3314

Tando Allahyar 12 689 2341 - 2341

Thatta 8 210 3650 - 3650

Matiari 5 543 5590 - 5590

Abbottabad 5 1199 4702 60 4762

DI Khan 5 618 4990 52 5042

Nowshera 5 590 4195 820 5015Pishin 4 295 3207 960 4167

Lasbella 4 346 2818 - 2818

Bolan 6 290 3230 - 3230

Vaccination in Smallholders Rural Production SystemDistrict Villages # Farmers # Animals #

Initial New Total

Muzaffarabad 6 2288 3480 2070 5550

Mirpur 14 1002 3451 49 3500

Rawalakot 11 2768 3874 426 4300

Ghizer 4 910 7000 - 7000

Gilgit 4 750 5177 - 5177

Skardu 4 1012 2928 - 2928

Mohmand Agency 5 664 3816 123 3939

Bajur Agency 5 1628 4517 102 4619

FR DI Khan 2 195 2500 - 2500

Total 145 19143 91956 4551 96507

No evidence of clinical disease in vaccinated animals

Vaccination at government livestock breeding farms

Province Farms # Animal #

Punjab 18 8890

Sindh 5 1064

Khyber Pakhtunkhwa 5 735

Total 28 10689

No case of FMD recorded in vaccinated animals in last 14 months

FMD Vaccination in Desert Cattle Farming• Sero-monitoring showed wide spread FMD virus

circulation in the Cholistan area in 2014 • Demonstration of FMD control through

vaccination in animals of selected farmers in Greater and Lesser Cholistan in Feb 2014

• 7500 animals, ear tagged, given primary and booster and 6-monthly vaccination

• Sero-monitoring showed good antibody titres in vaccinated animals

• Regular clinical surveillance of vaccinated herds is in place

• No significant clinical case in vaccinated animals

FMD Vaccination in Yak• Yak are special to high mountain areas and are important in livelihood

of the communities• No information on FMD in yaks• Blood samples taken from yak for sero-surveillance [66 out of 136 (48.5

%) were positive for FMD-NSP antibodies before vaccination]• Vaccination trial planned in Ghizer district (9 villages) in Feb 2012• Vaccinated group consisted of 2615 yaks while unvaccinated group had

1224 yaks• Analysis of serum samples collected from vaccinated animals shows

good antibody response in yaks. Average % PI values are shown below:

• FMD outbreak (approx 2000 yaks affected with serotype A) recorded in July 2013 in Nala Khukhush in district Ghizer in unvaccinated animals

• No clinical cases recorded in vaccinated animals• On community’s request another 1709 yaks were vaccinated• No clinical case has been reported in two vaccinated populations

Serotype Day 0 Day 30 Day 210

O 39 84 89

A 42 74 87

Asia-1 44 65 82

Expanding Vaccination Program – Vaccination on Cost Sharing Basis

• Two meetings held with farmers of Landhi cattle colony and Nagori Cooperative Dairy Farmers Society to introduce concept of vaccination on cost sharing basis

• Karachi Dairy Farmers Association, Landhi Cattle colony signed an agreement with the Project for implementation of vaccination on cost sharing basis on 30/1/2014. Counsel General of US in Karachi chaired the ceremony. Covered by all major TV news channels and print media.

• Farmers to pay Rs. 150 per animal (3 doses) per year for project vaccination against FMD

• Large dairy farms (exotic animals) being offered vaccination on full cost recovery (Rs. 85 per dose)

• 1010 farmers with 64127 animals (including 755 farmers with 51187 animals in Karachi and Hyderabad dairy colonies have already availed vaccination under cost sharing mechanism

Output 3: Control of FMD through immunization Activity 5: Evaluation of FMD vaccination effects on productivity in different dairy production systems

• Detailed economic analysis of current FMD status undertaken by Social Sciences Institute, NARC / PARC has been engaged

• Detailed farm level survey of 982 dairy farms including 779 rural smallholder and 203 peri-urban dairy colonies farms

• High occurrence (>85% sample farms) of FMD during last five years in peri-urban farms in Karachi and Quetta followed by Peshawar and Islamabad (67%), while lowest in Lahore (21%)

• Prevalence in rural areas ranged from 14% in AJK to 90% in Balochistan with an overall average of 40 percent

• Main sources for FMD transmission identified• Value of milk loss due to FMD Rs. 64590 per cow and 55605 per

buffalo in peri-urban dairy production system• In rural smallholder dairy production system, the value of milk loss at

Rs. 20871 per cow and 25336 per buffalo. • Other monitory losses include mortality in young stock, body weight

loss, distress sale, disturbance in calving interval, abortion and permanent lameness

Mid-term Evaluation Report• The project has high relevance to beneficiary needs, the West Eurasia

PCP-FMD Roadmap and FAO programming priorities.• The project’s efficiency is very good. Efficient delivery followed strong

management, working closely with Government, the FAO LTU’s involvement and technical support and partnership with USDA

• The project has been implemented effectively. It has helped Pakistan progress along the PCP-FMD to stage 2

• The financial sustainability of the existing FMD control model is dubious. The model is founded on subsidies and incentives. There may be opportunities to reduce vaccine costs and increase cost-recovery from farmers, but vaccine quality must be maintained. Sustainability will require careful planning and Government commitment.

• The project is on track and has contributed to the results stated in the Project Document by improving both farmer livelihoods (through reduced production losses) and food security (by safeguarding milk production). It also makes contributions to FAO’s five Strategic Objectives and to the Organizations seven Core Functions.

Mid-term Evaluation Report – Good practices

Although it is early in the project cycle to draw out “lessons learned”, the evaluation has identified three successful, good practices that could be relevant to the design of similar projects:

1. First, with the right selection, a national Project Coordinator (rather than an international Chief Technical Advisor) can effectively manage a FAO project of this type and efficiently lead it to deliver results.

2. Second, the strong partnership that has been developed between the Government (federal and provincial) and FAO is crucial to enabling efficient project delivery.

3. Third, in a dynamic, endemic setting where there are changing FMD virus serotypes and subtypes, the project has shown the importance of monitoring circulating virus strains and matching these with vaccine procurement specifications.

Mission’s Recommendations• Better participation of women• Training Needs Analysis (TNA) followed by assessment of

learning and tracking of capacity development• Government chaired conference to consider future gaps in

the FMD control system and to mobilize regional/ international resources to address these gaps

• Project management should work with the GoP to develop an operation system to support the veterinary field officers during FMD outbreak control and response work. This element should be included in the national control strategy plan and in any future phase of the project

• Project management should, by the end of 2014, work on improving the project logical framework and impact monitoring

Outcome• Based upon results achieved in the

project, Pakistan have provisionally been place in Stage 2 of the OIE-FAO Progressive Control Pathway for FMD in the 5th Annual Meeting of West EurAsia Roadmap meeting in Astana, Kazakhstan in April 2014

What Next ? • Model legal framework for Animal Health in

federal and provincial governments being developed

• Risk based control policy developed for Pakistan. Necessary for effective FMD control in the country and moving towards stage 3 of PCP-FMD

• Current Phase of the project to conclude on 30 September 2015

• Concept paper for Phase II (3 years) of the FMD control program developed

Risk based FMD Control Strategy for Pakistan – Component

1. Strengthening the liaison between federal and provincial levels to harmonize the procedures for FMD control and prevention

2. To further strengthen the diagnostic laboratory capacity at federal and provincial levels

3. To strengthen the surveillance systemfor FMD and create a national FMD information centre

4. Promote more extensive use of good quality vaccine against FMD

5. Improving the legal framework for FMD control

6. Promote a more intensive involvement of stakeholders’ on FMD control and prevention