Presented at the

Global Ministerial Forum on Research for Health

Bamako, Mali 17-19 November 2008

Gabriel Rugalema and Giulia Muir Food and Agriculture Organization of the United Nations

Transboundary Diseases, Agriculture and Health:

Policy Implications and Research Priorities

What are Transboundary diseases? diseases of significant economic, trade and/or food security

importance for a considerable number of countries;

diseases which can easily spread between countries and reach epidemic proportions;

the environment in which these diseases are found and the human activities which facilitate their spread straddle common borders;

their control/management, including exclusion, requires co-operation between several countries.

Some examples of Transboundary diseases of agricultural importance

HUMAN ANIMAL PLANT (dis+pests)

HIV and AIDS Peste des petits ruminants

(PPR)

Banana Fusarium Wilt

Malaria Foot and Mouth Disease

Banana Weevils

Tuberculosis Contagious bovine/caprine

pleuropneumonia

Coffee Wilt Disease

Highly Pathogenic Avian Influenza

(HPAI)

East Coast Fever Nematodes

Severe Acute Respiratory

Syndrome (SARS)

Bovine SpongiformEncephalopathy

(BSE)

Desert Locust

Cholera Worms Cassava Mosaic Virus

Typhoid Rift Valley Fever Soybean Rust

Dysentery Rinderpest Mango Fruit Flies

Measles Coccidiosis Coconut Leaf Beetle

The Burden of Disease:

a global snapshot

HIV and AIDS

•Number of people living with HIV: 33 million people [30–36 million] •New infections in 2007: 2.7 million•Deaths due to AIDS in 2007: 2 million

Source: UNAIDS 2008 Report on the Global AIDS epidemic

Malaria

• Percentage of the world’s population at risk = 40%• Cases of Clinical Malaria each year = 300 million• Malaria cases resulting in death each year = 1 million (some studies indicate as many as 3 million)

Source: http://www.theglobalfund.org/en/files/about/replenishment/disease_report_malaria_en.pdf

Tuberculosis

•People carrying the bacterium that causes Tuberculosis globally = 2 billion•Deaths due to Tuberculosis each year = 1.6 million•Estimated number of people who will become sick from TB between 2000 and 2020 = 200 million

Source: http://tballiance.org/why/tb-threat.php

H5N1 Avian Influenza

Severe Acute Respiratory Syndrome (SARS)

Cholera

Peste des Petits Ruminants (PPR)

FAO, 2008

Factors making diseases “transboundary” :

What we know

1. Ecological and Environmental changes2. Human mobility and migration3. Internal and International Trade4. Unregulated movement of animals and plants5. Interaction between humans and animals

Consequences of Transboundary Diseases

Direct health impact (illness, death, disability) Costs related of prevention, treatment and care Economic loss at household and national level Disruption of trade and employment Barriers to entry into international commodity

markets International trade and traffic may spread

transboundary diseases Potential for exacerbation of political tensions

between countries

Macro-economic costs of diseases

According to recent macro-economic estimates, the growth rate per capita GDP in highly Malarious countries (0.25-1.3% points lower than non-endemic countries) can amount to almost half of the per capita GDP of poor countries over a period of 25 years. (Malaeny and Sachs, 2004)

During the two months after the first outbreaks in Nigeria (February 2006) about 440,000 birds were destroyed. Assuming the disease follows the same course for the remaining year, compensation for 2.64 million birds will have to be paid in the first year. The Nigerian government has announced a compensation rate of US$ 1.95 per culled chicken, which would result into a compensation bill of about US$ 5.15 million for one year. (Hinrichs, Sims and McLeod, 2006)

Research Priorities, Capacity, Conduct and

Translation

Why is further research called for?

• Extent of the problem not well known

• Dynamic environment (including climate change)

• Differentiated (social, geographical) cost of transboundary diseases not well known nor appreciated

• Control measures not always evaluated for their efficiency and effectiveness

•Etc

Research priorities—what we need to know

Identify factors and channels facilitating the establishment and spread of transboundary diseases in different areas

Epidemiological studies to examine and identify microbial types and sub-types, their prevalence and distribution in time and space;

Economic analyses of impact of diseases at micro, meso and macro economic levels;

Analysing existing disease surveillance systems, their strengths and weaknesses

Examine international disease control efforts, gaps and lessons learned over the years.

Research Capacity Assess capacity building needs of institutions in areas

considered as hotspots for disease outbreaks.

Assess effectiveness of disease-control infrastructure and identify weaknesses.

Assess the role and potential for use of modern technology in disease surveillance (mobile phones, PDA, computers).

Research Conduct Who will conduct the research? International

Organizations like the FAO; Local and international research institutions.

Collective, multi-sectoral efforts are necessary through coordination and joint planning.

Need for a common set of research tools and instruments.

Need for both bottom-up and top-down approaches.

Research TranslationTranslating research into ACTION: Need for frequent dialogue between researchers and

end users of research (policy makers, local communities).

Research should be policy orientated. International collaboration in research, policy

development and implementation. Strong coordination of activities related to [human]

health. Stimulate culture of evidence-based policy

formulation.

Future Scenarios: Transboundary diseases require Transboundary solutions Given factors such as climate change, increased human

mobility/travel and agricultural change, it is likely that Transboundary diseases will continue to pose a serious challenge.

Transboundary disease challenges respect no internal, national or international borders; they hence require global perspectives and responses, conceptually and geographically.

Human activities are the most potent factors driving disease emergence; our response or lack thereof will determine their persistence.