East African Community One People. One Destiny

Transcription

1 East African Community One People. One Destiny Veterinary Services in the EAC A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

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3 Veterinary Services in the EAC A Report prepared to facilitate MRA Negotiations for Veterinary Professionals Supported by: ISBN

4 Table of Contents 1. Introduction Background on MRAs in the EAC The EAC Context What is meant by Mutual Recognition? What is the EAC Approach to Mutual Recognition? Veterinary Services in East Africa The Legal Framework for Veterinary Services The Definition of Veterinary Practice Related Legislation on Veterinary Practice in the EAC Partner States State of the Market for Veterinary Services What do Veterinary Professionals do in East Africa? How many new Veterinary Surgeons are coming on the Market each Year and from where? The Supply of Veterinary Para-Professionals The Education and Training of Veterinary Professionals Recognised Bachelor of Veterinary Medicine Courses in East Africa Accreditation of Academic Qualifications in Veterinary Medicine Course Standards and Curricula An Overview of the current State of Regulation of Veterinary Services Who regulates Veterinary Professionals and what is the Scope of their Powers? Registration Policies and Procedures Registration of Para-Professionals Registration of Facilities Registration of Foreign Veterinary Professionals Regulation in Practice after Registration Disciplinary Processes Veterinary Professional Associations Membership of Veterinary Professional Association Veterinary Para-Professional Membership Associations A Summary of the Strengths, Weaknesses, Opportunities and Threats for the EAC Partner States in considering an MRA in Veterinary Services Strengths Weaknesses Opportunities Threats and Challenges Lessons and Experience from other MRAs Other EAC MRAs Experience from elsewhere in the World European Union ASEAN (The Association of South East Asian Nations) Negotiations for a Veterinary Services MRA in the EAC How MRA Negotiations should be conducted The Gap Analysis Issues to be addressed in MRA Negotiations A Roadmap for MRA Negotiations Conclusions Annexes 73 4 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

5 List of Tables Table 1: Laws Governing the Veterinary Profession in the EAC 17 Table 2: Veterinary Medicine/Science 18 Table 3: The Control of Veterinary Surgeons and Veterinary Para-Professionals 18 Table 4: Definition of Veterinary Practice 20 Table 5: Veterinary Para-Professionals 21 Table 6: Wider Legislative Context for Veterinary Practice 23 Table 7a: Number of Veterinary Surgeons in East Africa 25 Table 8: The Status of Veterinary Para-Professionals in East Africa Table 9: New Registrations of Veterinary Surgeons 28 Table 10: New Registrations of Veterinary Para-Professionals 29 Table 11: Admission to Study Veterinary Medicine in East Africa 29 Table 12: Numbers Graduating in Veterinary Medicine 30 Table 13: The Process for Accrediting Academic Institutions for Recognition by Competent Authorities 32 Table 14: Accreditation Process for Tertiary Level Courses for Recognition of Veterinary Para-Professional Qualifications 33 Table 15a: Academic Standards for Recognised Veterinary Degrees in the Partner States 34 Table 15b: Academic Standards for Recognised Veterinary Degrees in the Partner States 34 Table 16: Recognised Courses for Veterinary Para-Professionals 36 Table 17: Powers of the Competent Authority 38 Table 18a: Registration Requirements for Veterinary Surgeons in the EAC 39 Table 18b: Registration Process for Veterinary Surgeons in the EAC 40 Table 19a: Registration Requirements for Veterinary Para-Professionals in the EAC 42 Table 19b: Registration Process for Veterinary Para-Professionals in the EAC with VSBs 43 Table 20: Registration of Facilities 44 Table 21: Licensing of Veterinary Premises 44 Table 22: Registration of Veterinary Surgeons with Foreign Licences 45 Table 23: EAC Partner State Commitments under the Common Market Protocol 46 Table 24: How is the Practice of registered Veterinary Surgeons monitored? 46 Table 25: How is the Practice of registered Veterinary Para-Professionals monitored? 47 Table 26: Code of Ethics 48 Table 27: Continuing Professional Development Requirements 50 Table 28: Disciplinary Procedures 50 Table 29: Membership of Veterinary Professional Association 51 Table 30: Membership in Veterinary Para-Professional Associations 52 Table 31: Gap Analysis 62 Table 32: Key Issues for MRA Negotiations 66 5

6 Foreword The East African Community (EAC) is a regional inter-governmental organization of the five Partner States, namely; the Republic of Burundi, the Republic of Kenya, Republic of Rwanda, Republic of Uganda, and the United Republic of Tanzania, with its Headquarters located in Arusha, Tanzania. The EAC is pursuing an ambitious agenda of economic and social integration and is in the process of creating a common market underpinned by free movement of goods, services, people and capital. The protocol on the establishment of the East African Community Common Market under Article 11 states that Partner States shall undertake a mutual recognition of academic and professional qualifications granted, experience obtained, requirements met, licenses or certificates granted in other Partner States. Partner States have negotiated the Annex (VI) the East African Community Common Market (Mutual Recognition of Academic and Professional Qualifications) Regulations 2011 which provides the modalities through which Article 11 of the Common Market Protocol will be implemented. Mutual Recognition Agreements (MRAs) have an important role to play in meeting the objective of free movement of skilled labour and encouraging the mobility of regulated professionals in particular. Since 2011, the competent authorities responsible for accountancy, architecture and engineering have signed three such MRAs. A number of other professions have also expressed an interest in signing similar agreements and the veterinary profession is one of these. Veterinary services play a vital role in promoting economic growth, developing export potential and securing public health in East Africa. An MRA was designed to promote the increased availability of veterinary services across the region, to spread best practice in regulation and raise standards of qualification. This report represents a comprehensive stocktaking of the current state of the veterinary services sector in East Africa and the scope for its development through the negotiation of an MRA. It contains a comparative analysis of the laws, regulations, education and training and other requirements pertaining to veterinary and para-professional veterinary practices in the East African Community. It also sets out the possible lessons that the veterinary profession might draw on given the experience of other East African professions that have already adopted MRAs, as well as experience that might be drawn on from other parts of the world. The publication of this report is an indication of the commitment of the regulators of the veterinary professions across the Partner States, to negotiate and agree to an MRA, as well as of the EAC Secretariat s commitment to support this process. Dr Richard Sezibera Ambassador Secretary General East African Community 6 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

7 Acknowledgements This stocktaking study on the regulatory and legal framework of the veterinary professionals in East African Community (EAC) is a result of the thorough work of a consultancy team under the guidance of the EAC Secretariat and in co-operation with German Development Cooperation implemented by GIZ. In this regard, the EAC Secretariat wishes to acknowledge the contributions of the consultant Alison Hook as the team leader, the focal points from each EAC Partner State (Dr Gerard Nigarura, Deputy Chairman Burundi Veterinary Board and national focal point for Burundi; Dr Joseph Amesa Omega, Chairman Kenya Veterinary Board and national focal point for Kenya; Dr Francois-Xavier Rusanganwa, Chairman of Rwanda Council of Veterinary Doctors and national focal point for Rwanda; Dr Bedan Masuruli Manyama, Ag. Registrar Veterinary Council of Tanzania and Dr Theresia Ponela Mlelwa, former registrar for Tanzania; Dr Florence Masembe Kasirye Secretary/Registrar Uganda Veterinary Board and Dr Dominic Mundrugo-Ogo Lali, national focal point for Uganda) who assisted in the background research and drafting of the report. The contribution of all of the other participants in the first validation workshop held in Nairobi, September 2014, unfortunately too many to list here individually, was also invaluable (see Annex 7.6). Last but not least, the EAC Secretariat recognizes the technical contribution and logistical support made by Mr. Timothy Wesonga, Senior Livestock and Fisheries Officer at EAC Secretariat, Ms. Staicy Wagala, Trade Policy Advisor at GIZ and Mr. Gustave Siniziziye, Advisor on Mutual Recognition Agreements at GIZ in planning of the study, guiding and advising the consultant in formulation and finalization of this report. 7

8 Abbreviations and Acronyms used in this Report ACSA Agents Communautaires en Santé Animale (Burundi)/Community Animal Health Agents AHITI Animal Health and Industry Training Institute (Kenya) AI Artificial Insemination ASEAW Association of South East Asian Nations AVB Veterinary Association of Burundi AVMA American Veterinary Medicine Association BF Burundian Francs BML Base Metabolic Rate BMR Basal metabolic rate BVM Bachelor of Veterinary Medicine BVM&S Bachelor of Veterinary Medicine and Surgery CBPP Contagious Bovine Pleuropneumonia CCPP Contagious Caprine Pleuropneumonia CMP Common Market Protocol CNS Central Nervous System CPC Central Product Classifications CPD Continuous Professional Development CSE Certificate of Secondary Education (Tanzania) DNA Deuxyribonucleic Acid DVO District Veterinary Officer EAC East African Community EISMV Ecole inter-etats des Sciences et Medecine Veterinaires EU European Union FAO Food and Agriculture Organisation FMP Fisheries Management Plan GPV Gross Protein Value GVA Gross Value Added ITAB Institut Technique de l Agriculture Biologique (Technical Institute of Organic Farming, Burundi) KCSE Kenyan Certificate of Secondary Education KCVA Kenya Christian Veterinary Association KSH Kenyan Shillings KWVA Kenya Women Veterinary Association KVB Kenya Veterinary Board KVA Kenya Veterinary Association LSU Livestock Standard Units MRA Mutual Recognition Agreement NCHE National Council of Higher Education (Rwanda) NGO Non-Governmental Organisation NPR Net Protein Retention OIE World Organisation for Animal Health ONMVB Ordre National des Médecins Vétérinaires du Burundi (National Board of Veterinary Doctors of Burundi) PER Protein Efficiency Ratio PVR Protein Replacement Value etc. RF Rwandan Francs RVC Rwandan Veterinary Council RVF Rift Valley Fever SEVET Self-Employed Veterinary Professionals Association (Kenya) SINE Short Interspersed Nuclear Element TADs Transboundary Animal Diseases TSH Tanzanian Shillings TVA Tanzanian Veterinary Association UGX Ugandan Shillings UN CPC United Nations Central Product Classification UVB Uganda Veterinary Board UVA Uganda Veterinary Association VCT Veterinary Council of Tanzania VSB Veterinary Statutory Body WHO World Health Organization WTO World Trade Organization 8 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

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10 Part 1 Introduction 10 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

11 1. Introduction Veterinary services are vital to the health and economic wellbeing of all the East African Community (EAC)Partner States. For countries in which agriculture is the main economic activity for the majority of people and in which livestock has a great cultural significance, animal health and welfare are of paramount importance. Poverty alleviation and food security, for example, are two key regional policy goals that can only be achieved with the appropriate assistance of veterinary services. Moreover, potential export earnings from regional and wider international trade in animals and animal products will only be realized if animal production and the inputs into it, meet required sanitary and phytosanitary standards. And beyond specific regional concerns, veterinary services play a vital role in maintaining animal and human health for all countries. Their significance is regularly thrown into sharp relief through the emergence of new zoonotic diseases which underline the increasing complexity of the health environment and the need for veterinary services to be fully part of a One Health 1 approach. The veterinary profession around the world is on the frontline in fighting the battle against animal diseases and needs to be armed in this fight not only with the latest scientific information on animal welfare and up to date disease control methods, but also with the opportunity to communicate and collaborate across borders. This shared context across the region has made veterinary services an obvious area of activity in which it will be beneficial for the EAC to promote greater collaboration. This report is designed to set out the current state of play in these services across the region and in particular, to examine whether and how veterinary services might be made the subject of an EAC Mutual Recognition Agreement (MRA). It has been compiled from a variety of sources and in particular from evidence gathered by national focal points, who are individuals appointed by each EAC Veterinary Statutory Body to act as a liaison point for the preparation and negotiation of the MRA. 1 Originating out of the USA, the One Health movement attempts to promote interdisciplinary collaborations and communications in all aspects of health care for humans, animals and the environment. (see 11

12 Part 2 Background on MRAs in the EAC 12 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

13 2. Background on MRAs in the EAC 2.1 The EAC Context The Treaty Establishing the East African Community sets out the ambition of the Partner States to create an East African Common Market. It provides in Article 76 for the negotiation of a Common Market Protocol which is intended to set out in more detail how the integrated single market in East Africa is to be achieved. Article 104 of the Treaty also commits the Partner States to adopt measures to achieve the free movement of persons, labour and services and to ensure the enjoyment of the right of establishment and residence of their citizens within the Community. The EAC Common Market Protocol (CMP) was subsequently concluded in 2009 and entered into force on 1 July It provides for free movement within the EAC of goods, persons, labour, services and capital and for equal rights of establishment and residence. The CMP is itself supplemented by five annexes which set out more detailed provisions on each of the afore-mentioned rights and freedoms and on the general removal of restrictions on cross border provision of services. Many of the rights and freedoms contained in the CMP are relevant to East African professionals who are members of regulated professions and who wish to exercise their professions elsewhere in the EAC. However, the two most directly applicable provisions are found in Article 5.2(e), which states that the Partner States agree: To remove measures that restrict movement of services and service suppliers, (and) harmonise standards to ensure acceptability of services traded. And in article 5.3(a), which states that, in order to facilitate the implementation of the CMP, they will Co operate to harmonise and to mutually recognise academic and professional qualifications. Article 11 fleshes out the commitment on mutual recognition by stating: 11.1 For the purpose of ensuring the free movement of labour, the Partner States undertake to: (a) Mutually recognise the academic and professional qualifications granted, experience obtained, requirements met, licences or certifications granted, in other Partner States; and (b) Harmonise their curricula, examinations, standards, certification and accreditation of educational and training institutions The implementation of this Article shall be in accordance with Annexes to be concluded by the Partner States. In the last few years, these commitments have been turned into specific sectoral agreements relating to individual professions. Before looking in more detail at whether, and how, veterinary services might be made subject to such an agreement, it is worth recapping briefly on what is meant by mutual recognition and at the broad lines of the EAC approach to it. 2.2 What is meant by Mutual Recognition? When regulated services are traded across international borders, the question of market access for foreign suppliers becomes an issue. MRAs have therefore evolved as a way of allowing foreign service suppliers to provide their services into regulated markets without the need for duplicate authorization processes in both the supplier s home country and destination market (so-called host country ). The use of the word mutual implies that these arrangements are reciprocal, although that does not necessarily mean that the requirements on either side are identical. Moreover, the word recognition has not always implied full authorization in the importing country, it may simply mean that there is recognition of the level of testing or certification already carried out in the exporting country which may then supplemented in the host state. MRAs generally take one of the following forms: They can be harmonising MRAs which seek to create a common standard in which underlying educational curricula and training regimes are identical. This approach is often used as a starting point by regions looking to create MRAs but is often quickly abandoned as it has very little immediate effect as harmonised standards are time-consuming and politically difficult to negotiate. 13

14 They can be competency based MRAs which seek to recognise that regional agreements can be based on the recognition of different qualifications which are all based on the same underlying competences. They can be managed MRAs which recognise that although basic underlying competences are largely shared, there are essential elements of practice which are local. These MRAs therefore permit regulatory authorities in the host country to impose some compensatory measures on the migrant professional. These measures might range for example, from a test on specific local legal, regulatory and cultural issues or a requirement to work in association with a local professional. One thing that all MRAs have in common, is that they cover the following seven issues i) Governance MRAs need to include answers to the following questions: Who is responsible for authorization and registration of professionals in the sector under consideration? What dispute resolution arrangements exist? And what arrangements are made for deepening regional collaboration? ii) Mode of supply An MRA should also cover the temporary presence of service suppliers as well as permanent establishment; and take account of the role played by commercial organizations as well as authorized individuals in the supply of services iii) Scope of authorization - An MRA will need to set out the scope of the practice being permitted to any foreign qualified persons authorized under the terms of the agreement. These will often take their lead from UN Central Product Classifications (CPC) used as a basis for gathering statistics on trade which are also frequently used by countries in scheduling market access commitments under the GATS or in bilateral trade treaties. iv) Eligibility - MRAs will also usually set out the minimum requirements that a professional in one country has to fulfil before they can use the MRA to access the market in another country. These minimum requirements may range from detailed specifications about the content of prior training and experience through to eligibility to use the MRA simply on the basis of a professional title or qualification already acquired in another country. v) Equivalence - Eligibility under an MRA does not, on its own, necessarily provide the basis for accessing the market. A foreign qualified professional who is eligible under an MRA may still be subject to compensatory measures before they can be deemed to have achieved equivalence and have obtained the right to access the host country market. vi) Automaticity this relates to the degree of discretion involved in making determinations under the MRA. vii) Post approval conditions - Once recognition has been granted under an MRA, the agreement may also specify whether there are ongoing conditions attached, such as regular submission of home state approval documentation, proof of indemnity insurance cover, or compliance with continuous education and training requirements 2.3 What is the EAC Approach to Mutual Recognition? The agreements that have been negotiated within the EAC to date have been based on a common approach, as outlined in a further draft annex 2 to the Common Market Protocol (see annex 2 of this report). This approach does not significantly limit the relevant competent authorities in shaping their MRAs to suit the nature of their professional sectors. Those MRAs that have been negotiated so far, have all been based on a competency based approach. This is based on the understanding that there is sufficient underlying commonality in the qualifications and form of practice of the professions in the Partner States that are signatories to the agreements. What this approach has meant, however, is that not all Partner States have participated fully in the MRA from the outset, as qualifications and regulatory frameworks must first reach the defined EAC recognised minimum level which would indicate equivalence in the competences gained through the required education and training. 2 NB this annex is still in draft form and although it has been discussed at Ministerial level it has not yet been signed off, it has however been used as the starting point for the negotiation of most of the MRAs concluded to date. 14 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

15 The use of the competency based approach in the EAC MRAs to date means that an EAC national who is licensed to practise a profession that is covered by a mutual recognition agreement and from a Partner State that is party to it, is automatically eligible for recognition elsewhere in the EAC. Such an individual can obtain recognition by presenting the competent authority of the East African country in which he or she wants to practise, with the evidence of his or her professional qualification and good standing at home. The host authority should then approve the EAC candidate s application for a licence to practise within 30 days, and if it is not approved should provide a written explanation why the application for a licence has been rejected. Once approved, an eligible EAC national may practise by being physically present in the host Partner State, either on a temporary or a permanent basis. A licensed professional from another EAC Partner State is also entitled to be treated in the same way as a member of the local profession under the terms of the MRA; in other words they cannot be charged higher fees or have conditions put on their practice which would not apply to local practitioners. If there is a separate professional body, then the EAC migrant professional must also be permitted to join that body and be represented by it. In exchange for these rights, a migrant EAC professional will be expected to observe the following conditions: They must register with the body responsible for regulating their profession if they intend to practise in another EAC country. They must pay the designated registration or licensing fee and, once registered, observe the same rules and scope of practice that apply to that profession locally when practising in that Partner State. EAC professionals covered by MRAs may register in as many EAC countries as they wish to practise in but they need to remain registered and pay the fees in all of the countries in which they are practising. If an EAC migrant professional breaks the rules of the profession in the host country, they will be subject to the disciplinary procedures of that country. The host country will also inform the migrant professional s home regulatory authority will also be informed and may choose to pursue its own separate disciplinary action. Depending on the profession concerned and host country requirements, migrant professionals may be required to take out professional indemnity insurance and fulfil continuous professional training obligations on an annual basis. Before we go on to consider how veterinary services in East Africa might fit with such a model, we will look in more depth at the state of play in this sector in relation to the factors that are relevant to the negotiation of an MRA. 15

16 Part 3 Veterinary Services in East Africa 16 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

17 3. Veterinary Services in East Africa This section of the report reviews the current state of veterinary services in the EAC. It covers the legal framework governing veterinary services, the demand for and supply of veterinary surgeons and veterinary para-professionals, their regulation, education and training and professional support mechanisms. Reference is made throughout this report to the World Organisation for Animal Health (OIE) 3, which is a key player in identifying and promoting best practise in the education and training and regulation of veterinary services. 3.1 The Legal Framework for Veterinary Services The starting point for the analysis of the veterinary services sector in East Africa is the legal framework which governs it. All of the EAC Partner States have primary legislation covering veterinary services, which in some cases is further elaborated in secondary legislation. The main governing laws are outlined in table 1, below. This table illustrates that the legal framework for veterinary practice in East Africa is very young in some parts of the region, and still subject to change. In four of the five Partner States, new governing legislation has been enacted only in the last few years, or is under consideration or review. It is worth noting that both Uganda and Rwanda currently have legislation that only covers veterinary surgeons but both intend to amend this position in order to include veterinary para-professionals in full. In the case of Uganda, a draft Bill to reform the Veterinary Surgeons Act 1958 was put before Cabinet in 2006 but has not resulted in agreement on any changes. In the interim a new proposed law has been developed, entitled the Veterinary Surgeons and para-professionals Bill This has been widely discussed by stakeholders, but has not yet been presented to the Minister, so it is not yet clear when, or in what form, it might pass. In the case of Rwanda, the law governing veterinary practice is new (published on 21 October 2013) but contains a number of errors and omissions, which the profession is keen to ensure are corrected, such as an overly narrow definition of veterinary practice. There is no timetable yet for this to happen. Table 1: Laws Governing the Veterinary Profession in the EAC Partner State Name of Act/Regulations Who is covered by it? Burundi Loi n 1/06 du 21 Mars 2011 portant Réglementation de l Exercice de la Profession Vétérinaire 4 ; and Règlement d Ordre Intérieur de l Ordre National des Médecins Vétérinaires du Burundi 5 Veterinary surgeons and veterinary para-professionals Kenya The Veterinary Surgeons and Veterinary Para-Professionals Act, 2011 Veterinary specialists, veterinary surgeons, veterinary para-professionals Rwanda Law n 56/2013 of 09/08/2013 establishing Rwanda Council of Veterinary Doctors and determining its mission, organization and functioning And Ministerial Order N 008/11.30 of 18/11/2010 determining the organization of veterinary pharmacy practice Veterinary surgeons (doctors) only. Government veterinary surgeons may register voluntarily Tanzania Veterinary Act No16, 2003 Veterinarians, veterinary specialists, veterinary paraprofessionals, veterinary practice and veterinary practice facilities Uganda The Veterinary Surgeons Act 1958 (NB. Under review) All veterinary surgeons operating in the private sector (i.e. government veterinary surgeons are excluded) 3 The organisation was founded in 1924 as the Office International des Epizooties and has retained its French acronym despite changing its name in 2003 ( 4 Law on the regulation and practice of the veterinary profession 5 Internal regulation of the National Order of Veterinary Surgeons of Burundi 17

18 Perhaps the best starting point for analysing the differences and similarities between the above listed legislation in the different Partner States is the OIE framework 6. This framework sets out the points which the international community of veterinary surgeons has suggested need to be covered in legislation in order to ensure that the proper goals of veterinary practice can be achieved. It is divided into two parts: The first looks at how the legislative framework treats the practice of veterinary science in general terms and the second at how it defines the control of veterinary professionals and veterinary para-professionals. The key essential elements in the OIE framework and how the governing laws on veterinary practice in the Partner States match up to these, are outlined below in tables 2 and 3. These tables show that most Partner States cover the broad outline of what OIE considers essential in their legislation. The two major weaknesses relate to the lack of detail underpinning some of the provisions and the absence of a legislative framework to cover veterinary para-professionals. Table 2: Veterinary Medicine/Science Burundi Kenya Rwanda Tanzania Uganda 7 a) Act define prerogatives of veterinary surgeons 8 and veterinary para-professionals Only covers veterinary surgeons Yes Only covers veterinary surgeons Yes Only covers veterinary surgeons b) Act sets out minimum initial and continuous educational requirements and competencies for veterinary surgeons and veterinary para-professionals Only for veterinary surgeons CPD not covered Yes CPD is covered by Gazetted regulations and approved guidelines Only for veterinary surgeons. No mention of CPD Yes and a CPD programme is a pre-requisite for retaining registration, enrolment and enlistments Only for veterinary surgeons. No mention of CPD c) Act sets out conditions for recognition of the qualifications for veterinary surgeons and veterinary para-professionals Only for veterinary surgeons Yes Only for veterinary surgeons Yes Only for veterinary surgeons d) Act defines conditions to perform the activities of veterinary medicine/ science e) Act defines exceptional situations Yes, in outline Yes Yes Yes Yes Yes in article 21 Yes Not covered Yes Yes Table 3: The Control of Veterinary Surgeons and Veterinary Para-Professionals Burundi Kenya Rwanda Tanzania Uganda a) Act describes the general system of control of veterinary practice b) Act describes the various categories of veterinary para-professionals and prescribes its training, qualifications, tasks and extent of supervision Yes Yes Yes Yes Yes No Yes No Yes No c) Act sets out powers to deal with conduct and competence issues, including licensing requirements, that apply to veterinary surgeons and veterinary para-professionals Covered in outline in articles 28 & 29 Yes Only for veterinary surgeons Yes Only for veterinary surgeons d) Act describes delegation of powers to a professional organisation such as a veterinary statutory body In broad outline in article 29 Yes Yes Yes Yes 18 6 OIE Terrestrial Code Chapter 3.4. on veterinary legislation (2012) 7 These tables refer to the current governing law, not the draft under discussion 8 These definitions draw on the OIE definitions in which veterinarian = veterinary surgeon. Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

19 It would, however, appear to be the case that, notwithstanding some differences between the Partner States in the way in which they organize their veterinary professions; there is a strong fundamental common basis on which to build. 3.2 The Definition of Veterinary Practice A key issue in the legal framework relating to veterinary practice, is how that practice is defined. This is crucial to the control of those exercising the functions of veterinary surgeons and para-professionals. A useful starting point for the definition of any traded service is the UN Central Product Classification (CPC). Box 1 sets out the UN CPC definition of veterinary services which underpins all discussions on trade and the measurement of these services as economic products in their own right. This definition has been used in the EAC Schedule of Commitments on the liberalisation of services (Annex V to the Common Market Protocol) which is the starting point for determining which professions might be subject to MRAs. However, the definitions of veterinary services used in the Partner States, as set out in the governing laws for the profession are somewhat different from CPC 932. As table 4 below illustrates, there is no distinction made in the governing laws of any of the Partner States about the type of animal that is the subject of veterinary services. Box 1: CPC Ver.1.0 code 932: Veterinary Services This Group is divided into the following Classes: Veterinary services for pet animals This subclass includes: - animal and veterinary hospital and non-hospital medical, surgical and dental services delivered to pet animals. The services are aimed at curing, restoring and/or maintaining the health of the animal - hospital, laboratory and technical services, foods (including special diets) and other facilities and resources Veterinary services for livestock This subclass includes: - animal and veterinary hospital and non-hospital medical, surgical and dental services delivered to livestock. The services are aimed at curing, restoring and/or maintaining the health of the animal - hospital, laboratory and technical services, foods (including special diets) and other facilities and resources Other veterinary services This subclass includes: - animal and veterinary hospital and non-hospital medical, surgical and dental services delivered to animals other than pets (including zoo animals and animals raised for their fur production or other products). The services are aimed at curing, restoring and/or maintaining the health of the animal - hospital, laboratory and technical services, foods (including special diets) and other facilities and resources. This subclass does not include services related to animal husbandry such as artificial insemination, cf

20 Table 4: Definition of Veterinary Practice Partner State Burundi Definition of Veterinary Practice contained in Governing Law The exercise of the veterinary profession in the public veterinary service covers the following activities: The organization and supervision of disease control, the protection of animal health, the control the movement of animals within the country and cross border, the inspection of food of animal origin, the issuance of necessary transport documents for the import or export of animals and animal products, the application of regulations governing veterinary pharmaceuticals, the improvement of diagnostic services and availability of vaccines, participation in improvements in livestock production, the promotion of the privatization of the veterinary profession, the performance of any other tasks required by the Ministry in control of livestock. The exercise of the veterinary profession outside of the public sector is limited to the following circumstances: Performance of any medical, surgical or obstetric-gynaecological act contributing to the maintenance or improvement of animal health; the provision of advice on animal care; the delivery of any document relating to the health status of animals in the charge of the veterinary surgeon. The private veterinary surgeon is also permitted to practice veterinary pharmacy in compliance with prevailing rules and regulations. The private veterinary surgeon may nevertheless be mandated by the Minister overseeing livestock or his delegate for the execution of certain activities falling under the definition of public veterinary services within the jurisdiction. He/she can also be mandated by the judicial authority to put his/her expertise into practice. Kenya A person practices as a veterinary surgeon if such person engages in the: a) Prevention of an infectious or organic disease or pathological condition b) Performance of a surgical operation on an animal c) Dispensing or administration of veterinary medicines on animals d) Giving of any treatment, advice, training, research, consultancy, services diagnosis or attendance and other related veterinary services e) Inspection of foods of animal origin for purposes of food safety f) Provision of animal welfare services Rwanda The law contains a definition of the veterinary profession and states that it relates to the following: a) Purative and preventative veterinary medicine b) Animal reproduction c) Veterinary pharmacy practice and use of inputs and livestock equipment d) Hygiene and quality of animal products e) Wild animal medicine Tanzania Uganda The practice of veterinary medicine means the diagnoses, prognoses, treatment, administering to, prescribing for, operations on, manipulations of appliances or any apparatus or appliance for any disease, pain, deformity, defect, injury, wound or physical or mental condition of any animal or for the prevention of, or to test for the presence of any disease of any animal and includes acts related to statutory or compliance functions, and of persons representing themselves as engaged in the practice of veterinary medicine or uses of any words, letters or titles in such connection and under such circumstances as to induce the belief that the person using them is engaged in the practice of veterinary medicine in any of its branches as defined by this Act. The practice of veterinary surgery shall be deemed to mean the performance of any operation and the giving of any treatment, advice, diagnosis or attendance in respect of an animal for gain or reward. In practice, the definitions used by the various Partner States are notably more detailed than the UN definition on the type of services covered for the purposes of trade agreements. On the other hand, the UN definition covers veterinary services and not simply veterinary surgery, veterinary medicine or the veterinary profession. The commitments made in the EAC Liberalisation of Services Schedule (Annex V) which have used the UN definition can therefore be read to cover veterinary para-professional practice and not simply the practice of veterinary surgeons. There is, not surprisingly, significant overlap between the definitions of veterinary practice used in Partner States: Preventative and curative veterinary services and veterinary pharmacy are explicitly, or at least implicitly, covered in all the definitions. There is however an important and significant difference between some of the above definitions which will need to be considered in any discussions on the shape of a Mutual Recognition Agreement. This lies in the distinction made in a number of Partner States between private veterinary practice and the 20 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

21 government veterinary service. In the case of the latter there are some specific tasks such as inspection and certification of livestock and foodstuffs of animal origin which are covered in some of the above definitions, but not in others. It is perhaps worth referring to the OIE for assistance in dealing with these differences. The OIE defines veterinary services to mean: The governmental and non-governmental organisations that implement animal health and welfare measures and other standards and recommendations in the Terrestrial Code and the OIE Aquatic Animal Health Code in the territory. The Veterinary Services are under the overall control and direction of the Veterinary Authority. Private sector organisations, veterinarians, veterinary para-professionals or aquatic animal health professionals are normally accredited or approved by the Veterinary Authority to deliver the delegated functions. In other words, all veterinary services are considered by the OIE to be in their essence public functions, which may or may not subsequently be delegated to private sector providers to carry out under regulated conditions. The OIE goes on to define a veterinarian or veterinary surgeon as: a person with appropriate education, registered or licensed by the relevant veterinary statutory body of a country to practice veterinary medicine/science in that country. Given that Annex V of the CMP implicitly includes veterinary para-professionals it is important to look also at how these functions are defined in Partner States legislation. These definitions are summarised in table 5, below. Table 5: Veterinary Para-Professionals Partner State Burundi Kenya Definition of Veterinary Para-Professional Practice contained in Governing Law There is no specific legislation related to the statutory definition Veterinary Para-Professional practice. Under delegated responsibility from a superior veterinary officer of the government or from a veterinary surgeon, the following is the veterinary para-professional practice: a) Implementation of parasite control programmes in animals b) Meat inspection and other duties under the relevant legislation, if authorized therefore by the Director of Veterinary Services c) Delegated duties pertaining to regulated animal diseases, including the various eradication schemes d) Extension services (including training and education) to farmers and community members e) The collection, capturing and evaluation of data and the compiling of reports whilst assisting with epidemiological and research projects f) The collection of samples, including blood smears, impression smears, skin scrapings, and wool scrapings, and faecal samples (excluding the collection of samples by biopsy) g) The examination and analysis of samples, including blood smears, skin and wool scrapings, urine analysis and faecal samples and elementary clinical chemistry h) Basic post mortem examinations and the collection and submission of samples i) Artificial insemination provided that the veterinary para-professional is registered as an inseminator with the Director of Veterinary Services j) Under the responsibility or direction of a veterinary surgeon i. The lancing of abscesses ii. The treatment of septic wounds; and iii The administration of injections and medicines On their own without veterinary supervision, veterinary para-professional practice comprises the following: a) Closed castrations of cattle under 6 (six) months of age b) Closed castrations of sheep and goats under 3 (three) months of age c) Open castrations of pigs up to thirty days of age d) De-horning of immature cattle, sheep and goats under 4 (four) months of age e) Tail docking of sheep under 2 months of age by using the open method f) Hoof trimming Rwanda The law mentions veterinary technicians but gives no definition of this role, or the tasks that these individuals may perform. 21

22 Table 5: Veterinary Para-Professionals Partner State Tanzania Definition of Veterinary Para-Professional Practice contained in Governing Law The law defines a para-professional to mean any person enrolled as para-professional under the Veterinary Act. Under s.32 of the Act: A Para-professional or Para-professional Assistant enrolled or enlisted pursuant to this Act shall at all times practice under the supervision of a registered Veterinarian or Veterinary Specialist. A veterinary para-professional may undertake the following tasks: Under the immediate supervision of a veterinarian: a) Assist in diagnostic, medical and surgical procedures b) Induction and management of anaesthesia Under direct supervision of a veterinarian (when on the same premises): a) Carry out routine laboratory tests b) Application of splints and slings c) Radiology setting, positioning and processing d) Dispensing of drugs and medicine e) Perform post-mortem f) Vaccination g) Euthanasia h) Providing nursing care Under indirect supervision (when the vet is not on the same premises as the para-professional: a) Give appropriate advice to clients on animal health management and animal house management b) Carry out prophylactic measures against diseases c) Carry out artificial insemination Uganda The draft bill has a provision as below: A veterinary para-professional means a person who, is authorized by the council to carry out specific tasks related to animal health, production and welfare under the direct or general supervision (responsibility and direction) of a registered or licensed veterinarian. The tasks authorized for each category of veterinary para-professional are provided for in the schedule of the Act The schedule is being developed in consultation with the para-professionals country-wide So it would appear that in those Partner States which have definitions of veterinary para-professionals there are some common underlying concepts: First, a veterinary para-professional will have a certain recognised level of education and training; Secondly, they need to be registered to hold a certain title; Thirdly, the tasks they are permitted to undertake are specific (they may or may not be defined in detail in the legislation) and will have been delegated by a registered and licensed veterinarian; Lastly, those tasks will be undertaken under the direct or indirect supervision of a veterinarian. These common concepts can all be found in the OIE definition of a veterinary para-professional, which is as follows: a person who, for the purposes of the Terrestrial Code, is authorised by the veterinary statutory body to carry out certain designated tasks (dependent upon the category of veterinary para-professional) in a territory, and delegated to them under the responsibility and direction of a veterinarian. The tasks for each category of veterinary para-professional should be defined by the veterinary statutory body depending on qualifications and training, and according to need. What we can take from this discussion are the following points: An EAC MRA should cover veterinary services in its widest possible definition, including veterinary para-professional services, given the commitments made in Annex V of the Common Market Protocol. 22 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

23 The role of the veterinary statutory body is key to who can benefit from the MRA those veterinary surgeons who are registered with this authority are eligible to take advantage of the agreement in order to work in other Partner States. Although there are differences between the definitions of veterinary practice used in the different Partner States, these should not matter as the right to register as a veterinary surgeon in another Partner State does not automatically confer the right to practice as a government veterinary surgeon or to carry out public veterinarian functions. These are a matter of employment. What an MRA would do, therefore, is allow a qualified veterinary surgeon in one Partner State to have the opportunity to register and the possibility of gaining employment in another Partner State, whether in the public or private sector. The situation for veterinary para-professionals is slightly more complex as each veterinary statutory body will have the responsibility of defining what veterinary services may be delegated to veterinary para-professionals and what qualifications are required to perform them. There are differences in the titles used by the Partner States for veterinary professionals. These titles include: Veterinary surgeon, veterinary doctor and veterinarian. These are all essentially synonymous, however, Kenyan legislation utilises the word veterinarian to mean both veterinary surgeons and veterinary para-professionals. This use of terminology and titles will need to be resolved in future discussions between the Partner States. But for the purposes of this report, the term veterinarian in direct quotations from Partner States legislation and is used synonymously with qualified veterinary surgeon/doctor. Veterinary professionals and para-professionals collectively are referred to here as veterinary services professionals. This is in accordance with the definitions used by the OIE. 3.3 Related Legislation on Veterinary Practice in the EAC Partner States The definition and regulation of veterinary practice is, of course, only one part of the legislative context in which veterinary surgeons work in the EAC. There are many other legislative provisions that govern veterinary practice in its different forms and it is important to take note of these, in order to provide a true comparative position of how veterinary surgeons work in the region. The OIE has identified 7 additional categories of relevant legislation, outlined in the OIE Terrestrial Animal Health Code 2012, which affect veterinary practice. These are: The powers of competent authorities, laboratories in the veterinary domain, health provisions relating to animal production, animal diseases, veterinary medicines, the human food production chain, and import and export. Table 6 outlines the main legislative acts relating to each of these areas, where they can be identified in Partner States legislation. How the various Partner States laws deal with the powers of competent authorities will be dealt with in a later section of this report. Table 6: Wider Legislative Context for Veterinary Practice (i) Legislation relating to human health and animal production Partner State Burundi Kenya Rwanda Tanzania Legislative Act Loi N 1/28 du 24 décembre 2009 relative à la Police Sanitaire des Animaux Domestiques, Sauvages, Aquacoles et Abeilles 9 The Public Health Act (C.242), Dairy Industry Act (C 242), Pharmacy and Poisons Act (C 244); Food, Drugs and Chemical Substances Act, Chapter 254; Crops and Livestock Production Act (C 321); Dairy Industry Act (C 336); Fertilizers and Animal Foodstuffs Act (C 345); Pest Control Products Act (C 346); Meat Control Act (C 356); Cattle Cleansing Act (C 358); Kenya Meat Commission Act (C 363); Animal Diseases Act (C 364); Rabies Act (C 365); Fisheries Act (C 378); Narcotics Drugs and Psychotropic Substances (Control Act), 1994; Biosafety Act, Number 2 of 2009 Law N 38/2010 of 25/11/2010 establishing Rwanda Agriculture Board and determining its responsibilities, organization and functioning Animal Disease Act No 17, 2003, Tanzania Food Drugs and cosmetics Act No 1, 2003; Public Health Act No 1, 2009; Grazing Land and Animal Feed Resources No , Animal Resources Act No 11, 1999 Zanzibar, Zanzibar Food Drugs and Cosmetics Act No 2, 2006 Uganda The Public Health Act (C.281), Animal Breeding Act, 2001; Rabies Act, 1935; Animals (Straying) Act cap 40; Branding of Stock Act cap 41; Cattle Grazing Act cap 42; Animal Diseases Act 1965; 9 Law on Health Policy relating to domestic and wild animals, aquaculture and bees 23

24 (ii) Legislation relating to the Human Food Production Chain Partner State Burundi Kenya Rwanda Tanzania Uganda Legislative Act Loi N 1/28 du 24 Décembre 2009 relative à la Police Sanitaire des Animaux Domestiques, Sauvages, Aquacoles et Abeilles 1 (covers inspection at import and export of animals and animal products but a much more comprehensive legislative Act has been called for by the Burundi Veterinary Association (AVB)) Prevention of Cruelty to Animals Act (c. 360), Dairy Industry Act (c. 336) Fertilizers and Animal Foodstuffs Act (c. 345), Branding of Stock Act (c. 357), Customs and Excise Act (c. 472) Ministerial Order Nº 012/11.30 of 18/11/2010 on animal slaughtering, meat inspection; Ministerial Order N 013/11.30 of 18/11/2010 on transport and trade of meat; Law No 47/2012 du 14/01/2013 relating to the regulation and inspection of food and pharmaceutical products; Law No 33/2002 of 06/11/2002 on livestock Identification; Law No 25/2013 of 10/05/2013 determining the organization and functioning of bee-keeping in Rwanda; Ministerial Order Nº 009/11.30 of 18/11/2010 on stray cattle and other domestic animals; Ministerial Order Nº 011/11.30 of 18/11/2010 on the importation, marketing and distribution modalities of aquaculture and fisheries products, equipment and materials; Ministerial Decree No 001/06 on permit of livestock and livestock products Animal Welfare Act 2008, The Meat Industry Act, The Tanzania Dairy Industry Act 2004, The Hides, Skins and Leather Trade Act 2008 The Animals (Prevention of Cruelty) Act (c. 39), The Animals (Straying) Act (c. 40), The Branding of Stock Act (c. 41), The Cattle Traders Act (c. 43), The Cattle Grazing Act (c. 42), the Dairy Industry Act (c. 85), The Hide and Skin Trade Act (c. 89), The Animal Breeding Act (2001), The Public Health Act (c. 281), Meat Rules S.I (iii) Legislation relating to animal diseases, use and control of veterinary medicines Partner State Burundi Legislative Act Loi N 1/28 du 24 décembre 2009 relative à la Police Sanitaire des Animaux Domestiques, Sauvages, Aquacoles et Abeilles 1 but a Ministerial decree setting out further detail is pending Kenya The Animal Diseases Act (c. 364), Rabies Act (c. 365), Food, drugs and chemical Substances Act (c. 254), Pharmacy and Poisons Act (c. 244), Narcotics Drugs and Psychotropic Substances (Control Act) 1994, Pest Control Products Act (c. 346), Biosafety Act (2/2009) Rwanda Tanzania Uganda Law N 54/2008 of 10/09/2008 on prevention and fight against contagious diseases for domestic animals in Rwanda; Ministerial Order N 008/11.30 du 18/11/2010 determining the organization of veterinary pharmacy practice Food, drugs and cosmetics Act, 2003, Tropical Pesticides Research Institute Act No 18,1979,Veterinary Act, 2003 and Animal Diseases Act 2003 governing animal diseases control, Animal Resources Act No Zanzibar, Zanzibar Food Drugs and Cosmetics Act No The Animal Diseases Act (Amended) 2006; Rabies Act Cap 44; Food and Drug Act Cap 278; National Drug Authority and Policy Act (iv) Legislation relating to Laboratories in the Veterinary domain and powers of competent authorities (e.g. Inspection etc.) Partner State Burundi Kenya Rwanda Legislative Act No detailed legislation, but inspection is covered in outline in La Loi Portant Règlementation de l exercice de la profession vétérinaire 1 The Veterinary Surgeons and Veterinary Para-Professionals Act, 2011; Kenya Medical Laboratory Technicians and Technologists Act (C 253) None Tanzania Animal Disease Act No 17, 2003, Veterinary Act (16/2003) Uganda Animal Disease Act cap 38, Veterinary Surgeons Act cap Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

25 (v) Legislation relating to game and other wildlife Partner State Burundi Kenya Rwanda Legislative Act No detailed legislation but inspection is covered in outline in La Loi Portant Règlementation de l exercice de la profession vétérinaire 1 The Veterinary Surgeons and Veterinary Para-Professionals Act, 2011; Kenya Medical Laboratory Technicians and Technologists Act (C 253) None Tanzania Animal Disease Act No 17, 2003, Veterinary Act (16/2003) Uganda Animal Disease Act cap 38; Veterinary Surgeons Act cap 277 The importance of these various laws is as follows: Firstly, it illustrates that veterinary service professionals in most of the Partner States need to have knowledge of a wide range of legislative Acts and whilst these may cover broadly similar ground, they will differ in detail and the MRA framework needs to take this into account. Secondly, it illustrates that, as the EAC Common Market develops, there will be an increasing need for convergence in these laws. As regional agricultural and livestock trade further develops, issues such as health inspections, disease control and certification for export from the region, will all take on far greater significance. Aside from the role that an MRA for veterinary surgeons (and para-professionals) could play in the free movement of professionals, it also has a very important role to play in bringing together all of the veterinary regulatory bodies to advise the EAC Partner States collectively on how the legislative framework should develop at a regional level. Lastly, the level of completeness of each Partner State s legislative framework for veterinary practice varies significantly. There is therefore not only scope for all Partner States to continue improving their frameworks to meet OIE standards, but there is also scope for Partner States to assist each other, either through bilateral collaboration or through regional cooperation. 3.4 State of the Market for Veterinary Services Before looking at how veterinary services are regulated in the different Partner States, it is first worth looking at what we can tell about the overall supply and demand for veterinary services. We will first look at the situation in relation to veterinary surgeons before considering the role played by veterinary para-professionals in the market. Table 7(a), below, illustrates the heavy dependence of all the Partner States on agriculture as a contributor to national income and employment. Given the economic importance of agriculture and related activities, the number of veterinary surgeons practising in the region might be expected to be considerably greater. There does appear therefore to be an undersupply of veterinary surgeons in the region. Table 7a: Number of Veterinary Surgeons in East Africa Partner State Number of Veterinary Surgeons registered, 2013 Share of Agriculture in Country s GVA, % Share of Country s Employment in Agriculture, % Burundi Kenya Rwanda Tanzania Uganda TOTAL 3141 This possible undersupply is further evidenced in the data available from the OIE on the number of veterinary surgeons in public sector practice per 10,000 livestock standard units (LSU) as shown in table 7(b). 25

26 Table 7b: Comparative Evidence on Number of Public Sector Veterinary Surgeons per 10,000 Livestock Units in selected Countries in Africa Country Public Sector Veterinary Surgeons Public Sector Veterinary Surgeons/10,000 LSU 13 DRC Kenya Uganda Zambia What do Veterinary Professionals do in East Africa? From the evidence gathered from national focal points, it would appear that about 50% of all qualified veterinary professionals work for the government across all Partner States with 42% in private practice, 6% in parastatals and 1% in NGOs or unclassified. In each Partner State these shares vary, with a much higher proportion working in government in Rwanda (70%) and Tanzania (60%) compared to Kenya (40%). In fact Kenya is the only Partner State in which there are more veterinary professionals working in the private sector than working in government. On average, with the exception of Kenya, the private sector for professional veterinary services would appear to be smaller in the EAC than in many other comparable countries in Africa. In Mozambique, Mali and the Democratic Republic of Congo for example, the ratio of private sector veterinary surgeons to public sector veterinary surgeons is comparable to that of Kenya. In Cameroon and Zimbabwe, qualified veterinary surgeons working in the private sector outstrip those in the public sector by some considerable margin (1.27:1 in Cameroon and 4.23:1 in Zimbabwe) 14. It is interesting then to look at the number of veterinary para-professionals of different types that are registered in the different Partner States as this helps to provide a more complete picture of the availability of veterinary services in the region. 13 LSU: 250kg livestock standard unit, calculated on the basis of average weights of different species. 14 Source: OIE statistical database Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

27 Table 8: The Status of Veterinary Para-Professionals in East Africa 2013 Partner State Title of registered para-professional Name of competent authority Current number registered Ratio of regulated veterinary paraprofessionals to veterinary professionals Area of work Burundi Veterinary technician Ministry of Agriculture & Livestock % government, 27% parastatals, 21% private practice Kenya Veterinary technologist and veterinary technicians Kenya Veterinary Board 4829 (46 veterinary technologists veterinary technicians) 4 28% in government, 1.5% parastatals, 70.5% private practice/selfemployed or unemployed Rwanda None None - a registration scheme is under consideration (Estimated number registration not required = 2500) N/A 20% in government, 30% in illegal private practice, 10% with NGOs, 40% - unknown (although most of the time join illegal practices) Tanzania Veterinary paraprofessional and paraprofessional assistant Veterinary Council of Tanzania % government, 2% parastatals, 14% private practice Uganda None (The following titles exist but registration is not required: Assistant Animal Husbandry Officer, Animal Husbandry Officer, and Animal Production Officer) None - not required to register with the Uganda Veterinary Board N/A N/A Not known Total 7,731 Table 8 illustrates that the existence of veterinary para-professionals is important for most EAC countries but particularly for Burundi, where there are 13 veterinary para-professionals for every veterinary surgeon. In Kenya and Tanzania the ratio is very similar at roughly three to four veterinary para-professionals for every veterinary surgeon. On this evidence it would appear that veterinary para-professionals are in some cases filling the void left by the short supply of fully qualified veterinary surgeons. This particularly seems to be the case in the private sector How many new Veterinary Surgeons are coming on the Market each Year and from where? If there is an undersupply of veterinary surgeons in East Africa, where are the new veterinary professionals are coming from? Table 9 illustrates new registrations of veterinary surgeons in the different Partner States, including both home grown veterinary surgeons and foreign qualified veterinary professionals who have registered locally. 27

28 Table 9: New Registrations of Veterinary Surgeons Veterinary Surgeons Foreign qualified Veterinary Surgeons Foreign qualified Veterinary Surgeons Foreign qualified Burundi Kenya Rwanda Tanzania Uganda Total (NB. Foreign Qualified veterinary surgeons include both local citizens who have foreign qualifications and foreign nationals with foreign veterinary qualifications). Table 9 shows that Kenya has over the last few years produced the highest number of veterinary surgeons in the region. Burundi and Rwanda have traditionally had no home grown veterinary professionals, although this situation in now changing in Rwanda with the opening of a veterinary school at the University of Rwanda. Surprisingly, the number of registered foreign trained veterinary surgeons across the region is generally in single figures or low double figures. These low numbers of imported veterinary surgeons, despite the general under provision of veterinary services in the region, perhaps reflects the dominance of government veterinary services across East Africa. There is no single source for foreign trained or qualified veterinary surgeons who have been registered in the region. In recent years Tanzania has admitted veterinary surgeons from the UK, USA and South Africa and has also recognised veterinary degrees earned in Cuba and Russia. Most of Rwanda s foreign trained veterinary surgeons have graduated from EISMV in Senegal, the Université d Alger, Belgium and Russia. Burundi has admitted veterinary surgeons from Algeria, Rwanda and Uganda. One other interesting point to emerge from this table is the variability in the number of new veterinary surgeons registering over the last few years The Supply of Veterinary Para-Professionals Qualified professional veterinary surgeons may be at the apex of the system but they represent only a small part of the overall veterinary related activity being undertaken in the region. Table 10, below, further reinforces that veterinary para-professionals play an essential part in the provision of veterinary services across the region. This table also shows that the registration or enrolment of veterinary para-professionals of different types with the relevant competent authorities is relatively recent. In the case of Burundi and Tanzania, 30-40% of all veterinary para-professionals have been registered for three years or less. In Kenya, the legislation requiring registration by different types of veterinary para-professional was only enacted in Neither Rwanda nor Uganda currently require registration of veterinary para-professionals. 15 The 2013 graduation numbers include two cohorts: 75 from 2012 and 70 from 2013 who graduated together in Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

29 Table 10: New Registrations of Veterinary Para-Professionals Partner State Newly registering Practitioners Burundi Veterinary technicians Kenya Veterinary technicians 3, No registration No registration Tanzania Veterinary para-professionals Tanzania Veterinary para-professional assistants Tanzania Meat inspectors Tanzania Veterinary laboratory technicians Tanzania Foreign qualified veterinary para-professionals 0 2 (South Africa) 0 It is also evident from this table that there are various levels of veterinary para-professional practice in the different Partner States. In Tanzania, both para-professionals and para-professional assistants are registered each year in greater numbers than veterinary surgeons. In the case of Burundi, in addition to veterinary technicians a further group exists, known as Agents Communautaires en Santé Animale (ACSA) or Community Animal Heath Agents. These individuals are responsible for animal health in their areas. They are trained by veterinary technicians and although they have limited knowledge in veterinary medicine, their role in animal health in their communities is very important. Overall, given the current availability of veterinary services within the EAC, one of the key objectives of the Mutual Recognition Agreement on Veterinary Services should be to encourage improvements in both the quantity and quality of available veterinary service suppliers. 3.5 The Education and Training of Veterinary Professionals Recognised Bachelor of Veterinary Medicine Courses in East Africa Most veterinary surgeons in the East African Community are educated and trained within the region, even though historically, there have been very few local institutions providing undergraduate degree level qualifications in veterinary medicine. Table 11 below, sets out the recognized universities providing such courses and their entry requirements. Table 11: Admission to Study Veterinary Medicine in East Africa Partner State Institution Entry Requirements Kenya University of Nairobi Egerton University (Awaiting final approval from Kenya Veterinary Board) University admission requirement of Kenya Certificate of Secondary Education (KCSE) with a requirement of at least C+ (12 years) or at least a credit pass in Diploma in Animal Health (no credit transfer). University admission requirement of KCSE (12 years). In addition applicants for the Bachelor of Veterinary Medicine &Surgery (BVM&S) must have at least C+ grade in the following subjects drawn from the KCSE (Kenya Certificate of Secondary Education): Biology, Chemistry, Mathematics/Physics and English. Hold A-level or its equivalent with two principals and one subsidiary pass, one of which must be in biology and others from chemistry, physics and mathematics. Or Hold a Diploma in Animal Health, Animal Husbandry, Wildlife Management, Range Management and related disciplines from recognized institutions subject to Senate approval. Hold a degree in Biological Sciences from institutions recognized by Egerton University senate. 16 Registration of this category of para-professional only began in

30 Partner State Institution Entry Requirements Rwanda University of Rwanda Advanced General Certificate of Secondary Education (12 years). Applicants for the BVM offered by the University of Rwanda must have two (2) Principal passes with at least twenty four (24) points in specified courses relevant to the programs applied for. In addition, all applicants must have: Tanzania Uganda Sokoine University of Agriculture Makerere University a) A pass in General Paper b) An English language proficiency test certificate Tanzania Advanced Certificate of Education (CSE) (13 years) or Dip. Animal Health (No credit transfer). Specific Entry Requirements: Principal level passes in Chemistry, Physics, Biology/ Botany/Zoology, Advanced Level Mathematics/Geography/Science and Practice in Agriculture in the Advanced Certificate of Secondary Education or its equivalent. Of these, Chemistry is mandatory and must be passed at principal level. Candidates without a Principal level pass in Advanced Level Mathematics should have passed Basic Applied Mathematics at the subsidiary level OR Diploma/Certificate in the fields of Physical, Chemical or Biological sciences. Uganda Advanced Certificate of Education (13 years) (or its equivalent) with principal passes in Physics, Biology and Chemistry obtained at the same sitting. Dip. Animal Health -Transfer of credit possible. Table 11 shows that all of those institutions which have been accredited to offer Bachelor of Veterinary Medicine degrees in the region, or its equivalent, have similar entry requirements. This is perhaps to be expected given the background work that has been undertaken at an EAC level to harmonise education systems and training curricula. Table 12: Numbers Graduating in Veterinary Medicine Partner State Institution Kenya University of Nairobi Rwanda University of Rwanda Tanzania Sokoine University of Agriculture Uganda Makerere University TOTAL It is worth noting that there has been a recent expansion in the number of available university places for the study of veterinary medicine in East Africa: The University of Rwanda has been offering a veterinary medicine course since 2009 and a second institution in Kenya, Egerton University, has been approved as a body awarding the degree of Bachelor of Veterinary Medicine and Surgery from One question which arises from a comparison of the numbers in tables 9 and 12 is why there is a difference between the number of veterinary medicine graduates in the region and the number registering as veterinary surgeons. It is possible that one reason for this could be that graduates have decided to pursue alternative careers given cutbacks in public sector employment for veterinary surgeons. Most of the region s universities also offer Masters and PhD level courses in veterinary science. In Kenya, holders of higher degrees in veterinary science may obtain recognition from the KVB as veterinary specialists following a defined process for obtaining such recognition. 30 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

31 3.5.2 Accreditation of Academic Qualifications in Veterinary Medicine Table 13 sets out a summary of the key aspects of the accreditation process in all of the Partner States. In Kenya, Tanzania and Uganda, recognition of degree courses for the purpose of admission as a veterinary surgeon is a function undertaken by the relevant Veterinary Statutory Body (VSB). However, in all three cases there is also a Universities Act which sets out the framework within which degree courses are accredited and the standards they must reach to be classified as such. However, the university accrediting bodies across the region work closely with the VSBs to ensure that any approved courses for veterinary surgeons meet the generally required standards for a university level education as well as the specific requirements of the VSBs. In the case of Rwanda, recognition of degree courses is undertaken by the National Council of Higher Education (NHCE). The NCHE follows a similar process to other EAC Partner States when accrediting new institutions (documented at but for specific courses will appoint an expert committee to provide advice on the application. The five members of the expert committee are selected from amongst the Rectors, Vice Rectors Academic or other senior staff of higher education institutions and may in addition include one Rector/Vice Rector/senior academic from an institution of higher education outside of Rwanda. The expert committee scrutinizes the application and takes whatever expert advice it considers necessary in coming to agreement as to the advice it will provide the Minister of Education. The expert committee provides written advice to the Minister on the merits of the application together with a recommendation as to whether provisional recognition should be given or not. If the recommendation is to reject the application, the committee may also indicate if a revised application should be encouraged. In the case of the approval of the BVM course offered by the University of Rwanda, the newly established Rwandan Veterinary Council was one of a number of stakeholders involved. This process of recognition differs slightly from the process in Kenya, Tanzania and Uganda where recognition of the courses offered for BVM qualifications is effectively a two stage process with the VSBs having the final say. In the case of Burundi, as there is no local University offering the BVM, it falls to the Ministry of Education to recognise appropriate foreign degree courses. Ministerial Orders recognising BVM or equivalent degrees awarded by foreign universities include the Bauman Kazan State Academy of Veterinary Science in Russia, which is a course of 5 years duration also recognised by the American Veterinary Medical Association (AVMA). Although the VSBs in Rwanda and Burundi have, to varying degrees, less direct control over the recognition of BVM degrees, they do require all applicants for admission as veterinary surgeons to undergo an interview and therefore are not simply accepting all of those holders of the BVM degree automatically. Arguably their quality control mechanisms are exercised at a later stage in the qualification process. However, in order to bring their accreditation procedures into line with the best practice outlined by the OIE, it is recommended that both Partner States give their VSBs a much greater role in future in the process of accrediting academic qualifications. Table 14 then sets out the accreditation process for approving new veterinary para-professional courses that may lead to registration with the VSB. This is only relevant in the cases of Kenya and Tanzania. Burundi does recognise veterinary para-professional courses for licensing but the licences are awarded by the Ministry of Agriculture and not by the Ordre National des Médecins Vétérinaires du Burundi (ONMVB). There are also many other para-professional courses in veterinary subjects, listed in table 16, but these qualifications do not necessarily confer any right to deliver regulated services. 31

32 Table 13: The Process for Accrediting Academic Institutions for Recognition by Competent Authorities Partner State Does the competent authority maintain a list of accredited academic institutions? What is the procedure for adding new institutions? What are the criteria for approval? How often are approved courses reappraised or monitored for standards/ performance? Burundi No approved institutions and courses are set out in Ordonnance Ministérielle 1 610/2737 of 2011 Applications are made by institution to the Ministry of Higher Education and Research Unknown Unknown Kenya Yes Institutions apply to KVB for recognition of degree courses following approval of institution by the Commission of University Education (CUE). The process includes: Self-assessment forms Presentation of curriculum Payment of requisite fees Inspection Rwanda Yes Application to Ministry of Education National Council for Higher Education (NCHE) forms expert committee Audit of proposed institutions/ courses undertaken Approval by both the Rwanda Council of Veterinary Doctors and Cabinet Tanzania Yes Application to Commission of Universities and Veterinary Council of Tanzania New institutions must supply a strategic plan, curricula, human and financial resources. They must also undergo a verification visit Uganda Yes Application to Uganda National Council for Higher Education UNCHE) and the Uganda Veterinary Board (UVB) Physical inspection by UNCHE & UVB. Paper work critical review Interface with promoters Satisfactory completion of checklist of requirements Satisfactory report from expert committee based on University approval criteria. Course contents, contact hours, staff qualifications, training facilities, other related infrastructures, farm units, institution governance, etc. Land, structures etc. Viability of programme curriculum, admission requirements, examination, regulations & awards. Governance structure Financing, Adequate qualified staffing, educational facilities etc. Formally every 5 years but monitoring is both ad hoc and continuous NCHE carries out an audit report annually. Curricula are reviewed every 3-5 years Nb. Since the establishment of the Rwanda Council of Veterinary Doctors the accreditation functions of NCHE will in future be shared. Five years for accreditation, periodic monitoring through auditing. Statutory Instrument 2005 No 85 Quality Assurance Framework Annual report Every 3 years self evaluation External Audit UNCHE analyse all reports & gives instructions 32 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

33 Table 14: Accreditation Process for Tertiary Level Courses for Recognition of Veterinary Para-Professional Qualifications Partner State Does the competent authority maintain a list of accredited academic institutions for veterinary paraprofessional courses? What is the procedure for adding new institutions accredited to offer veterinary para-professional courses? What are the criteria for approval? How often are approved courses reappraised or monitored for standards/ performance? Kenya Yes Institution completes selfassessment forms and presents curriculum Pays requisite fees Undergoes inspection Tanzania Yes Recognition by Minister on recommendation of VCT Completion of satisfactory checklist Course contents, contact hours, staff qualifications, training facilities, other related infrastructures, farm units, institution governance, etc. Every 5 years but monitoring is continuous and ad hoc Course Standards and Curricula Tables 15(a) and (b) compare the broad contents of the BVM courses undertaken at universities within the region. It sets out duration and detail on credit and contact hours, and core courses where known. Further information about the curricula at these different universities is set out in the annexes to this report. It is worth noting that the Partner States are working towards harmonising higher education through the creation of a credit transfer system and a qualifications model. The proposed new qualifications system would lead to harmonisation of courses offered across universities in the region. Preparatory studies have found that while most courses are almost identical in name and general content, they differ in areas such as duration and qualifications considerations such as numbers of credit hours. The new qualification and credit transfer systems, which have not yet been finally agreed, would allow students to start a degree course, for instance, at the University of Burundi and finish it at Nairobi University. This general view of the situation in East Africa is echoed at the sectoral level in veterinary sciences. Whilst all of the recognised BVM and BVM&S courses have a duration of 5 years and contain courses with similar names, as table 15(a) illustrates, there are significant differences across the region in the number of underlying contact hours and credits obtained for these courses. 33

34 Table 15a: Academic Standards for Recognised Veterinary Degrees in the Partner States Partner State/ Institution Duration Contact Hours and Credits Methods of Delivery Form of Testing Pass Mark Kenya - Egerton University 5 years Not available Lectures, practical work, clinics, attachments, project Written, practical, clinical, oral 50% Kenya - University of Nairobi 5 years 5,040 Contact hours (336 Credit units) in curriculum Lectures, practical work, clinical, attachments, project, internship Written, practical, clinical, oral, 50% Rwanda - University of Rwanda 5 years 4,800 Contact hours (480 Credit units) Lectures, practical work, clinics, attachments Written, practical, dissertation, oral, clinical 50% Tanzania - Sokoine University 5 years 5,400 Contact hours (340 Credit units) Lectures, practical work, clinics, attachments, project Written, practical, clinical, oral 50% Uganda - Makerere University 5 years 3,600 Contact hours (240 Credit units) Lectures, practical work, clinics, attachments, project Written, practical, oral 50% Table 15b: Academic Standards for Recognised Veterinary Degrees in the Partner States Partner State Institution Core Curriculum Notes Kenya University of Nairobi and Egerton University Animal Genetics and Breeding, Animal Nutrition, Animal Physiology, Gross Anatomy, Histology and Embryology, Immunology, Large Animal Medicine, Large Animal Surgery, Livestock Economics, Livestock Production Systems, Microbiology, Parasitology, Pathology, Pharmacology, Physiology, Public Health, Small Animal Medicine, Small Animal Surgery, Toxicology, Vertebrate Anatomy, Veterinary Andrology, Veterinary Epidemiology, Veterinary Gynaecology and Obstetrics OIE compliant (This is the minimum curriculum set by the KVB, universities may add additional courses) Rwanda University of Rwanda Veterinary Anatomy, Biochemistry, Veterinary Histology and Embryology, Veterinary Physiology, Veterinary Pharmacology and Therapeutics, Toxicology, Veterinary Microbiology and Immunology, Veterinary Parasitology, Veterinary Reproduction, Animal Production, Medicine, Surgery, Veterinary Ethics and Jurisprudence, Entrepreneurship, Ambulatory Clinics OIE compliant Tanzania Sokoine University of Agriculture Veterinary Gross Anatomy, Animal Physiology, Biochemistry, Cell Biology, Developmental Anatomy, Histology, Introduction to Animal Health, Management and Ethology, Computer Application, Introductory Statistics, Microbiology, Parasitology, Introductory to Animal Genetics, Animal Nutrition, Biometry, Principles in Animal Breeding, Molecular Biology, Pharmacology and Toxicology Veterinary Pathology, Anaesthesiology and Principles of Surgery, Production Animal Medicine, Epidemiology, Introduction to Ecology and Wildlife Management, Animal Production, Imaging Techniques, Diagnostic and Special Surgery, Draught Animal Management and non-conventional Animal Farming, Avian Medicine, Small Animal Surgery, Theriogenology, Clinical Pathology, Extension Methods, Research Projects, Large Animal Surgery, Companion Animal Surgery, Veterinary Public Health, Veterinary Economics, Clinical Surgery, Clinical Theriogenology, Veterinary Jurisprudence, Animal Welfare and Veterinary Practice. Clinical Medicine, Herd Health Management, Wildlife Health and Fish Medicine OIE compliant 34 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

35 Partner State Institution Core Curriculum Notes Uganda Makerere University Animal Management, Animal Nutrition, Aquaculture, Art and Practice of Medicine, Biochemistry, Biostatistics and Research Methods, Communication Skills, Computer Training, Embryology, Epidemiology, Genetics and Breeding, Gross Anatomy, Histology, Immunology, Livestock Production Systems, Microbiology, Parasitology, Pathology: General, Systemic, Clinical/Diagnostic Pharmacology, Physiology, Practical Years and Practice Attachment, Preventive Medicine, Public Health, Sociology, Special Medicines/ Species-specific: (Ruminants, Equine, Swine, Poultry, Canine and Feline, Laboratory Animal), Special Project, Surgery, Therapeutics, Theriogenology, Toxicology, Veterinary Extension and Project Planning, Veterinary Human Resource Management, Communication Skills, Computer Training, Special Project, Practical Years and Practice Attachment, Veterinary Medicine, Wildlife Diseases and Management, Zoo Medicine OIE compliant Naturally, the degree courses differ in their contents but it may be interesting for the EAC to look at the approach taken in the European Union with regard to the content of veterinary degrees. This will be explained in more detail in Part III of this report but in brief, the Member States of the European Union have agreed upon the basic minimum criteria that any degree course must cover, these are listed in annex 3. It is perhaps also worth noting both the OIE model core educational curriculum for veterinary surgeons and the day one competences which have been defined for a newly qualified veterinary practitioner. These are set out at annex 4. These may prove useful as greater consideration is given to the overall shape of an EAC MRA for veterinary services. A number of the Partner States also recognize specific qualifications for veterinary para-professionals and these are outlined in table 16 below. These qualifications are recognized for registration purposes but there may be other courses available elsewhere that offer similar material but which do not lead to recognition. Over time there may be scope for greater mutual recognition of these courses by Partner States, not least in order to grow the supply of qualified veterinary para-professionals across the region, and perhaps also to encourage the development of centres of excellence for different areas of veterinary para-professional practice. 35

36 Table 16: Recognised Courses for Veterinary Para-Professionals Partner State Does passing this Course Permit Registration with the VSB? If so, as what? Academic Awarding Body Title of Academic Qualification Course Duration Burundi No but registration with Ministry of Agriculture as a Veterinary Technician possible ITAB Karusi, ITAB Kigozi, ITAB Mahwa and ITAB Gisozi Veterinary Technician 2 years for Certificate, 4 years for Diploma Kenya Yes as a Veterinary Technician Animal Health and Industry Training Institute (AHITI) Ndomba, Kerugoya Animal Health and Industry Training Institute (AHITI) Kabete Animal Health and Industry Training Institute (AHITI) Nyahururu Chuka University Chuka Baraton College of Animal Health & Production Kapsabet Kenya YMCA College of Agriculture & Technology Limuru Mt. Kenya University (Nakuru campus) Nakuru Certificate in Animal Health 2 years Yes as a Veterinary Technologist University of Nairobi Mt. Kenya University (Thika Campus) Thika Mt. Kenya University (Nakuru campus) Nakuru Egerton University, Njoro Chuka University Chuka YMCA College of Agriculture & Technology Limuru Baraton College of Animal Health & Production Kapsabet Diploma in Animal Health 3 years Yes as a Veterinary Technologist Egerton University, Njoro Jomo Kenyatta University of Agriculture & Technology (JKUAT) Juja BSc. in Animal Health 4 years Yes as an Artificial Inseminator Animal Health and Industry Training Institute (AHITI) Kabete Animal Health and Industry Training Institute (AHITI) Ndomba Kerugoya Egerton University, Njoro Mt. Kenya University (Thika Campus) Thika Certificate in Artificial Insemination 2 years Yes as a Veterinary Technician Animal Health and Industry Training Institute (AHITI) Kabete Upgrading Certificate Course in Animal Health 1 year Rwanda No National Council for Technical Education Diploma in Animal Health and Production No National Council for Technical Education Diploma in Animal Health and Production No National Council for Technical Education Diploma in Meat Inspection or Diploma Animal Health and Production No National Council for Technical Education Diploma in Veterinary Laboratory Technics 3 years 3 years 3 years 3 years 36 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

37 Partner State Does passing this Course Permit Registration with the VSB? If so, as what? Academic Awarding Body Title of Academic Qualification Course Duration Tanzania Yes as a Veterinary Para-professional Livestock Institutes Training Agency (8) Sokoine University of Agriculture Diploma in Animal Health and Production 2 years Yes as a Veterinary Para-professional Assistant Visele (Livestock Institutes Training Agency private) Kaole (private) Certificate in Animal Health and Production 2 years Yes as a Veterinary Laboratory Technician Temeke Livestock Institute Training Agency Diploma/Certificate Veterinary Laboratory Technician 2 years Uganda No Busitenma University, Uganda Martyrs (Mbuye Rural Farm School,) Bukalasa Agricultural College, Ankole Western Institute of Science and Technology, Ssese Farm School, Kayunga Centenary College, Kyera Agrovet College, Mityana Agrovet College, Mityana School of Livestock Husbandry UBTEB Diploma and Certificate in Animal Husbandry 3 years (Diploma) 2 years (Certificate) No Makerere University Bachelor of Animal Production Technology Management 4 years 37

38 3.6 An Overview of the current State of Regulation of Veterinary Services Who regulates Veterinary Professionals and what is the Scope of their Powers? The governing legislation in each of the Partner States sets out, to a greater or lesser extent, the delegation of powers to a statutorily created body for the regulation of the veterinary professions. These authorities and their powers are set out in table 17. Table 17: Powers of the Competent Authority Partner State Burundi Competent Authority Ministry of Agriculture and Livestock Powers Registers and licenses veterinary practitioners, veterinary para-professionals and facilities Kenya Rwanda Tanzania Uganda Ordre National Des Médecins Vétérinaires du Burundi (ONMVB) Kenya Veterinary Board (KVB) Ordre des Médecins Vétérinaires au Rwanda (Rwanda Council of Veterinary Doctors) Veterinary Council of Tanzania (VCT) Uganda Veterinary Board Upholds professional competence and standards Maintains independence of profession practice Handles disputes and conflicts between members or between a member and client Advises government on veterinary matters Fixes fees for services provided by veterinary professionals Advises government, prescribes training and qualifications, approves training institutions for veterinary professionals and veterinary para-veterinary professionals, registers and inspects facilities (clinics, laboratories etc.), formulates code of conduct, registers and regulates profession, collaborates nationally and internationally on professional matters, manages animal welfare and use of technology in breeding Controls entry of persons into the profession; Sets professional conditions for practice and decides on applications for the practice of the profession; Ensures that all members comply with the rules, standards and codes of ethics of the veterinary profession; Is responsible for the honour and dignity of the veterinary profession; Protects and promotes the interest of the veterinary profession; Resolves conflicts and settles disputes that might arise between a member and his/her client; Monitors and exercises discipline over members; Participates in the development of curricula and teaching programmes for veterinary doctors, veterinary technicians and other animal husbandry experts; Trains members; Intervenes in cases requiring the expertise of veterinary doctors; Cooperates with regional and international councils Registers and regulates professional practice, advises government, prescribes training and qualifications, conducts examinations, approves training institutions for veterinary professionals and para-veterinary professionals, sets minimum standards for veterinary facilities (clinics, laboratories etc.), monitors practice and exercises disciplinary control, promotes educational advancement, collaborates with professional association, advises on use of veterinary pharmaceutical, drugs and poisons, other functions as required The Board registers and regulates professional practice The key regulatory tasks which underpin any MRA are recognition of educational courses leading to qualification (as described in the previous section), registration of professionals, the maintenance of standards of practice and disciplinary arrangements. The following sections set out a summary of how the relevant authorities in each Partner State deal with these functions Registration Policies and Procedures Table 18(a), sets out the conditions, as specified in Partner State laws or bylaws, which are required of any individual who wishes to register as a veterinary surgeon. This shows that although all Partner States share the common requirement for a degree course, further requirements vary significantly. Kenya has the most stringent requirements, including an internship, examination and membership of the professional association. However, Kenya is also the only Partner State to have a nationality requirement for its veterinary practitioners. Nonetheless this should not be an impediment to the movement of EAC professionals since the Constitution of Kenya states that international agreements 38 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

39 or Treaties to which Kenya is a party will be recognised in Kenyan law. Kenya also only requires that citizens must be members of the KVA before they can be registered. Non-citizens do not have to be members of the KVA. Table 18(b) then sets out how the Professional Regulatory Authorities deal with registration, which will be relevant to the negotiation of any MRA. The following points are worth noting: Kenya, Tanzania and Uganda do not have deadlines for responding to requests for registration. Burundi and Rwanda both have 3 month deadlines for registration with provision to extend the length of time for consideration, if further verification is required. The Tanzanian legislation requires any application to be submitted to the Tanzanian Veterinary Council for approval and it is only after this that the Registrar may issue a licence. This means that the registration of individual applicants will be subject to the meeting cycle of the VCT. The Kenyan legislation does not specify any time limits for the processing of applications for registration but does require that applicants have first registered with the professional association. These provisions should be set alongside the expectation contained in Article 8 of the Draft Annex on EAC MRAs (see annex 2) that registration of an EAC national as a professional in another Partner State should be completed within 45 days. Table 18a: Registration Requirements for Veterinary Surgeons in the EAC Partner State Citizenship required? Degree from recognised University Internship Pre-Approval from Veterinary Professional Association required? Examination Other requirement? Fee Burundi No - but for foreigners residency and work permit required and reciprocal rights. Must speak Kirundi or French Yes - BVM or equivalent from recognised university No No Interview with ONMVB required but no exam Clean Police record 100,000 BF (US$65} US$100 for foreigners Kenya Yes - but foreign veterinary professionals from countries with agreements with Kenya are permitted to register Yes - BVM or equivalent from recognised university Yes, 12 month internship will apply from 31 December 2014 Yes prior to registering with KVB At KVB discretion for citizens (e.g. for those registering 5 years after graduation or with qualifications from universities other than those recognised by KVB); Foreigners must sit exam Oath for new graduates 20 CPD points per year for retention of registered members 4,000 KSH (US$45) US$1,000 for foreigners (temporary only) Rwanda Yes - foreign veterinary professionals from countries with bilateral agreements with Rwanda are permitted to register but must have home registration Yes BVM or equivalent from recognised university 1 year No Entry interview required with Council but no exam Must not have a disciplinary record from any other veterinary statutory body 30,000 RF for citizens (US$43) 100,000 RF for foreigners (US$145) Conclusions and Key Recommendations 39

40 Partner State Citizenship required? Degree from recognised University Internship Pre-Approval from Veterinary Professional Association required? Examination Other requirement? Fee Tanzania No - temporary registration of foreigners possible under S.21 of Veterinary Act Yes - BVM from recognised university Internship is being incorporate in updated regulations. Possible start from No Yes for non-citizens and foreign trained citizens (including EAC) Fit to practice 30,000 TSH for citizens (US$18) Foreigners up to US$300 Uganda No Yes BVM from recognised university Law provides for UVB to require internship but not currently required. No Only if the degree is from a university not recognised by the UVB Foreigners must be registered in home country and must have a letter of good standing from their home registration authority. 80,000 UGX for citizens (US$30) US$150 for foreigners (incl. EAC citizens) Table 18b: Registration Process for Veterinary Surgeons in the EAC Partner State What Documentation is required with Application for a Veterinary Licence? Are these required in a specific Form? Who approves or rejects Applicant? Is prior Approval required by any other Bodies? Is there a Time Limit for Approval If an Application is refused, is there a formal Process and Appeal Procedure? Burundi BVM or equivalent degree; No police record; Evidence of identity; Curriculum Vitae Payment of fee Certified copy Ministry of Higher Education and Research The Council of ONMVB Within 3 months of being lodged Yes Kenya Evidence of identity and citizenship, BVM or BVM&S degree, Evidence of association membership, Signed oath Payment of fee Original & notarised or issued by Registrar of KVB KVB No None Yes Rwanda Letter of application; Identity documents; Certified versions of educational documentation, Proof of good conduct (obtained from the Ministry of Justice), Registration certificate, Proof of interview by the Board, Proof of payment of fee Notarised copies of original documents. Board Yes - national board approval (foreigner) Within 30 days Yes to General Assembly of Council; then to Minister in charge of vet services Court 40 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

41 Partner State What Documentation is required with Application for a Veterinary Licence? Are these required in a specific Form? Who approves or rejects Applicant? Is prior Approval required by any other Bodies? Is there a Time Limit for Approval If an Application is refused, is there a formal Process and Appeal Procedure? Tanzania Application form containing personal details, certified copy of professional award from a recognized institution, fee payment receipt, photograph. For foreigners: Registration certificate from home country board, letter of good standing from home board and evidence of passing registration exam. Foreign applicants must attach relevant documents from prospective employer. Yes, Copies must be notarised VCT after which Registrar issues licence No for local applicant. Yes for foreigners from their respective boards. Within 30 days but 3 month extension possible Refusal must be notified in writing and subject to appeal to the Minister Uganda Valid ID Academic Certificate Application Form Sworn Affidavit ID Original & certified copy Certified & notarised copies Registrar and ratified by Board No No Yes appeal to High Court Registration of Para-Professionals Given that veterinary para-professionals are currently registered by the VSBs in only two of the five Partner States (and by the Ministry of Agriculture in Burundi), there is little specifically contained in the various legislative Acts governing the requirements and procedures for registration. The information available is summarised in tables 19(a) and 9(b) The following are the most pertinent points: In Kenya, veterinary para-professionals must fulfil very similar general registration conditions to those required of veterinary surgeons. A veterinary para-professional must be a citizen of Kenya, who has either completed a two year post-secondary school training course in animal health at an approved institution, followed by a 12 month internship; or has completed a one year course in animal health (for those who have a certificate in Animal Husbandry, Range Management or Wildlife Management) and served a 12 month internship of a registered veterinary surgeon. In addition they must be a member of a registered association representing the interests of veterinary para-professionals and swear a prescribed oath. In Tanzania, individuals with qualifications in animal health may enrol with the Council to practice as a para-professional and the Act permits the Minister, on the recommendation of the Council, to specify other certificates or qualifications that are recognised and linked to registration under the Act. 41

42 Table 19a: Registration Requirements for Veterinary Para-Professionals in the EAC Partner State Citizenship required? Entry Qualification Internship Membership of Para- Professional Association required? Examination Other Requirement? Fee Kenya Yes Post-secondary school training for at least 2 years (Two registers exist: One for veterinary technologists and one for veterinary technicians) 12 months Yes At the discretion of the KVB Oath 2,000 KSH (US$22) Tanzania Yes For Veterinary Para- Professionals: Two year diploma in animal health and production from a recognised institute No No No No 30,000 TSH (US$18) For veterinary paraprofessional assistants: Two year certificate in animal health and production from a recognised institute Meat inspectors and veterinary laboratory technicians: licences granted on submission of certificates 42 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

43 Table 19b: Registration Process for Veterinary Para-Professionals in the EAC with VSBs Partner State What Documentation is required with Application for a Veterinary Para-Professional Licence? Are these required in a specific Form? Who approves or rejects Applicant? Is prior Approval required by any other Bodies? Is there a Time Limit for Approval If an Application is refused, is there a formal Process and appeal Procedure? Kenya KVB Registration Certificate; Confirmation from a KVBregistered Vet Surgeon that he/she will supervise the Para-professional; Physical details of the practice office There is a form to be filled which captures all the details requires Registrar of KVB No 2 weeks but flexible Yes, as permitted by the laws of Kenya Tanzania (Para- Professionals) Application form containing personal details, certified copy of professional award from a recognized institution, receipt for payment of fee, photograph For foreigners: registration certificate from home country board, letter of good standing from home board and evidence of passing registration exam Yes, copies must be notarised VCT after which Registrar issues licence No for local applicant. Foreigners must be in good standing with their respective boards Within 30 days but 3 month extension possible Refusal must be notified in writing and subject to appeal to the Minister Tanzania (Para- Professional Assistants) Application form which contain personal details, certified copy of certificate in animal health and production award from recognized training institution, fee payment receipt, photograph Yes, copies must be notarised VCT after which Registrar issues licence No Within 30 days but 3 month extension possible Refusal must be notified in writing and subject to appeal to the Minister Registration of Facilities The requirement for facilities to be registered in the EAC varies significantly between Partner States. The situation is summarised in table 20, below. It is worth emphasising that: In Rwanda, the registration of facilities is still being worked out. Uganda registers veterinary clinics under internal guidelines after inspection by the UVB and payment of inspection and registration fees. In Tanzania, the Act provides that registration of facilities are required and that these must be run by registered Veterinary professionals. Facilities must be inspected prior to registration and this registration can be removed, however biosafety levels are still being worked out. 43

44 In Kenya, the Act also provides for the inspection and licensing of veterinary ambulatory services, clinics, hospitals and laboratories. So far 90 practices have been registered as the legislation is still being rolled out. In Burundi, the law on the profession sets out the establishments that the Competent Authority needs to register. Currently there are two registered establishments with designated biosafety levels. Table 20: Registration of Facilities Partner State Kind of Practice Number registered Bio Safety Level Comments Burundi Veterinary Laboratory 1 2 A government facility - no private practices are registered Burundi Veterinary Clinic 1 1 A government facility - no private practices are registered Kenya Kenya Kenya Kenya Veterinary Practice Licenses Veterinary Practice Licenses - Para- Professionals Veterinary Hospitals Veterinary Laboratories 90 N/A Legislation is new and is being rolled out 85 N/A Legislation is new and is being rolled out Nil N/A Legislation is new and is being rolled out Nil N/A Legislation is new and is being rolled out Rwanda N/A Nil N/A An administrative structure of the Rwanda Council of Veterinary Doctors is being set up which will register all matters related to veterinary profession Tanzania Uganda Veterinary Hospitals/ Clinics/Centres/ Ambulatory Services/ Quarantine Facilities Veterinary Clinics 300 N/A Laboratory biosafety levels need to be worked out 3 N/A Private small animal clinics Table 21: Licensing of Veterinary Premises Partner State What Documentation is required with Application for a Practice Licence? Are these required in a specific Form? (e.g. Originals, notarised Copies etc) Who approves or rejects Applicant? (e.g. Registrar or Board/Council?) Is prior Approval required by any other Bodies? (e.g Association) Is there a Time Limit for Approval If an Application is refused, is there a formal Process and appeal Procedure? Burundi N/A N/A N/A N/A N/A N/A Kenya Registration ID Inspection fee receipt Inspection report Yes Board No None Yes Rwanda N/A N/A N/A N/A N/A N/A Tanzania Does not license veterinary practices N/A N/A N/A N/A N/A Uganda Valid ID. Registration Certificate Application ID Original & copy Certified copies Registrar & ratified by Board No No Yes appeal to High Court 44 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

45 3.6.5 Registration of Foreign Veterinary Professionals All of the Partner States allow for the possibility that foreign qualified veterinary surgeons might be admitted to practice and the various conditions that they impose on such individuals are set out below in table 22. Table 22: Registration of Veterinary Surgeons with Foreign Licences Partner State Burundi Kenya (Kenya Veterinary Board) Rwanda Tanzania Uganda Rules covering Registration of foreign qualified Veterinary Professionals Foreign veterinary professionals may apply for registration but must fulfil the following conditions before they can be entered on the register: Be resident in Burundi Have obtained a work permit before arrival in Burundi Reciprocal rights of practice exist in applicant s home country Submission of required documents Pass an interview with the Conseil de l Ordre National des Médecins vétérinaires du Burundi 18 Speak at least one of the official languages of the Republic of Burundi (Kirundi, French). Foreign veterinary surgeons may apply for temporary registration under the Act provided it is as a volunteer for a non-profit organization recognized by the Board, providing veterinary services in underserved areas. Applicant must be in good standing with home professional regulator and may be asked for an oral or written examination. A foreign vet may register with the RVC provided that he/she fulfils the following conditions: Holds the required degree, is a member of the Veterinary council in the country where they used to practice, is a national of a country with a bilateral agreement which would allow a Rwandan national to practice there as a veterinary doctor. Foreign qualified veterinary professionals are required to pass an examination prior to full registration with VCT. There is also provision for granting temporary registration for foreign veterinary professionals engaged in research, training, consultancy and volunteer works. The Act allows the Board to recognise veterinary officers or assistant veterinary officers in the service of the East African Community or other university college in the Partner States. In Burundi, Rwanda and Tanzania foreign qualified veterinary professionals may be admitted following required national procedures; in Uganda and Kenya the circumstance in which such veterinary professionals can be admitted is considerably more circumscribed. In Kenya, foreign veterinary professionals may only be admitted to practice on a basis and emphasis is laid on expertise and knowledge transfer. Foreign veterinary professionals must bring in expertise that cannot be found in Kenya and they should work with local veterinary professionals who will understudy them for two years during which time the local vet should be able to take over the job. Table 23 shows the commitments that the Partner States have made to each other in relation to trade in veterinary services. This shows that Burundi, Rwanda and Uganda have committed to open up veterinary services to qualified nationals from other EAC Partner States and to give the same treatment to these individuals as they would to their own citizens. Kenya and Tanzania have not yet made any commitments. 18 Ibid 45

46 Table 23: EAC Partner State Commitments under the Common Market Protocol Partner State Defined Scope of Services Market Access Commitments National Treatment Commitments Burundi (CPC 932) Modes 1-3: No restrictions Mode 4: In accordance with schedule on free movement of workers Modes 1-3: No restrictions Mode 4: In accordance with schedule on free movement of workers Kenya N/A None None Rwanda (CPC 932) Modes 1-3: No restrictions Mode 4: In accordance with schedule on free movement of workers Modes 1-3: No restrictions Mode 4 : In accordance with schedule on free movement of workers Tanzania N/A None None Uganda (CPC 932) Modes 1-3 : No restrictions Mode 4: In accordance with schedule on free movement of workers Modes 1-3: No restrictions in market access. Mode 3 unbound for national treatment. Mode 4: In accordance with schedule on free movement of workers Regulation in Practice after Registration Following on from registration, all of the Veterinary Statutory Bodies in the Partner States have a responsibility to maintain standards of practice amongst those whom they regulate. The main tools they use for doing this are a combination of the following: Annual registration, inspection reports, codes of ethics and increasingly, continuous professional development (CPD). Tables 24 and 25 set out the main requirements in relation to monitoring of both veterinary surgeons and para-professionals post-registration. All VSBs which register veterinary surgeons or para-professionals have some kind of re-registration and monitoring requirements which allow them to control standards in the profession. Table 24: How is the Practice of registered Veterinary Surgeons monitored? Partner State Is Registration renewed - if so how often? What is Licensing Renewal Procedure? How is Professional Practice monitored? How is Malpractice detected? How are Disciplinary Procedures initiated? How are others made aware of Disciplinary Action? Burundi No N/A Through periodic and annual reports Reports, visits and inspection Disciplinary procedures are conducted by the ONMVB Council The Council produces a report which is kept in the Council office Kenya Yes - annually 20 CPD points required annually (Form 27) Payment of retention fee Visits and reports by Inspection team Feedback systems The Veterinary Surgeon in charge Visits and reports by Inspection team Feedback systems Disciplinary Committee investigates, summons and makes recommendations to the Board Through Official Gazette and updating the Website Rwanda Yes - annually Reapplication letter Payment of fee Inspection committee reports Inspection committee Internal regulations Findings are documented and published in Board annual report 46 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

47 Partner State Is Registration renewed - if so how often? What is Licensing Renewal Procedure? How is Professional Practice monitored? How is Malpractice detected? How are Disciplinary Procedures initiated? How are others made aware of Disciplinary Action? Tanzania Yes - annually Reapplication letter Payment of fee Renewal application form Payment of fee De-registration procedure triggered by non-payment CPD requirements. Regular and ad hoc inspection, complaints from stakeholders/ clients Inspection reports, complaints, reports from superior Registrar undertakes preliminary examination before forwarding complaint to VCT Disciplinary committee which determines whether enquiry is warranted or not and reports to the Council. Council determines action The Registrar shall inform the respondent and complainants within 21 days, Publication in official Gazette, VCT Website Uganda Yes - annual Renewal application. Inspection by UVB. Payment of fee. CPD requirements (scheme under consideration). By District Veterinary Officers (DVO) By DVO and complaints. Made by the Board under the Veterinary Surgeons Act. Depends on the nature of offence. Gazette. Further qualification may be registered by notifying Registrar and paying 150,000 UGX (US$45) Table 25: How is the Practice of registered Veterinary Para-Professionals monitored? Partner State Is Registration renewedif so how often? What is renewal Procedure for Veterinary Para- Professionals? How is Veterinary Para- Professional Practice monitored? How is Malpractice detected? How are Disciplinary Procedures initiated? How are others made aware of Disciplinary Action? Kenya Yes - annually 14 CPD points required annually (Form 27) Payment of retention fee 2,000 KSH (US$22) Feedback systems The veterinary surgeon in charge. Visits and reports by inspection team Visits and reports by Inspection team Feedback systems Disciplinary Committee investigates, summons and makes recommendations to the Board Publication in official Gazette and updating the KVB website 47

48 Partner State Is Registration renewedif so how often? What is renewal Procedure for Veterinary Para- Professionals? How is Veterinary Para- Professional Practice monitored? How is Malpractice detected? How are Disciplinary Procedures initiated? How are others made aware of Disciplinary Action? Tanzania (Veterinary Para- Professionals and Para- Professional Assistants) Yes - annually Fill renewal application form, Pay retention fee of 5,000 TSH (US$3), File evidence of CPD, Deregistration on nonpayment of fee Regular and ad hoc inspection, complaints from stakeholders and clients Inspection reports, complaints from stakeholders/ clients, reports from superior Registrar undertakes preliminary examination before forwarding complaint to VCT Disciplinary committee which determines whether inquiry is warranted and reports to the Council The Registrar shall inform the respondent and complainants within 21 days. Publication in official Gazette Tanzania (Licensed Meat Inspectors, AI and Veterinary Laboratory Technicians) Yes - annually Fill renewal application form Pay fee Deregistration on nonpayment of fee Regular and ad hoc inspection, complaints from stakeholders/ clients Inspection reports, complaints from stakeholders/ clients, reports from superior Registrar shall translate the complaint and do preliminary examination before forwarding the complaint to VCT Disciplinary committee which shall review to determine whether inquiry is warranted or not and shall report to the Council The Registrar shall inform the respondent and complainants within 21 days, Publication in official gazette As tables 24 and 25 illustrate, some of the monitoring of veterinary professional and para-professional practice is carried out on the basis of inspections but complaints also have a role to play. What the disciplinary committees of VSBs will need to take into account in assessing these complaints is whether they breach the code of ethics laid down for the profession in each country. The main provisions of each Partner State s veterinary code of ethics is set out in table 26. Table 26: Code of Ethics Partner State Code of Ethics Key Contents Burundi Some aspects are covered in the Law but a specific draft Ministerial Decree is under consideration. The main principles covered in Articles of the governing law. include: the protection of professional secrecy, not holding political office, upholding the honour of the profession, a prohibition on the delegation of key functions, a prohibition on incompatible employment, the responsibility to maintain skills and knowledge, responsibility to conduct examinations, restrictions on advertising, relations between members of the profession 48 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

49 Partner State Code of Ethics Key Contents Kenya (Kenya Veterinary Board) Code of Ethics for Veterinary Surgeons and Veterinary Paraprofessionals, regulations 2005 NB. Currently under review. Guiding Principles of Ethical Conduct a. The duty to safeguard animal welfare and alleviate animal suffering b. Conduct that maintains and promotes the reputation of the veterinary profession c. Avoidance of any act that in any way may bring the veterinary profession s image into disrepute d. Handling clients and members of the public with respect, consideration and courtesy e. Being conversant with, and abiding by, all laws affecting them professionally and, as far as possible, ensuring their observance by others f. The responsibility to be well informed on veterinary matters, to keep abreast of current knowledge and skills and to ensure that expert knowledge, experience and judgment are available to the community g. The duty to advise and report to the Board and other law enforcement agencies on any illegal or unauthorised veterinary practice h. The promotion, selling and use of only veterinary products whose formula is known i. The keeping within one s own area of competence and to refer cases responsibly Rwanda The draft of a Ministerial decree exists. (Projet d Arrête Ministériel portant Code de déontologie de la profession vétérinaire au Rwanda 19 ). It will be submitted to the Cabinet once translated in English and Kinyarwanda. Tanzania Uganda Code of conduct and ethics for veterinarians and veterinary specialists, regulations 2005, and Code of conduct and ethics for veterinary para professionals and para-professional assistants, regulations 2005 Guide to Professional Conduct, Veterinary Clinics and Hospitals in Uganda, 2001 The main provisions outlined in the 2005 Code are: Principles underlying the Code of Professional Conduct, the Obligation to Statutory Functions, Research and Teaching, Animal Welfare; Obligations at Veterinary Practice Facility, Supervisory Obligations; Veterinarian-Client-Patient Relationship, Fees, Record Keeping and Disease Reports; Certification, Independent Professional Judgement; Avoidance of Conflict of Interest, Responsibilities of Employed Veterinary professionals to Commercial and Industrial Firms employing them; Evidence in Courts of Law, Continuing Professional Education The key ethical requirements outlined in the Code include: Fundamental Principles, responsibility to clients, advertising, name boards, name plates and signs, stationery, professional premises, ownership and control of veterinary practices, certificates, evidence in Court, statutory reporting responsibilities, relationship between professionals, consultations, replacement of an existing practitioner, insurance certification, disputes, relations with lay persons This table illustrates that Codes of Conduct are still in an evolving form in most Partner States. In Burundi and Rwanda full texts are still awaited, whilst in Uganda the code focuses very heavily on conduct of practice within the profession. This differs from the emphasis in the Tanzanian and Kenyan codes which lies rather in the obligations of the profession to clients and the responsibility of professionals to keep up to date in their practice. 19 Draft Ministerial Decree on the Ethical Code of the Rwandan Veterinary Profession 49

50 Another area which is still under development is the requirement for continuing professional development (CPD). Table 27 shows the prevailing requirements in the different Partner States. Table 27: Continuing Professional Development Requirements Partner State Burundi Kenya Rwanda Tanzania Uganda CPD Requirement for Veterinary Surgeons Not currently required 20 credit points per year. CPD providers accredited by the KVB. The new governing law is not explicit on this point but it identifies one of the roles of the Rwandan Council of Veterinary Doctors as: To regularly train the members of the Council and assist those that have just finished their studies to get experience in the profession; a scheme will be put in place by the RCVD. The Regulation and Guidelines in place require veterinary surgeons to obtain 30 CPD points annually and veterinary para-professionals to obtain 15 CPD points annually. Not specified in current Act although the Code of Conduct 2001 refers to the licensed veterinary surgeon s obligation to utilise current professional and scientific knowledge. New regulations are currently under consideration Disciplinary Processes The final piece of the regulatory jigsaw is the role of disciplinary procedure in maintaining standards. Table 28 below, summarises the position in the different Partner States and shows that all have some kind of disciplinary body established under the authority of the VSB and all of these have the right to impose various levels of sanction, including the ultimate penalty of removal from the register. Table 28: Disciplinary Procedures Partner State Disciplinary Body Cause of Action Sanction Right of Appeal Burundi Council of ONMVB Complaint or a charge of endangering public health, or standards of practice Suspension or prohibition from practice Yes to President of ONMVB or Minister Kenya Disciplinary Committee of the KVB Complaint or allegation in violation of Act or regulations made under it The Board can also initiate investigations/inquiries on its own volition Reprimand; suspension, cancellation of licence; fine; removal from register Yes to High Court Rwanda Board of RVC (general assembly decides in cases of deregistration) Contravention of the provisions of the Act Written warning, reprimand, temporary suspension, removal from register Right to be heard mentioned in law, but not appeal Tanzania Disciplinary committee of VCT Unprofessional or unethical conduct (defined in Act) or complaint Reprimand; fine, suspension, removal from register Yes to Minister Uganda Special seating of the some members of UVB chaired by a magistrate Criminal conviction; infamous or disgraceful conduct in veterinary practice ; failure to observe licensing conditions Removal from register; cancellation of licence; suspension; reprimand Yes 50 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

51 3.7 Veterinary Professional Associations Veterinary professional associations have a very important role to play in the maintenance of standards in any profession. Such veterinary professional associations exist across East Africa and are increasingly in evidence for veterinary para-professionals as well Membership of Veterinary Professional Association Table 29 below shows that all Partner States have professional associations for veterinary surgeons. A number of these are particularly well established and active: The Uganda Veterinary Association (UVA) is a legally registered professional association with regional governance branches. It organises a regular annual forum which is important in assisting members of the profession in keeping up to date with latest developments. It also organises special annual commemoration events to observe World Veterinary Day (April) and World Rabies Day (September) and organises loan schemes to enable veterinary surgeons to start up and operate businesses that can also employ veterinary para-professionals. In Kenya, the Kenya Veterinary Association plays an important role in lobbying on behalf of the profession. As a result, the Kenya Veterinary Board treats the KVA as a major stakeholder. Moreover the Act entitles the Chairman of the Kenya Veterinary Association to sit on the Board as a full member. The KVA is one of the most active and accredited CPD Providers. It is composed of Branches which are either regional (e.g. Rift Valley Branch), commercial (e.g. Self Employed Veterinary professionals (SEVET)), Gender-based (e.g. Kenya Women Veterinary Association (KWVA)), Religious (e.g. Kenya Christian Veterinary Association (KCVA)) etc. Each of the KVA Branches as well as the main KVA holds Annual General Meetings usually preceded by Scientific Conferences which also double up as CPD activities. Field days, World Veterinary Days, Rabies Days, World Egg Days and other ceremonies of veterinary importance are organized and held either by the main KVA office or its branches. The Tanzania Veterinary Association (TVA) is a legally registered professional association with zonal representatives. It organises regular annual forums which are important in assisting members of the profession in keeping up to date with latest developments. It also runs loan schemes to enable veterinary surgeons to start up and operate businesses that can also employ veterinary para-professionals. Table 29: Membership of Veterinary Professional Association Partner State Title of Practitioner Name of Veterinary Professional Association Size of Membership in 2013 % of registered Veterinary Professionals Burundi Veterinary surgeons Burundi Veterinary Association (AVB) 47 84% Kenya Veterinary surgeons Kenya Veterinary Association (KVA) 1340 (in 2014) 120% Rwanda Veterinary surgeons Association Rwandaise de Médecine Vétérinaire (ARMV) % Tanzania Veterinary surgeons Tanzania Veterinary Association (TVA) % Uganda Veterinary surgeons Uganda Veterinary Association (UVB) % Table 29 shows that the membership of veterinary professional associations across the region is high, even though in most cases membership is voluntary. It is only in Kenya that membership of the veterinary professional association is mandatory and must be obtained prior to registration with the veterinary board Veterinary Para-Professional Membership Associations Not surprisingly, the picture in relation to veterinary para-professional associations is more mixed. Table 30 sets out the current known state of membership. 51

52 Table 30: Membership in Veterinary Para-Professional Associations Partner State Name of Veterinary Para- Profession Name of Veterinary Para-Professional Association Number of Members Burundi Veterinary technicians No association currently exists N/A Kenya Veterinary Para-Professional Kenya Association of Livestock Technicians (membership includes some non-veterinary cadres) 4600 (in 2014) Kenya Veterinary Para-Professional Kenya Veterinary Para-Professionals Association 1650 (in 2014) Kenya Veterinary Para-Professional Kenya Animal Scientists Professional Association 200 (in 2014) Tanzania Veterinary Para-Professional Tanzania Veterinary Para-Professionals Association 500 Uganda Veterinary Para-Professional Uganda Para-Professional Association (Nonoperational) No information as of now This suggests that where such associations exist, they have significant memberships and are therefore important communication mechanisms. The value of these networks in disseminating information could well be of great importance to any future MRA. 3.8 A Summary of the Strengths, Weaknesses, Opportunities and Threats for the EAC Partner States in considering an MRA in Veterinary Services Before turning to the possible shape of any Mutual Recognition Agreement for veterinary services in East Africa, it is worth summarising briefly what we can conclude from the above picture in terms of the strengths, weaknesses, opportunities and threats to the various Partner States in approaching such an MRA. The following discussion also draws heavily on the views of the EAC focal points for veterinary services Strengths There are particular strengths in each of the Partner States which are highlighted in the individual country reports, however when taken as a whole, the following can perhaps be seen as the strong points for the profession in East Africa as a whole as it approaches an MRA negotiation: The legislative framework is in place across the region. This is important, even if it is at different stages of development. All Partner States have a Veterinary Statutory Body (VSB), even if their powers are not entirely equivalent in Burundi and Rwanda, the framework in those countries is still evolving and approximating to the norm elsewhere in the EAC. All Partner States are members of OIE and are working towards implementation of its frameworks and recommendations. As a result there are broadly similar entry requirements to the profession across the region and similar approaches to regulation of practice. Although their presence is not evenly spread throughout the region, professional associations appear to have a strong presence in many Partner States and could no doubt be encouraged to develop in the others Weaknesses There are however, a number of weaknesses which will make negotiation of an MRA more difficult: The demographics of the profession are very uneven. There is a shortage of qualified veterinary professionals across the region as a whole, but some Partner States reported unemployment amongst veterinary professionals and this is a particular concern in relation to newly qualified veterinary surgeons. There were, however, also reports of shortages of veterinary services in rural parts of the country. The skills and ethics of the profession as a whole could be strengthened. It is possible that the revamping of the legislative framework across the region in the Partner States, not least in response to the prospects of an MRA, will improve the regulation of the profession in general. CPD is still only at early stages of development. Systems for notification and coordination within and between the Partner States could be much 52 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

53 improved. Systems for monitoring biosafety and registering facilities as well as individual veterinary professionals are very much at an embryonic stage. In some instances, devolution has made the overall management and coordination of veterinary services much more difficult. The veterinary para-professions are underdeveloped. In many cases, they are only just being brought into a regulatory framework. The input into government policy from the veterinary profession across the region does not appear to be as strong as it could, or should, be given the critical importance of the profession to the economic wellbeing and development of the EAC. The majority of livestock keepers as small holders and this cannot sustain private veterinary practice. This effectively constrains what they can do with their livestock and locks them into a cycle in which they will never be able to afford professional veterinary services. Equally, it leaves the veterinary profession as risk of marginalisation and at the mercy of funding cutbacks Opportunities An MRA negotiation, however, would potentially enable the veterinary profession across the region to embrace some of the opportunities that it is possible to see, despite the weaknesses that currently exist: There are potential opportunities for private sector services. There is an increasing urban/middle class that will need quality services from veterinary surgeons and commercial livestock and animal production should grow over time. More thought could perhaps be given to the latter area and how donors could assist in this area to help build more public-private sector collaboration to expand veterinary capacity. There has been a recent expansion in study places for veterinary medicine/science at universities within the region. Above all the East African Community integration process represents an opportunity to improve regulation, raise practice standards, improve disease control, enhance the One Health policy and benefit from increased animal product and livestock trade. There is a large body of veterinary para-professionals who could perhaps be harnessed more effectively to fill in gaps in basic veterinary services and could be structured within the sector to allow veterinary surgeons to focus on higher value, higher skilled work. The MRA process offers the veterinary profession the opportunity to make its voice heard more effectively and to have a bigger input into the development of relevant policy and legislation. The MRA for veterinary profession will play a significant role in the implementation of the EAC Common Market by allowing the movement of the veterinary trade and services in the region in which animals contribute significantly to the economic growth and well-being of the citizens. The veterinary service professionals have an opportunity to understand the EAC integration process as they participate in the MRA roadmap Threats and Challenges All opportunities are matched by challenges, and the sector faces a significant number: The veterinary profession needs to compete with many other areas for attention and investment by government. A strong case needs to be made on behalf of the profession and the infrastructure it needs to do its work, effectively presenting a strategy for veterinary services for the region as a whole, as seen through the eyes of the profession. The risks of continued underfunding and neglect of the sector are significant. Poorly managed livestock and uncontrolled livestock diseases are a threat to economic and human health. The market for veterinary services is not being effectively managed. Unemployment amongst graduates is a cause for concern and needs to be investigated further to see if there are underlying problems. If bottlenecks and structural issues in the demand and supply for veterinary services persist, this will generate concern about EAC integration within the profession and stymie moves towards an MRA. The pace of change in the way in which the profession is being regulated in the different Partner States is very uneven. In Kenya, for example, regulatory practice is continually being modernised and requirements on both veterinary professionals and para-professionals have been increasing steadily. This contrasts with Uganda, for example, where the modernisation process has been stuck at the political level for some years and it is difficult for the Uganda Veterinary Board to update its approach without the passage of new legislation. 53

54 Part 4 Lessons and Experience From other MRAs 54 Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

55 4. Lessons and Experience from other MRAs Before turning to the substance of a veterinary services MRA, it is worth touching on those lessons that might be gleaned in relation to MRAs both from other professions within East Africa and from veterinary professions elsewhere in the world. 4.1 Other EAC MRAs Veterinary surgeons are not the first profession to embark on mutual recognition negotiations in the East African Community. There are therefore some useful lessons that can be extracted from the experience of the other professions that have already implemented such agreements. Three MRAs are currently in place in East Africa, covering accounting services (2011), architectural services (2011) and engineering services (2012). It is still early days for the MRAs that have entered into force so far, however in the eighteen months or so in which they have been in existence, the following results have been seen: All EAC Partner States have either sent or received professionals within the region under the mutual recognition agreements; Around 1% of the East African professionals covered by MRAs have used them to practise in another EAC country. No qualified professionals in good standing with their home regulators have been declined registration elsewhere in the East African Community and there have been no reported cases where disciplinary measures have been taken against an EAC migrant professional. Although the absolute number of professionals using the MRAs may seem low at present, this is in line with the experience of other regions including the European Union, which has the longest history of implementing MRAs. The potential benefits of an MRA should, in any case, be judged on a much wider basis than simply the number of professionals using them. The following are the kind of benefits that are expected to arise from MRAs in those sectors where they have already been adopted: The MRAs are as much a tool for promoting economic integration, growth and development as they are for individual mobility. The existence of these agreements is beginning to pave the way for regional level action and discussion of the harmonisation of wider legislative frameworks. This makes it easier for professionals to work more freely across national boundaries in East Africa and promotes wider access to much needed skills. In the case of the veterinary profession, there are huge opportunities for their skills to be harnessed to support regional initiatives to promote commercial livestock trade. Those professions that have been early adopters of MRAs have already reported a growing sense of a regional professional identity because of the collaboration required in negotiating their MRAs. This is encouraging them to think about regional co-operation projects that will further enhance the quality and standard of the services that their regulated members provide in East Africa. For the bodies who are responsible for regulating the professions in East Africa, the MRAs are also delivering rewards. They are providing regulatory authorities with the framework for reviewing and raising the standards that apply to qualifications and to professional practice in general. The process of negotiating the mutual recognition agreements and working at a regional level with counterparts in other East African states has given regulatory authorities the opportunity to learn from each other and provided the impetus to benchmark national and regional regulation against international standards. This will clearly benefit all client groups and not just those using the services of the relatively small number of professionals who have made use of the MRAs. MRAs offer new opportunities for individual professionals: Their market is no longer limited to the size of their home country and they have access to a market of 135 million people across the region. This, in turn, can be expected over time to increase the range and depth of services these professionals can offer, as a larger regional market will support a wider range of types of services and an expansion in private sector opportunities. In the case of veterinary services, the MRA could help to improve the distribution of veterinary services across the region, particularly if it can assist in the process of recognising and harnessing veterinary para-professional services and providing support to such individuals who are operating in remote areas. 55

56 There have, nonetheless, been challenges for the professions adopting MRAs. These can be summarised as follows: Although all the relevant competent authorities in the three sectors undertaking MRAs to date have been supportive of free movement, this has not been reflected in the services sector commitments made by the Partner State governments. Where an MRA is not backed up by a full commitment to free movement of professionals in all four service sector modes of supply 20, then individuals wishing to move can face problems at the border, regardless of the willingness of competent authorities to permit access. This is particularly the case in relation to work permit issues. A number of the sectors undertaking MRAs have reported significant delays in the processing of work permits, even where competent authorities have waived these as a prior requirement for registration. The Partner States have often been slow in bringing their national legislation into line where there are domestic provisions that are incompatible with an MRA. This is the case, for example, where there are nationality requirements for registration. There is sometimes a mismatch in the institutions involved in registration in different professional sectors. In some Partner States, professional associations play a strong role and membership is mandatory prior to registration. In some of the sectors, there has been experience of problems faced by competent authorities when trying to meet the 30 day deadlines they have specified in their MRAs, because of local procedures (e.g. a requirement for a Veterinary statutory body or Council meeting to approve admission etc.). What has been interesting about this early MRA experience, is that Competent Authorities, both individually and collectively have found solutions to all of the issues under their control. For example, where procedures have made conformity with MRA deadlines difficult, competent authorities have invented special fast-track EAC procedures, reflecting the true spirit of an MRA and the fact that there is no need to replicate admission procedures already undertaken in other countries. As far as the broader issues are concerned, it is encouraging that the Partner State governments have recognised these issues and are working during 2014 in order to find a resolution. Perhaps the crucial lessons which can be drawn from all of this prior EAC MRA experience are as follows: Firstly, any profession embarking on discussions that might lead to an MRA should make early contact with the EAC Secretariat and then continue to engage with it as negotiations evolve. At present, MRA negotiations are not yet a formal process, which means that negotiations should consider at an early stage whether there are important legislative gaps or incompatibilities in different Partner States which make agreement difficult, and produce a strategy for addressing these with the governments concerned. Secondly, in order for the implementation process to be smooth, it is important for a full assessment and gap analysis of the professions in different Partner States to have been undertaken. This analysis can then be used to shape the eventual agreement. The current report is part of this process. Thirdly, the prior analysis also needs to ensure that all relevant stakeholders to the MRA have been identified and that discussions are not simply limited to those who are formally competent authorities. This is particularly the case where there are split responsibilities between professional bodies and regulators, since both need to be actively involved for the MRA to be successful. Fourthly, the bodies involved in the MRA need to establish some form of regional level institutionalised cooperation, whether a coordinating committee or some other form of umbrella body. This is essential as it will provide ownership of the MRA. Fifthly, the need for sensitization of the profession, its leadership, the public and the potential clients of the users of MRAs is significant and ongoing. Lastly, it is important for the MRA not to be seen as the final word on developing a cross border professional services market. MRAs are simply one tool, albeit an extremely important one, and need to be supplemented with other activity and initiatives to develop a wider body of increasingly convergent laws and regulations. Only then will the full benefit of the MRAs be realised These modes of supply are categorised by the WTO as: Mode 1: Crossborder supply, Mode 2: Consumption overseas, Mode 3: Establishment of a commercial presence overseas, and Mode 4: Movement of natural persons. Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

57 4.2 Experience from elsewhere in the World There are also a few other parts of the world where a mutual recognition system for veterinary professionals has been adopted or is under consideration European Union The European Union (EU) has been in existence in one form or another since It now consists of 28 Member States and has a population of more than 500 million inhabitants. The EU has been engaged in the promotion of professional mobility since its very earliest days and the system that it now has in place has evolved over fifty years, so it is highly sophisticated and well resourced. The EU system for mutual recognition of professional qualifications is a legislative one. The relevant Ministers of the governments of the Member States have agreed to a number of Directives. The two most relevant directives are the Professional Qualifications Directive (2005/36/EC) which deals collectively with all professional qualifications that require three or more years of study; and a second directive, the Crafts and Industries Directive (99/42/EC), which deals with regulated activities that required less than three years of study to enter. The latter is potentially useful when considering how the EAC might approach veterinary para-professional qualifications. The provisions governing the mutual recognition of veterinary surgeons within the EU are set out in Article 38 of the Professional Qualifications Directive. This states that: Article 38: The training of veterinary surgeons 1. The training of veterinary surgeons shall comprise a total of at least five years of full-time theoretical and practical study at a university or at a higher institute providing training recognised as being of an equivalent level, or under the supervision of a university, covering at least the study programme referred to in Annex V, point The Commission may adapt the content listed in Annex V, point 5.4.1, to scientific and technical progress. That measure, designed to amend non-essential elements of this Directive, shall be adopted in accordance with the regulatory procedure with scrutiny referred to in Article 58(3). Such updates may not entail, for any Member State, any amendment of its existing legislative principles relating to the structure of professions as regards training and conditions of access by natural persons. 2. Admission to veterinary training shall be contingent upon possession of a diploma or certificate entitling the holder to enter, for the studies in question, university establishments or institutes of higher education recognised by a Member State to be of an equivalent level for the purpose of the relevant study. 3. Training as a veterinary surgeon shall provide an assurance that the person in question has acquired the following knowledge and skills: a) adequate knowledge of the sciences on which the activities of the veterinary surgeon are based; b) adequate knowledge of the structure and functions of healthy animals, of their husbandry, reproduction and hygiene in general, as well as their feeding, including the technology involved in the manufacture and preservation of foods corresponding to their needs; c) adequate knowledge of the behaviour and protection of animals; d) adequate knowledge of the causes, nature, course, effects, diagnosis and treatment of the diseases of animals, whether considered individually or in groups, including a special knowledge of the diseases which may be transmitted to humans; e) adequate knowledge of preventive medicine; f) adequate knowledge of the hygiene and technology involved in the production, manufacture and putting into circulation of animal foodstuffs or foodstuffs of animal origin intended for human consumption; g) adequate knowledge of the laws, regulations and administrative provisions relating to the subjects listed above; h) adequate clinical and other practical experience under appropriate supervision. 21 See annex 3 of this report 57

58 In summary therefore, the EU system is a competence based one. It lays down the overall duration and content of education and training as a veterinary surgeon required within the EU, but does not require the underlying curricula to be identical. The EU, like the East African Community, has members who are at different stages in developing their professions and the way in which it has dealt with this may be of interest to the EAC veterinary professions. Article 39 sets out how veterinary surgeons should be treated where formal qualifications have only recently been introduced but where there are individuals in practice with considerable experience: Article 39: Acquired rights specific to veterinary surgeons with regard to nationals of Member States whose evidence of formal qualifications as a veterinary surgeon was issued by, or whose training commenced in, Estonia before 1 May 2004, Member States shall recognise such evidence of formal qualifications as a veterinary surgeon if it is accompanied by a certificate stating that such persons have effectively and lawfully been engaged in the activities in question in Estonia for at least five consecutive years during the seven years prior to the date of issue of the certificate. Finally, it is worth noting that the EU also allows individuals who have only partially met the required qualifications to apply for recognition and for the host authority to require a compensatory measure to be undertaken either additional training or a test in order to make up the perceived difference between the individual s qualifications and experience and the required minimum set out in article 38. In the period , 8,411 veterinary surgeons applied for recognition in another EU Member State. 8,293 were automatically accepted on the grounds that they fulfilled the qualifications listed above, whilst the remainder were required either to complete the gap in their training by undertaking a test or further training period. Overall veterinary professionals were the eighth most mobile profession in Europe after professions including doctors, teachers, dentists and nurses. It is also interesting to note that all EU Member States were involved as both home and host country authorities for veterinary professionals using the mutual recognition arrangements. A further example of a regional economic area using MRAs for veterinary professionals is ASEAN ASEAN (The Association of South East Asian Nations) The Association of South East Asian Nations is a regional organisation comprising 10 member countries: Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam. It has a similar structure, aims and objectives to the EAC and is currently planning for the creation of a full ASEAN Economic Community in This will, in effect, be a single market, operating like the EAC Common Market and one of the building block in the creation of this single market is the negotiation of mutual recognition agreements for a range of professions. At present there is no MRA in place for veterinary practitioners but one is under active consideration. The detailed work has yet to be done on the shape of a possible MRA for veterinary practitioners in South East Asia, but the profession itself has identified the objectives that it would seek to fulfil in negotiating such an agreement 22. These are: To facilitate mobility of veterinary medical practitioners within ASEAN To exchange information and enhance cooperation in respect of mutual recognition of veterinary medical practitioners To promote adoption of best practices on standards and qualifications To provide opportunities for capacity building and training of veterinary medical practitioners Although the ASEAN Member States have not yet worked out the details of their mutual recognition scheme, it is interesting for the EAC professions to note the objectives that they have identified as this is an important starting point in the negotiation of any MRA For an interesting presentation on the possible Roadmap towards developing an ASEAN MRA in Veterinary Services, see chula.ac.th/vet2014/conference/2014/gufva2014/ /11.45_elizabeth_ %20%20asean%20mra%20-%20ppta.pdf Veterinary Services in the EAC - A Report prepared to facilitate MRA Negotiations for Veterinary Professionals

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