PRIVATISATION OF VETERINARY PRACTICE EVALUATION OF THE EXPERIENCE OF AFRICAN COUNTRIES IN THIS FIELD A. Tber Director of Animal Production and Veterinary Services, Ministry of Agriculture and Agricultural Development, Administrative Headquarters, Rabat Chellah, Morocco Original: French Summary: As a result of the economic and financial difficulties which exist on the African continent, more and more countries have adopted a policy of State withdrawal and privatisation in various sectors of economic activity. Veterinary practice and certain activities which previously were not a matter of concern for the public authorities, have also been affected by these policy changes in the African countries. The concept of privatisation is now widely accepted but the process must be gradual in order to take into account the different viewpoints within a partnership of the public service, the farmer and the private veterinarian. Based on the recent and past experience of African countries with respect to privatisation, three models have been identified for the withdrawal of the State and simultaneous improvement of its services: a model based on cost recovery by the Public Services; a model based on the privatisation of veterinary services; a mixed model based on a policy of cost recovery by the Public Services combined with a veterinary services privatisation system. From the descriptions of the experience of African countries, various aspects have been selected which can be considered prerequisites to privatisation. The first is the role played by the State in this process, both with regard to supervision and the setting up of an adequate legislative, regulatory and financial framework. The other aspects are the role played by producers and producer associations (by their training, information and organisation), and that played by private practitioners (by their organisation and training) in the improvement of animal health and production. For each model identified, the veterinary practice sector is examined in terms of the constraints, but also the advantages - or disadvantages - of professional supervision by the public and private sectors. This comprehensive report is based on reports received from the Member Countries of the OIE Regional Commission for Africa, supplemented by answers sent in by certain countries to a complementary questionnaire. Reports from the following countries were taken into account: Algeria, Angola, Benin, Burkina Faso, Botswana, Egypt, Ghana, Guinea, Kenya, Morocco, Niger, Namibia, Senegal, South Africa, Swaziland, Tanzania, Tunisia, Uganda, Zambia and Zimbabwe. Answers to questionnaires received from the following countries were used to complete this report: Benin, Burkina Faso, Botswana, Comoros, Egypt, Ghana, Côte d'ivoire, Malawi, Morocco, Senegal, South Africa, Tanzania, Tunisia, Uganda, Zambia and Zimbabwe. The other countries' reports or answers to the questionnaires were either not received, or were received too late to be taken into account in this report. 1. INTRODUCTION - 137 -
Liberalisation, privatisation, State withdrawal through the transfer of activities, reductions in State spending and cost recovery are constantly recurring terms in the context of an African continent in the depths of a severe economic crisis. In a region of demographic explosions and intense urbanisation, food issues remain the priority of countries faced with an increasing deficit of animal protein. These factors, aggravated by periods of consecutive drought, animal disease, trade deficits, etc. have modified the political trends of most African governments. In the various sectors of national economic activity, these changes are characterised, by a dividing up of tasks among the public authorities, operators in the private sector and those who benefit from the services provided. The expected effects are mainly a reduction in the State budget deficit as a result of State withdrawal; improvement of the quality of the services provided ("less State, but better State"); and stimulation of investment. The same considerations have also led the decision-makers to introduce the concept of the privatisation of veterinary services. * There are no international standards, references or models for the privatisation of veterinary practice. Each of the African countries which has made this choice has established its own privatisation model based on the experience of other countries in this field, and in particular, by taking into account its own specific political, economic and sociocultural data. However, it is commonly accepted that, in the field of privatisation of veterinary services, the main parties involved are: 1.1. The State, playing an active role in the field of appropriate legislation and regulations for the privatisation process and, where applicable, the financing of various stages of the process. It also plays a passive role by transferring certain tasks previously performed by the Public Services. 1.2. Banks and development organisations, whose role is to advise and help the government to plan privatisation operations according to their specificities, possibilities and needs. Their role will also be to contribute to the financing of these operations either in the form of direct aid or of reimbursable loans. 1.3. The veterinarians, through their basic training which must be quantitatively and qualitatively adapted to local conditions and needs. Their in-service training must be assured and their numbers must be determined and planned according to the absorption capacity of the country or region. Three financial conditions for private veterinary practice must be taken into consideration: the first is the capacity of the livestock owner to pay for veterinary care and drugs. the second is the possibility for the private veterinarian to sell these drugs, so that he can balance his budget. the third condition is the existence of a law on professional practice by which the State can sub-contract some of its activities to the private veterinarian. Financial measures and incentives can be offered to encourage veterinarians to go into private practice, and health insurance and retirement funds must be set up to accompany the privatisation process. 1.4. Para-veterinarians, who are an indispensable aid in the running of State Veterinary Services, are in an uncomfortable situation in the privatisation processes. Although some of them can be employed by private practitioners or groups of producers, their case often poses a problem to the Government. However, the idea of allowing them to sell veterinary drugs or open clinics must be totally eliminated, which is another reason why the privatisation process must be carried out gradually and prudently. 1.5. Since the livestock farmers are the main beneficiaries of the privatisation process, their participation conditions the success of the process. Several factors must be taken into account in this respect: The professional competence of the farmers * In this report the term "veterinary services" refers to the services offered by the veterinary profession while the term "Veterinary Services" designates the public administration handling animal health matters. - 138 -
This is result of their level of training and experience and it is indispensable for communication between the private veterinarian and the farmer. Such competence requires on-going training (continuing education) of the private practitioner, because of the farmer's increasingly sophisticated technical requirements. The standard of living and the spending power of the farmers These two factors are conditioned by the development level of the livestock sector, which is divided in four groups: - Nomadic livestock raising in arid zones, in which a privatisation policy would be difficult to achieve due to the relatively low value of the animals and the large distances to be covered which make veterinary care costly. Controlling the main contagious animal diseases in these regions is a priority. - Settled livestock raising, combined with crop growing, but always using native breeds. The animal pathology is more individual, and could justify private practice, but is still insufficient to meet the needs of the veterinarian. - Livestock raising improved by the selection of native breeds or by cross-breeding with highly productive breeds, whose value can justify private practice (dairy farms in peri-urban areas, poultry farming, etc.). - Raising of improved breeds, often imported, requiring more elaborate techniques (artificial insemination, industrial farming, embryo transplants, etc.). This type of livestock raising makes it possible to privatise veterinary activities because of the value of the animals and the attention which must be paid to them as a result of their natural sensitivity and fragility. These four stages can co-exist in the same country or in the same region, but, whatever the case, control of the main animal diseases must remain under the control and surveillance of public sector veterinarians. The sociocultural environment of livestock farmers Although the capacity of the farmers to pay for veterinary care and buy drugs depends on their spending power, there is also the fact that certain psychological habits, particularly that of "everything for free", remain deeply ingrained. Although farmers have gradually got used to paying for certain drugs, they are still hesitant to pay for the actual consultation. The veterinarian could therefore be paid either directly by the farmer or indirectly by a group of farmers. Furthermore, individual farmers or groups of farmers still have direct access to certain drugs, without the need for a veterinarian's prescription. Although this certainly reduces the cost for the farmer, it also represents a loss of earnings on the sale of drugs for the practitioner. This should be regulated by a law governing the distribution of veterinary drugs. Another psychological aspect to be taken into account is the individualism of the livestock owner, or, on the contrary, his sociability. It is the latter which will encourage him to join forces with other owners. These groups are important in setting up a privatisation policy since they can be a positive factor in developing livestock raising, training owners and paying or recruiting young veterinarians and paraveterinarians. 1.6. Technical and scientific back-up is provided by the laboratories (public or private) which will not only serve as a support structure for the private veterinarian in carrying out his practice, but also provide the documentation, training and information which enables veterinarians, para-veterinarians and livestock owners to keep up-to-date with the latest techniques and discoveries. 2. THE CURRENT SITUATION OF PRIVATISATION IN AFRICA Before exploring the different aspects of the privatisation process in Africa, it seems necessary to distinguish three main groups of countries according to the stage of development of their privatisation policy. It is important to note the broad consensus of the African countries concerning the necessity of setting up a privatisation policy, regardless of its form. The final aim of this process is not only to ensure State withdrawal whilst improving the - 139 -
quality of the services provided, but also to develop this sector with regard to the management and supervision of veterinary activities. It is useful to remember that behind any privatisation process, there is always a political will. This must be put into effect by legislative, regulatory and, where appropriate, financial measures, although the latter are the main stumbling block. These measures will provide an adequate framework and environment for the "privatisation policy" or strategy. The choice of the path to be followed and the various types of restrictions involved enable the countries to be divided into several categories shown in the flow chart below. Various statistics relating to the different countries are given in Appendix I to IV. State withdrawal, reduction of the budget deficit, improvement of services System of cost recovery by the public services Policy of privatisation of veterinary services Angola, Botswana, Egypt, Malawi, Namibia, Swaziland, Tanzania Mixed system: cost recovery and privatisation policy for veterinary services Algeria, Morocco Tunisia, Côte d'ivoire Benin, Burkina Faso, Ghana, Guinea, Kenya, Niger, Senegal, South Africa, Sudan, Uganda, Zambia, Zimbabwe The first two categories mainly include countries involved in the Pan African Rinderpest Campaign (PARC) which includes cost recovery and the reinforcement of veterinary services. As well as its actions to eradicate rinderpest on the African continent, the PARC project encourages the development of a strategy aimed at revitalising health and animal production services in the project's member countries. This strategy is mainly focused on the following - partial payment by farmers and livestock owners of the cost of vaccinations, treatment and any other intervention in their own interest, - improvement of the supply and distribution of veterinarian inputs, - privatisation of veterinary services, - staffing government services according to real needs, - encouragement of livestock owners to form associations and set up their own structures for basic animal health care, - creation of livestock development funds which could be financed (for example) by import or export taxes, profit margins on the sale of drugs or funds provided by livestock owners. 2.1. Policy of cost recovery by the Public Services This model mainly applies to countries which have opted for the system of cost recovery of certain activities conducted by the Public Services, provided there is adequate private veterinary practice. These countries may (Egypt, Malawi and Tanzania) or may not (Angola, Botswana, Namibia, Swaziland) be involved in the PARC project. Although certain countries had already planned to set up a privatisation policy as one of their priorities, the cost recovery system remains the main factor behind State withdrawal. - 140 -
The extent to which this system contributes to the budget allocated to the livestock sector, mostly provided by State funding, remains relatively low. On an average, it is 2 to 5% (except for Egypt where it is 40%) and this seems to play a role in the instigation of a privatisation policy. With the exception of Botswana, the principle of instigating this type of policy has not yet been adopted by the relevant government authorities. In cases where the principle has been adopted, the legislative and regulatory measures which should accompany the process have not yet been taken or applied. Also, there are no financial measures or incentives sufficiently developed for veterinarians to go into private practice, nor contracts with the Public Services to carry out a certain number of activities. In the case of Botswana, several veterinary tasks are entrusted to the private sector, such as vaccinations, the issuing of certificates, food inspection and epidemic surveillance schemes. This country aside, the Public Services in charge of health and animal production continue to be responsible for virtually all preventive, animal health care, pharmaceutical and veterinary public health activities: 90% on an average, with 100% for Egypt. The associative or co-operative sector for livestock owners is well developed in these countries and is subsidised. However, no tasks have yet been transferred to the producers' associations (although it is envisaged by all the countries concerned). The Public Services continue to recruit from among the veterinarians, para-veterinarians and technicians. In countries which train a large number of veterinarians (from 16 to 800 depending on the country), about 20 to 75% will be recruited by the public service. In other countries, due to budget restraints, only para-veterinarians (technicians) are still recruited by the State, sometimes 100%. With the exception of Botswana, the executive staff and their assistants in public Veterinary Services are not allowed to have a private practice on the side. However, competition exists between the veterinarians in the private sector and those in the civil service. It is interesting to note that the number of veterinarians in private practice with respect to the total number of veterinarians remains relatively low in each of the countries mentioned (3 to 16), with the exception of Egypt, which has 252 private veterinarians. These veterinarians mainly practise in urban and peri-urban areas and only secondarily in the veterinary drug sector. In the case of Egypt, all the private veterinarians practise in private laboratories. Privatisation of State Veterinary Services has become a necessity for several reasons, particularly the reduction in financial resources, the size of the budgets allocated to the livestock sector (representing 30 to 50 % of the Department of Agriculture's total budget), the difficulty experienced by the State in continuing to carry out all the tasks involved, and the increasing inability of the different countries to absorb all the veterinarians and paraveterinarians being trained. However, instigating this policy seems to come up against a number of financial and sociocultural restraints. These are mainly linked to the inability of livestock owners to pay for all the services provided, particularly in remote rural or underprivileged areas, where livestock systems are based on nomadism and extensive production. In other cases, where the cost recovery system contributes significantly to the financing of public sector activities, the approach to the privatisation policy seems to be gradual, and is only envisaged on a medium-term basis. 2.2. Policy of privatisation of veterinary services This group consists of the three North African countries Algeria, Morocco and Tunisia, together with Comoros and Côte d'ivoire. These five countries have opted for a policy of privatising certain activities allocated to the public sector and transferring others to the organised sector. The State, however, continues to provide certain services free of charge, since the pre-requisites for setting up a cost recovery system have not yet been met. Along with Mauritania and Libya, these three North African countries are part of the same economic structure - the Union of Arabic Maghreb. The privatisation of veterinarian practice has become increasingly important in these countries as a result of policy changes due to major economic upheavals. Liberalisation and privatisation have followed the structural adjustment policy. The innovative role of the State in the field of legislation has been extremely important since it has laid the foundations for private veterinary practice and drug distribution, and enabled the profession to be organised by the enactment of laws concerning the National Veterinary Association. This legislation defines the professional categories authorised to set up private practice (para-veterinarians having been excluded from the outset), outlines the tasks allotted to them and gives the State full control of this sector. - 141 -
It has not only avoided competition between civil servants (veterinarians and technicians) and private veterinary practitioners, but has given veterinarians the same access to veterinary drugs as pharmacists. These measures have protected the livestock owner, particularly by fixing veterinary fees. In the case of Morocco, this process has been actively backed up by the instigation, in 1987, of sub-contracting by the State to private practitioners and by defining disease prevention areas. This has enabled the private veterinarian to carry out vaccination campaigns against contagious diseases on behalf of the State, as well as being in contact with and tuned into the problems of livestock owners. In Tunisia, a similar action has been initiated as part of certain hygiene control activities for animal products. In Côte d'ivoire, it enables veterinarians in the private sector to intervene on behalf of the State in the field of vaccination and epidemic surveillance as well as the issuing of certificates. Animal care remains the main privatised activity, particularly in intensive peri-urban livestock production areas or in irrigated rural areas. This stepping up of production, initiated by the Public Services as part of national plans aimed at increasing the productivity of herds, gave a new boost to the privatisation process. Tighter livestock management methods also made it possible to set up an organised sector of producers, initially subsidised. Subsequently, a certain number of activities were handed over to producers' groups and cooperatives - stud and artificial insemination services, milk collection centres, basic animal health care centres, etc. Initially, State technicians were seconded to these groups and continued to be paid out of State funding, while providing basic care and certain vaccinations, to the exclusion of those aimed at notifiable diseases. In Morocco, more and more co-operatives recruit their own technicians or sign contracts with private veterinarians. As a result of this close professional supervision, the co-operatives can help popularise livestock management techniques, prevent diseases and train farmers. The development of producers' associations and an association of private practitioners has also resulted, in the case of Morocco, in a constructive dialogue among the different partners in the livestock sector. The veterinary drug sector has also developed to a large extent in the North African countries and Côte d'ivoire. It has enabled veterinarians either to set up practice in this sector, or to benefit from an appreciable source of income which allows them to balance their budget. When setting up their practice, private veterinarians also benefit from loans at subsidised interest rates and are exempted from taxes for the first two years. In the case of Morocco, Côte d'ivoire and Tunisia, activities subcontracted by the State to the private sector also offer an appreciable source of income. Credit lines have thus been opened in the budgets allocated to the livestock sector (consisting of 4 to 95% public funding), to pay the veterinary sub-contractors. The corresponding budget lines are supplied by loans from financial backers as well as special livestock funds financed by slaughter taxes, import taxes on cattle fodder and taxes on veterinary drugs. Because of the limited amount of recruitment by the Public Services, veterinary training programmes have been re-directed not only towards private veterinary practice, management and economics, but also towards practical training courses with private practitioners when students are at the end of their studies. Thanks to the various measures adopted, the number of veterinarians in private practice in these three countries is increasing considerably in the different sectors of veterinary practice - 1 605 private veterinarians in Algeria, 150 in Morocco, 101 in Tunisia and 7 in Côte d'ivoire. The choice locations for setting up new practices are mainly intensive production areas (dairy and poultry farms) and irrigated areas. The drug sector (Morocco and Tunisia) and private laboratories also offer good opportunities. In Morocco, with the system of State sub-contracting to private practitioners, unirrigated rural areas have attracted many private veterinarians. Currently, remote areas, characterised by extensive production over vast areas of land (most of the time unsuitable for agriculture) are beginning to attract more and more candidates to existing installations, while disease preventive areas are becoming scarcer elsewhere. Veterinarians and technicians in the public sector are not allowed to have a private veterinary practice on the side. Tunisia is an exception to this, where the practice is authorised in areas not covered by private practitioners. State withdrawal is virtually complete in areas allotted to private veterinarians and the Public Services now only control correct execution of national contagious disease eradication schemes, veterinary public health actions - 142 -
and epidemic surveillance and awareness campaigns for livestock raisers in order to develop their production. All the other tasks are entrusted either to private veterinarians or to groups of owners. However, as the process has been entirely financed by the State up until the present, the idea of a partial recovery of costs by the owners is gradually making headway. In the case of Morocco, thought is currently being given to the possibility of grouping owners into associations or groups with common health concerns. The practical aspects will be worked out with existing owners' associations and the veterinary association. Several incentives have been identified and a livestock training programme has been worked out. These measures will enable exchanges to be developed through close supervision from a health and livestock management point of view, within the framework of contracts between groups and private veterinarians, while ensuring total State withdrawal and the financial participation of the livestock owners when it comes to services. This "cost recovery" strategy will be set up gradually, and could be part of the State sub-contracting system in the next few decades. 2.3. Cost recovery policy combined with privatisation of veterinary services policy: mixed system Because of the way their overall economic context is developing, many countries agree that the cost recovery system alone will not result in an extensive withdrawal of Veterinary Services. It must therefore be completed by a veterinary services privatisation policy, within the framework of a partnership between the State, private operators and those benefiting from the services provided With the exception of South Africa and Zimbabwe, all the countries which have undertaken this process are part of the PARC Project. 2.3.1. In the case of South Africa and Zimbabwe, the private veterinary sector, as well as certain activities allotted to the public sector, were privatised or transferred several decades ago. With their limited budgets, the State Veterinary Services of these countries can only afford to provide services of a public character, mainly in urban and peri-urban areas or in areas suitable for livestock raising i.e. veterinary public health and control of the main animal diseases. Consequently, the financial contribution of the cost recovery system is relatively low. In the case of South Africa, for example, it only represents 0.1% of the budget allocated to the livestock sector. Costs are recovered from quarantine stations and laboratory diagnostic fees. Political reforms and texts regulating veterinary and para-veterinary practice have also been adopted as part of this process. However, even though huge investments are necessary to begin a career in the private sector (about $US 200,000 in the case of South Africa), there is no sign of financial aid or subcontracting of public service activities by the State to the private sector. The number of private veterinarians, practising mainly in the urban and semi-urban areas of South Africa and Zimbabwe, is relatively high in comparison with the total number of veterinarians; about two thirds in South Africa and half of the veterinarians in Zimbabwe are in private practice. In South Africa, where public servants are allowed to have a private veterinary practice on the side, there does not seem to be any competition between these two sectors. Although 95% of animal health care continues to be provided by veterinarians in the public sector, the private sector is responsible for 85% of vaccinations. However, as for the first group of countries, restraints of an economic and financial order make State action in the field of livestock development, particularly in remote rural areas, increasingly difficult. These restraints make it necessary to promote private veterinary practice as part of a gradual strategy, conducted in partnership with the various parties involved. 2.3.2. The second category of countries which have opted for this system are the countries involved in the PARC Project: Benin, Burkina Faso, Ghana, Guinea, Kenya, Niger, Senegal, Sudan, Uganda and Zambia. In most of these countries, where the privatisation process has been instigated only recently, a certain number of political reforms have been implemented. These mainly include setting up legislation to regulate private veterinary practice, as well as a Veterinary Association and a Code of Conduct. In order to encourage public service veterinarians or new graduates to go into private practice, incentive measures and financial aids have been adopted, whether in the form of bank loans, material aids, or the supply of veterinary drugs on credit. In Senegal the adoption of health sub-contracting, which will be - 143 -
put into effect in the future, and the withdrawal of the state from the distribution of veterinary inputs, have also contributed significantly to the promotion of these private sector. These different measures, added to cost recovery (3.5 to 60% of the budget allocated to the livestock sector, depending on the country) are conducive to State withdrawal and the development of a viable private veterinary sector. One of the major restraints encountered in certain countries, apart from the financial difficulties involved in setting up practice in the private sector, is the competition which exists between the public and private sectors for similar activities. This competition also exists within the private sector of the veterinary profession, between veterinarians and private practitioners with different training, who do not have the same needs and expenses. Many countries, such as Burkina Faso, Niger and Guinea initially opted for the privatisation of veterinary drugs. As a result, the sector rapidly expanded, which meant that services could be provided which the public authorities were no longer capable of supplying. The spin-off was that this policy encouraged the privatisation of certain activities in the field of veterinary practice which the State no longer had either the human or financial means to provide. The importance of the private veterinary sector is reflected in the role it plays in national supervisory activities concerning the livestock sector: from 10 to 35% of vaccinations and 20 to 40% of animal health care. Unlike South Africa and Zimbabwe, most of the countries in this group benefit from outside donations or loans which represent up to 90% of the budget allocated to the livestock sector with, in certain special cases, a contribution which is 4 to 5 times that provided by the State budget. However, the limited financial resources of certain countries do not enable them to reach cruising speed for the process they have initiated, and it is still too soon to evaluate the results of the policies they have adopted. 3. RESULTS OF PRIVATISATION The different models described above are aimed at State withdrawal, reduction of the budget deficit and improvement of the quality of services provided to livestock owners. 3.1. Cost recovery policy by the Public Services This system enables Public Services to recover part of the costs invested in health activities. This applies to certain vaccinations, food inspections, certificates, etc. The recovery of these costs can contribute to relative financial autonomy of the Public Services with regard to some of their activities, and can also enable them to increase their structures and means of intervention. However, the contribution of cost recovery remains relatively low in most African countries where it represents only 5 to 60% of the budget allocated to livestock services. Also, in many countries, staff expenditure alone accounts for about 40 to 80% of the budget allocated to this sector, and the costs recovered do not always correspond to the real cost of the intervention (subsidised input prices). This type of system can therefore have the drawback of fanning competition between the Public Services and the private sector, because of the differential which exists between the real intervention costs of these two sectors, since State intervention will always be less expensive than that of the private sector. The low income produced by this system can not only limit State withdrawal, but also prevent improvement of the quality of the professional supervision provided. This is the case when the Public Services continue to provide virtually all the country's animal care and vaccinations in order to prevent the budgetary resources allocated to them from being reduced. The trend, for this group of countries, is therefore to combine a veterinary services privatisation policy with a cost recovery policy. In this respect, several countries have already developed or intend to develop the foundations of this policy (see paragraph 3.3.). 3.2. Policy of privatisation of veterinary services The veterinary services privatisation system is mainly based on transferring production activities, formerly conducted by the Public Services, to organised groups of livestock owners. This transfer has taken place gradually and has accompanied national programmes to step up animal production or to bring livestock owners together in the pursuit of common interests in extensive production areas. This system has also been applied to the control of certain diseases not legally considered to be contagious, which has been entrusted to veterinarians in the private sector, with the costs to be borne by the livestock owners. This policy was preceded by the creation of an environment conducive to the development of the private veterinary and drug sector. In this case, the State is now only concerned with controlling diseases which - 144 -
are legally considered to be contagious, with animal hygiene and inspection and the control and epidemic surveillance of animal populations. These actions continue to be conducted free of charge and are paid for entirely by public funding. Sub-contracting to private practitioners also means that, while allowing for State withdrawal and development of the private sector, particularly in underprivileged areas, activities carried out by its services can be conducted at a lower cost and with greater efficiency e.g. vaccinations, hygiene and certification. Another advantage of this policy is that it contributes to a significant improvement in the professional supervision of livestock production, thanks to the complementarity which exists between the public and private sectors. The main disadvantage of this process is that it is based on the subsidising of professional organisation, on the payment of private veterinarians as part of a sub-contracting system, on help to veterinarians in setting up a private practice and on State purchase of the biological products needed for contagious disease vaccination campaigns. All these costs are becoming increasingly difficult for the Public Services to bear, because of their limited financial possibilities. For this group of countries, the trend is therefore also to combine this policy with a system designed to gradually cover the costs relating to the prevention of contagious diseases in order to limit State expenditure. 3.3. Cost recovery policy associated with a policy of privatisation of veterinary services: mixed system This system seems to be the logical result of the two previous systems. It combines the solutions to the problems mentioned above, and provides the foundations for private practice while clearly defining the roles and responsibilities of both the private and public sectors. Not only does this sharing of responsibilities prevent competition between the two sectors, it also allows the State to remain in control of the health situation. Livestock production is increasingly supervised by the private sector, both with regard to the statistical follow-up of activities and development of the epidemiological situation. In this case, the tendency is for the State to no longer provide any material encouragement to the private sector, once it has been developed and set up properly. It can then devote itself entirely to reinforcing those activities which are always the responsibility of a State veterinary service i.e. the control of contagious animal diseases, epidemic surveillance, veterinary inspection and hygiene and border control; however, it continues to control the activities of the private sector. 4. CONCLUSION Although the concept of privatisation is new for Africa, numerous countries are involved in the process, mainly under the pressure of budget restrictions and the international economic situation. Whatever the path chosen to achieve privatisation, a certain number of rules need to be taken into account to make this sector viable. The State must set up an adequate legislative and regulatory framework for the process, while ensuring that the missions, roles and responsibilities of both the private and public sectors are well defined in order to avoid unfair competition. Incentive measures must also be provided to encourage veterinarians to go into private practice, whether of a regulatory nature (by sub-contracting certain activities which are the responsibility of the State, while at the same time protecting the producer) or of a financial nature, in the form of subsidies or credits allocated to this sector. Organising and informing livestock owners, as well as promoting their associations, should improve cost recovery. This would enable outlets to be created for private veterinarians and ensure close supervision and better quality for the producer, while making State withdrawal possible. BIBLIOGRAPHY 1. Cheneau Y. (1986). The organization of Veterinary Services in Africa. Rev. Sci. Tech. Off. Int. Epiz., 5 (1), 107-154. 2. El Hicheri K. (1994). Study on the privatisation of Veterinary Services in Morocco, Algeria, Tunisia, Mauritania and Libya. Expert Consultation on the Privatisation of Veterinary Services, FAO, Regional Office for the Near East- Cairo. 3. FAO (1991). Directives pour le renforcement des services de santé animale dans les pays en développement. FAO, Rome. - 145 -
4. FAO, OIE, WHO (1992). Animal Health Yearbook. FAO, Rome, 272 pp. 5. Mpelumbe I.S. (1993). Perspectives on the privatisation of veterinary practice in the context of livestock production in Africa. In Comprehensive Reports on Technical Items Presented to the International Committee or to Regional Commissions. OIE, Paris, 81-87 (in English), 73-79 (in French). 6. OIE (1995). "Administration et gestion des Services vétérinaires : Vol. II. Exercice de la profession vétérinaire, conditions d'évolution" (Document provisoire), OIE, Paris, 33-39. - 146 -
Country DEMOGRAPHIC DATA AND RATIOS OF VETERINARIANS IN THE MEMBER COUNTRIES OF THE OIE REGIONAL COMMISSION FOR AFRICA First group of countries: Policy of cost recovery by the Public Services Data Ratios Human pop. (thousands) HOC (1) (thousands) Total no. of veterinarians Human pop. / veterinarian HOC / inhabitant Appendix I HOC / veterinarian Angola 9 000 3 858.0 63 142 857 0.3 61 241.7 Botswana 1 000 3 321.0 36 27 778 3.2 92 263.9 Egypt 52 000 8 667.0 11 250 4 622 0.7 770.2 Malawi 9 000 1 057.6 17 529 412 0.2 62 180.0 Namibia 1 000 3 155.4 47 21 277 3.6 67 145.3 Swaziland 788 791.8 23 34 261 1.0 34 403.8 Tanzania 25 000 15 453.4 344 72 674 0.2 44 923.8 Total 97 788 36 305 11 780 Average 13 970 51 86 1 683 (1) HOC: Head of Cattle Country Second group of countries: Policy of privatisation of veterinary services Data Ratios Human pop. (thousands) HOC (1) (thousands) Total no. of veterinarians Human pop. / veterinarian HOC / inhabitant HOC / veterinarian Algeria 24 000 5 583.96 2 800 8 571 0.23 1 994.27 Comoros... 74.94 11 6 812.73 Côte d'ivoire 11 000 1 538.76 34 323 529 0.14 45 257.65 Morocco 25 000 9 492.62 452 55 310 0.38 21 001.37 Tunisia 8 000 2 517.36 480 16 667 0.31 5 244.50 Total 68 000 19 208 3 777 Average 17 000 3 842 755 Data taken from reports and/or questionnaires received and completed using the FAO-OIE-WHO Animal Health Yearbook (1992). Third group of countries: Policy of cost recovery and privatisation of veterinary services (mixed system) Data Ratios Country Human pop. (thousands) HOC (1) (thousands) Total no. of veterinarians Human pop. / veterinarian HOC / inhabitant HOC / veterinarian Benin 4 000 1 436.00 82 48 780 0.36 17 512.20 Burkina Faso 8 000 6 576.38 118 67 797 0.82 55 732.03 Ghana 15 000 2 005.06 222 67 568 0.13 9 031.80 Guinea 5 000 1 983.54 203 24 631 0.40 9 771.13 Kenya 23 000 17 236.78 1 789 12 856 0.75 9 634.87 Niger 7 000 4 049.08 77 90 909 0.58 52 585.45 Senegal 7 000 4 538.70 157 44 586 0.65 28 908.92 South Africa 35 282 21 056.50 1 867 18 898 0.60 11 278.25 Sudan 25 000 30 260.18 3 388 7 379 1.21 8 931.58 Uganda 17 000 6 009.10 739 23 004 0.35 8 131.39 Zambia 8 000 3 040.02 137 58 394 0.38 22 189.93 Zimbabwe 9 000 6 959.92 132 68 182 0.77 52 726.67 Total 163 282 105 151 8 911 Average 13 607 8 763 743-147 -
Appendix II MAIN FACILITIES AND ACTIVITIES OF ANIMAL HEALTH/LIVESTOCK SERVICES First group of countries: Policy of cost recovery by Public Services Country Budget livestock / agriculture (%) Budget livestock ($US 1000) Contribution from the State Cost recovery Contribution to livestock budget Existence of organised producers Transfer of activities to organised sectors Sub-contracting to private sector Vac. (a) Cert. (b) Insp. (c) Vet. (d) Civil servants in Veterinary Services Eng. (e) Aux. (f) Coverage by public sector Vacc. Care Angola............................................. Botswana 50% 34 300 100% Yes 5% Yes No Yes Yes Yes 28 400 350 90% 95% Egypt......... Yes 40% Yes Yes No No No 11 000... 23 367 100%... Malawi... 600... Yes 5% Yes No......... 14.. 500 95%... Namibia 10% 5 000 100% Yes 15% Yes Yes No No No 32 126 120 90% 80% Swaziland 32% 6 187 100% Yes 5.2% Yes No No No No 16 74 122 91% 75% Tanzania.......................................... Second group of countries: Policy of privatisation of veterinary services Country Budget livestock / agriculture (%) Budget livestock ($US 1000) Contribution from the State Cost recovery Contribution to livestock budget Existence of organised producers Transfer of activities to organised sectors Sub-contracting to private sector Vac. (a) Cert. (b) Insp. (c) Civil servants in Veterinary Services Vet. (d) Eng. (e) Aux. (f) Coverage by public sector Vacc. Care Algeria...... 100% No 0% Yes Yes No No No 1 195... 10% 10% Comoros 11%...... No 0% Yes Yes No No No 11 2 10...... Côte d'ivoire 6% 1 270 4% No 0% Yes No Yes Yes No 27 7 230 100% 95% Morocco 22 200 80% No 0% Yes Yes Yes No No 242 89 1 326 40% 20% Tunisia 1.50% 4 500 45% No 0% Yes Yes No No Yes 180... 342...... (...) Information not contained in the reports and/or questionnaires received (a) Vaccinations (b) Issuing of certificates (c) Food hygiene and inspection (d) Veterinarians (e) Livestock technicians (f) Auxiliaries and other para-veterinarian categories - 149 -
Appendix II (contd.) Third group of countries: Policy of cost recovery and privatisation of veterinary services (mixed system) Country Budget livestock / agriculture (%) Budget livestock ($US 1000) Contribution Cost from State recovery Contribution to livestock budget Existence Transfer of organised of activities producers to organised sectors Sub-contracting to private sector Vac. (a) Cert. (b) Insp. (c) Civil servants in Veterinary Services Vet. (d) Eng. (e) Aux. (f) Coverage by public sector Vacc. Care Benin 9.7% 3 940 12% Oui 20% Yes Yes Yes No Yes 70 27 281 99% 85% Burkina Faso 25% 4 000 0.17% Oui 60% Yes Yes Yes No No 83 116 443 90% 80% Ghana......... Oui... Yes No No No No 201... 445 100% 98% Guinea............................................. Kenya............................................. Niger............................................. Senegal... 1 730 100% Oui 3.6% Yes Yes No No No 74 15 362 65% 65% South Africa 5.4% 18 700 100% Oui 0.1% Yes No No No No 134 500 350 15% 60% Sudan............................................. Uganda 34.4% 16 421 10% Oui... Yes Yes Yes No No 510... 1 300 90% 90% Zambia 14% 3 600 95% Oui 10% Yes Yes Yes Yes No 60 180 450 90% 75% Zimbabwe............................................. - 150 -
Appendix III GENERAL STATISTICS CONCERNING THE PUBLIC SECTOR AND PRIVATE VETERINARY PRACTICE First group of countries: Policy of cost recovery by the Public Services No. of vets. No. of vets. Recruited / Veterinarians Veterinarians in private practice Ratio Country trained / year recruited trained in the Urban Rural Veterinary Private Total private vet. / by the State % public sector area area drugs laboratories State vet. Angola.............................. Botswana... 4... 28 4 0 0 0 4 7 per 50 Egypt 800 600 75% 11 000 0 0 0 250 250 1 per 50 Malawi...... 14 3 0 0 0 3 1 per 5 Namibia... 1... 32 11 4 0 0 15 1 per 2 Swaziland 11 2 18% 16 3 0 1 0 4 1 per 4 Tanzania.............................. Second group of countries: Policy of privatisation of veterinary services No. of vets. No. of vets. Recruited / Veterinarians Veterinarians in private practice Ratio Country trained / year recruited trained in the Urban Rural Veterinary Private Total private vet. / by the State % public sector area area drugs laboratories State vet. Algeria 700...... 1 195 350 1250 3 2 1 605 4 per 3 Comoros......... 11.................. Côte d'ivoire 10 3 30% 27 3 0 4 0 7 3 per 4 Morocco 40 6 15% 242 20 110 7 3 140 3 per 5 Tunisia 30 10 33% 180 14 76 11 2 103 3 per 5 (...) Data not available in the reports or questionnaires received - 151 -
Appendix III (contd.) Third group of countries: Policy of cost recovery and privatisation of veterinary services (mixed system) No. of vets. No. of vets. Recruited / Veterinarians Veterinarians in private practice Ratio Country trained / year recruited trained in the Urban Rural Veterinary Private Total private vet. / by the State % public sector area area drugs laboratories State vet. Benin 6 0 0% 70 8 3 1 0 12 1 per 6 Burkina Faso 5 0 0% 83 13 22 35 1 71 7 per 8 Ghana... 10 201 1 4 9 0 14 7 per 100 Guinea.............................. Kenya........................ 154... Niger............ 2... 3.. 5... Senegal 10 0 0% 103 16 13 25 0 54 1 per 20 South Africa 100 5 5% 134 1 210 454 0 1 1 665 62 per 5 Sudan.............................. Uganda 35... 510 10 12 15 0 37 7 per 100 Zambia 21 15 71% 60 32 20 4 1 57 9 per 10 Zimbabwe......... 85............ 45 1 per 2-152 -
Appendix IV OVERALL FRAMEWORK AND ACTIVITIES IN THE FIELD OF PRIVATISATION OF VETERINARY PRACTICE First group of countries: Policy of cost recovery by the Public Services Country Legislative and Existence Subsidies and / Existence Contracts Budget Civil servants Public / Percentage of Percentage regulatory of a or loans to of an organised between for in private private vaccinations of care pre-requisites privatisation the private sector of public & these practice sector provided by provided by to privatisation policy / sector producers private activities on the side competition the private the private strategy sector ($ 1000) sector sector Angola No National........................ Botswana No In progress No Yes Yes... Yes No 10% 5% Egypt No No No Yes No 0 No Yes 0%... Malawi No Yes No Yes No 0 No Yes 5%... Namibia Yes No No Yes No 0 No No 10% 20% Swaziland No No No Yes No 0 No No 9% 25% Tanzania Yes Yes Yes..................... Second group of countries: Policy of privatisation of veterinary services Country Legislative and Existence Subsidies and / Existence Contracts Budget Civil servants Public / Percentage of Percentage regulatory of a or loans to of an organised between for in private private vaccinations of care pre-requisites privatisation the private sector of public & these practice sector provided by provided by to privatisation policy / sector producers private activities on the side competition the private the private strategy sector ($ 1000) sector sector Algeria Yes Yes No Yes No 0 No No 90% 90% Comoros No Yes No Yes No 0 No No...... Côte d'ivoire Yes Yes Yes Yes Yes 207 Yes No 0% 5% Morocco Yes Yes Yes Yes Yes 1 000 No No 60% 80% Tunisia Yes No Yes Yes Yes 75 Yes No...... (...) Information not contained in the reports and/or questionnaires received - 153 -
Appendix IV (contd.) Third group of countries: Policy of cost recovery and privatisation of veterinary services (mixed system) Country Legislative and Existence Subsidies and / Existence Contracts Budget Civil servants Public / Percentage of Percentage regulatory of a or loans to of an organised between for in private private vaccinations of care pre-requisites privatisation the private sector of public & these practice sector provided by provided by to privatisation policy / sector producers private activities on the side competition the private the private strategy sector ($ 1000) sector sector Benin Yes Yes Yes Yes Yes... No No 1% 25% Burkina Faso Yes Yes Yes/1995 Yes Yes 0 No Yes 10% 20% Ghana Yes Yes No Yes No 0 No No 0% 2% Guinea Yes Yes No..................... Kenya.............................. Niger Yes Yes No..................... Senegal Yes Yes No Yes In progress 0 No No 35% 35% South Africa Yes Yes No Yes No 0 Yes No 85% 40% Sudan No Yes........................ Uganda Partly Yes Yes Yes Yes... Yes Yes 10% 10% Zambia Yes Yes Yes Yes Yes 100 Yes No 10% 25% Zimbabwe Yes........................... - 154 -