EMERGENCY PREPAREDNESS: FORMULATION AND IMPLEMENTATION OF ANIMAL HEALTH CONTINGENCY PLANS IN THE MIDDLE EAST Sinan Aktas Deputy Directr, FMD Institute (SAP Enstitüsü) PK. 714, Ulus 06044, Ankara, Turkey Original: English Summary: Animal disease emergencies are ften caused by transbundary animal diseases, which are f significant ecnmic and fd security imprtance. Since these diseases can spread very rapidly, their cntrl requires advance planning, therwise they becme widespread and their eradicatin can be extremely difficult and cstly. Animal disease emergency preparedness and particularly cntingency planning shuld be regarded as an essential tl fr the cntrl f emergency diseases. Emergency preparedness planning is cmprised f tw main cmpnents: The first cmpnent is early warning, which is the rapid detectin f the intrductin f any emergency disease f livestck. It is based mainly n disease surveillance, disease reprting and epidemilgical analysis. The secnd cmpnent is early reactin, which is t implement withut delay disease cntrl measures t cntain the utbreak and t eliminate it prgressively. T achieve this gal, natinal emergency cntingency plans shuld be develped fr high risk diseases and these plans shuld be tested and refined thrugh simulatin exercises. Due t its gegraphical lcatin, the Middle East is under cntinuus risk f high pririty animal diseases frm Africa and Asia. Mst f the cuntries in the Middle East d nt have well dcumented cntingency plans in place fr mst f the high pririty emergency diseases. 1. INTRODUCTION The cntrl and eradicatin f animal diseases are primarily the respnsibility f individual cuntries whse executive fr this purpse is the natinal Veterinary Service. Due t the transbundary nature f many imprtant animal diseases, reginal and glbal cperatin is required fr the cntrl f these diseases. The Office Internatinal des Epizties (OIE), Fd and Agriculture Organizatin f the United Natins (FAO), Wrld Health Organizatin (WHO), Pan American Health Organizatin (PAHO) and the Inter-African Bureau fr Animal Resurces f the African Unin (AU/IBAR) are sme f the internatinal rganisatins dealing with the cntrl f such diseases. Animal disease emergencies may ccur when there are unexpected cases f epidemic diseases that can cause serius sci-ecnmic lsses. These emergencies are ften caused by utbreaks f transbundary animal diseases (TADs), such as OIE List A diseases, which are f significant ecnmic and fd security imprtance fr many cuntries. Transbundary animal diseases may be defined as thse epidemic diseases that are highly cntagius r transmissible and have the ptential fr very rapid spread, irrespective f natinal brders, causing serius sci-ecnmic and pssibly public health cnsequences. Their cntrl thus requires cperatin amng several cuntries. Such diseases may have serius cnsequences fr cuntries fr the fllwing reasns: They cause significant prductin lsses fr livestck prducts, such as meat, milk, wl and skins, They cmprmise fd security thrugh significant lss f animal prtein and lss f draught animal pwer,
They cause lsses f valuable livestck f high genetic ptential, They significantly increase the cst f livestck prductin thrugh the necessity t apply cstly disease cntrl measures due t expensive cntrl, TADs have the ptential t seriusly disrupt r inhibit trade in livestck and livestck prducts either natinally r internatinally, They increase pverty levels particularly in pr cmmunities that have a high dependence n livestck farming fr sustenance. The OIE recgnises 15 List A diseases, mst f which culd als be regarded as being TADs. These are ft and muth disease, rinderpest, peste des petits ruminants, cntagius bvine pleurpneumnia, Rift Valley fever, lumpy skin disease, vesicular stmatitis, swine vesicular disease, bluetngue, sheep px and gat px, African hrse sickness, African swine fever, hg chlera, fwl plague and Newcastle disease. All f these diseases may have serius cnsequences. Hwever, this list is nt exclusive. Other viral, bacterial, rickettsial and mycplasmal diseases may als be regarded as having the ptential t cause animal disease emergencies under sme circumstances. Althugh, in general, extic r freign animal diseases are accepted as emergency animal diseases, unusual utbreaks f endemic diseases may als cause an emergency. 1.1. The need fr animal disease emergency preparedness planning As mentined earlier, an utbreak f a transbundary animal disease can have serius sci-ecnmic cnsequences. Therefre, it is crucial t recgnise a new disease quickly while it is still lcalised and take necessary measures prmptly t cntain the disease and then prgressively eliminate it. If the recgnitin f the disease is delayed and it becmes widespread, eradicatin may be extremely difficult and cstly. The aim f an emergency planning shuld always be t eliminate a disease prgressively and finally eradicate it. The alternative f this apprach is limitatin f the disease by vaccinatin campaigns and ther disease cntrl measures. This alternative apprach will in the end prve mre cstly and will be a permanent cnstraint t efficient livestck prductin systems. In additin, the presence f a TAD in a cuntry will be disease emergency preparedness and in particular cntingency planning shuld be regarded as an essential tl t munting early effective actin during emergencies. These prgrammes shuld be accepted as an imprtant functin f natinal Veterinary Services. 1.2. Main cmpnents f animal disease emergency preparedness planning An efficient natinal quarantine system is very imprtant t prevent the entry and establishment f TADs. Hwever, even the best quarantine system cannt prvide an abslute barrier. Therefre, the develpment f cntingency plans and capabilities t respnd quickly t highly cntagius diseases shuld they enter a cuntry is essential fr the cntrl f such animal diseases. If a disease can be diagnsed early and a disease cntrl prgramme rapidly implemented, the chance f its eradicatin with minimal cst is high. Otherwise, if the disease becmes widespread in the cuntry, eradicatin may be very cstly and difficult. Tw essential parts f animal disease emergency preparedness planning are the develpment f capabilities fr early warning and early reactin t disease emergencies. Early warning is the rapid detectin f the intrductin f, r sudden increase in, any disease f livestck, which has the ptential f develping t epidemic prprtins and/r causing serius sci-ecnmic cnsequences r public health cncerns. It embraces all initiatives and is mainly based n disease surveillance, reprting and epidemilgical analysis. These lead t imprved awareness and knwledge f the distributin and behaviur f disease utbreaks and infectin, allw frecasting f the surce and evlutin f the disease utbreaks and the mnitring f the effectiveness f disease cntrl campaigns.
The success f a cuntry s capability fr rapid detectin f the intrductin r increased incidence f transbundary and ptentially epidemic animal diseases depends n: Gd farmer and public awareness prgrammes fr livestck diseases, Training f field veterinarians and veterinary auxiliary staff n recgnitin f imprtant epidemic diseases, Sustained active disease surveillance, Availability f reliable livestck identificatin systems fr enhancement f disease tracing capabilities, Efficient emergency disease reprting mechanisms, Implementatin f an emergency disease infrmatin system, Availability f labratry diagnstic capacity, Presence f links between natinal and internatinal reference labratries, Natinal epidemilgical capacity, Prmpt and cmprehensive internatinal disease reprting t the OIE and neighburing cuntries. Early reactin is t carry ut withut delay the disease cntrl activities needed t cntain the utbreak and then t eliminate the disease and infectin in the shrtest pssible time-frame and in the mst csteffective way, r at least t return t the status qu that existed previusly and t prvide bjective, scientific evidence that ne f these bjectives has been achieved. T achieve this, the fllwing elements need t be in place: Develpment f natinal emergency cntingency plans, bth generic and fr specific identified high risk diseases, which shuld be established, tested and refined thrugh simulatin exercises, Establishment f a natinal animal disease emergency planning cmmittee, Establishment f a cnsultative cmmittee n emergency animal diseases charged with the respnsibility f implementing the natinal animal disease emergency plans, Installatin f diagnstic capabilities fr all high threat diseases. These shuld be fully develped and tested in natinal and, where apprpriate, prvincial diagnstic labratries and linkages established with wrld and reginal reference labratries, Ensured arrangements fr invlvement f the private sectr, Arrangement fr epidemic livestck diseases t be included in natinal disaster plans s that the plice, army and ther services can be invlved as and when necessary, Preparatin f legislative and administrative framewrks t permit all necessary disease cntrl actins t be implemented withut delay, Arrangements whereby funding fr disease cntrl campaigns can be rapidly prvided, Ensuring that Veterinary Services are structured in such a way as t facilitate disease reprting and implementatin f a natinally crdinated disease cntrl/eradicatin campaign withut delay during an emergency, Prvisin f trained persnnel and ther necessary resurces, Cmpensatin arrangements whereby farmers r thers can be paid fair and quick cmpensatin fr any animals r ther prperty destryed as part f a disease cntrl campaign, Ensured access t quality assured vaccines thrugh a vaccine bank r frm ther surces, Harmnisatin f disease cntrl prgrammes and cperatin with neighburing cuntries t ensure a reginal apprach, Determinatin f the available internatinal agencies invlved in epidemic disease cntrl, which culd prvide early reactin assistance if needed and establishment f regular cmmunicatin channels with such rganisatins.
2. CONTINGENCY PLANS Cuntries need t have in place well-dcumented cntingency plans fr specific, high pririty emergency diseases, tgether with a series f generic plans fr activities cmmn t the varius specific disease cntingency plans. The purpse f a cntingency plan is t: Prvide plicy and guidelines fr the cnsistent management f an animal disease emergency by apprpriately trained persnnel, Prvide cherence f emergency disease plans, Prvide cmpatibility f peratin and prcedures between animal health authrities and emergency management rganisatins, Prvide guidelines fr the develpment f standard perating prcedures fr respnse persnnel. A cntingency plan fr a specific disease shuld include a disease strategy, which is the authritative reference t the cntrl/eradicatin plicies fr that emergency animal disease in that particular cuntry. It shuld prvide infrmatin abut: The nature f the disease, The principles f its cntrl and, Cntrl plicies. Each strategy shuld prvide sufficient infrmatin t allw authrities t make infrmed decisins n what plicies and prcedures shuld be used t cntrl an utbreak f that disease in that cuntry. Althugh they can be frmulated in different frmats, cntingency plans shuld have detailed infrmatin n the fllwing cmpnents: 2.1. Legal pwers The mst imprtant cmpnent f animal disease emergency preparedness is the availability f legal pwers t carry ut all necessary disease cntrl actins. This legislatin may include regulatins n: Cmpulsry ntificatin f animal diseases, Obligatin f animal wners t cperate in cntrl f infectius animal diseases, Establishment f restrictins (quarantine, surveillance zne, cntrl f mvements), Destructin f infected r suspected prducts and materials, Vaccinatin, Cmpensatin fr damage caused by the disease, Animal identificatin, Sanitary measures. 2.2. Financial prvisins Emergency disease cntrl is a cstly peratin and therefre financial planning is an essential part f any cntingency plan. Withut available funds, rapid respnse t emergency disease utbreaks may be delayed. The availability f special funds, which are accessible during emergencies, will help t save majr expenditure. Financial plans thus need t be develped that prvide fr the immediate prvisin f cntingency funds t respnd t disease emergencies. 2.3. Chain f cmmand The success f any cntingency plan fr emergency disease cntrl depends n the rganised management f all peratins. In rder t achieve this, the chain f cmmand frm the Chief Veterinary Officer (CVO) t field staff shuld be clearly mentined in the cntingency plan.
2.4. Natinal Disease Cntrl Centre (NDCC) The structures, respnsibilities and pwers f NDCC and Lcal Disease Cntrl Centres (LDCCs) and the list f equipment that shuld be available within these centres shuld be listed clearly. The NDCC is respnsible fr: maintaining disease preparedness and awareness, directin f lcal disease cntrl centres, liaisn with diagnstic labratries, liaisn with agricultural and trading bdies, and the media, arranging financial prvisins fr the cntingency plans, arranging training prgrammes, arranging disease awareness campaigns, directing the natinal strategy in the event f an utbreak f disease, deplyment f staff and ther resurces t lcal disease cntrl centres and liaisn with ther emplyers fr the release f staff, determinatin f prtectin and surveillance znes, prvisin f infrmatin t and liaisn with the media and natinal agricultural and trading bdies, sanctining the release f vaccine and the determinatin f vaccinatin znes, negtiating emergency financial prvisins t cver the csts assciated with an epidemic. 2.5. Cntrl at lcal level (LDCC) The respnsibilities f the lcal centres include: 2.6. Expert grups maintaining disease awareness and preparedness within its territry, directing and implementing the lcal cntrl strategy in the event f a disease utbreak. In the event f an utbreak reprt, the grup(s) will be alerted by the NDCC and mbilised in the field as sn as the disease is cnfirmed. The primary task f the expert grup is t prvide the natinal and lcal disease cntrl centres with a reprt. The team will als advise n sanitatin and carcase dispsal. The cmpsitin f the expert grups may vary, but it is advisable that each will cnsist f: a senir veterinarian, 1-2 veterinarians, 2.7. Required resurces 1 member f staff frm the diagnstic labratry, field staff with training in epidemilgy and meterlgy. Cntingency plans prepared fr animal disease emergency preparedness shuld include detailed infrmatin n persnnel, equipment and ther physical resurces. A list f all persnnel, wh are likely t be invlved in emergency disease cntrl, shuld be maintained. The qualificatins and expertise f these persnnel shuld be recrded and regularly updated. Arrangements shuld be made fr the temprary emplyment f veterinarians and ther staff. 2.8. Standing instructins
2.9. Diagnstic labratries Infrmatin n the diagnstic labratries, such as trained labratry staff, labratry equipment, diagnstic reagents and the capability f the labratries is essential. It is wrth mentining that fr the verall success f any cntingency plan the time perid between the intrductin f the disease and its detectin at the labratry is crucial. 2.10. Emergency vaccinatin Vaccinatin may be used as an ptin fr the cntrl f emergency animal diseases. If s, arrangements shuld be made fr the emergency vaccine stcks, vaccinatin teams, equipment fr vaccinatin and equipment t maintain cld chain. If there is n vaccine prductin in the cuntry, special agreements shuld be made with vaccine prducers t btain the vaccine. 2.11. Training prgrammes The persnnel t be invlved in an emergency situatin shuld be trained in their rles, duties and respnsibilities. The key persnnel shuld be given mre intensive training. Back-up staff shuld als be trained fr each psitin. 2.12. Publicity/Disease awareness The success f even the best cntingency plan depends n the supprt and cperatin f farmers, public and the media. Therefre, these interest grups shuld be very well infrmed n the cnsequences f specific animal diseases. 3. CONTINGENCY PLANS IN THE MIDDLE EAST Due t its gegraphical lcatin, the Middle East is under risk f high pririty animal diseases frm Africa and Asia. At present, ft and muth disease, rinderpest and peste des petits ruminants are accepted as the mst imprtant diseases fr the livestck sectr in the Middle East. Cntagius bvine pleurpneumnia, Rift Valley fever, px viruses, Newcastle disease are als seen as a threat fr the regin. Ft and muth disease, peste des petits ruminants, px viruses and Newcastle disease are still causing utbreaks in many cuntries f the regin. A simplified questinnaire was distributed by the OIE t the 19 Member Cuntries f the OIE Reginal Cmmissin fr the Middle East. Twelve cuntries cmpleted and returned the questinnaire. These cuntries are Bahrain, Cyprus, Egypt, Jrdan, Kuwait, Oman, Qatar, Saudi Arabia, Sudan, Syria, Turkey and United Arab Emirates. All cuntries that replied t the questinnaire have schematically well-rganised Veterinary Services t cntrl animal diseases. This shws that if they are prvided with required resurces, better cntrl f animal diseases will be achieved in the regin. The questinnaire shwed that mst f the cuntries in the Middle East d nt have well dcumented cntingency plans in place fr mst f the high pririty emergency diseases. Althugh sme cuntries have prepared cntingency against sme diseases, these plans have nt been reviewed and updated n a regular basis. Cntingency plans shuld nt be regarded as fixed dcuments. These shuld be regularly reviewed and updated by the natinal animal disease emergency planning cmmittee. In additin, the questinnaire shwed that the available plans have hardly ever been tested with simulatin exercises fr refinement. Simulatin exercises are very useful fr testing and refining cntingency plans befre facing the real disease emergency. The preparatin f cntingency plans against high pririty emergency diseases f animals with internatinal standards shuld be achieved in the regin. The cntingency plans that have already been prepared shuld be tested with simulatin exercises and the failing cmpnents shuld be reviewed. All the cuntries that replied t the questinnaire have the necessary legislatin fr the cntrl f animal diseases. Similarly, there is a direct chain f cmmand frm the CVO t field staff in all cuntries.
Only half f the cuntries that respnded t the questinnaire have special funds available t be used fr emergencies. The cntrl f emergency animal diseases requires a substantial amunt f financial resurces that are readily accessible. The cuntries f the regin shuld give mre imprtance t the allcatin f such funds t be used fr the cntrl f emergency animal diseases. The Natinal disease emergency planning cmmittee and the natinal disease cntrl centre are tw imprtant bdies fr the cntrl f emergency diseases. Mst f the cuntries reprted the presence f such structures. The diagnstic capabilities f the cuntries that respnded t the questinnaire are quite variable. While sme f the cuntries have n diagnstic capability t any f the OIE List A diseases, sme cuntries have the capacity f diagnsing mst f the OIE List A diseases. The cuntries f the regin shuld be encuraged t build up their natinal diagnstic capacities fr high risk animal diseases. On the ther hand, the pssibility f reginal and glbal cperatin fr the diagnsis f animal diseases shuld be sught. If feasible, the establishment f OIE reginal Reference Labratries fr the highest risk diseases fr the regin may be cnsidered. The vaccine prductin capacity f the cuntries in the regin is als variable. Sme cuntries can prduce vaccines against all majr emergency diseases and, n the ther hand, sme cuntries have n vaccine prductin at all. In additin, sme cuntries have n arrangements t btain vaccines in case f emergencies. The vaccine prductin capacity f the regin fr specific diseases shuld be determined and the use f excess capacity in the regin shuld be encuraged. The experiences and expertise f the individual cuntries fr vaccine prductin may als be shared fr the benefit f the whle regin. Active and passive surveillance systems are amng the essential parts f any disease cntrl prgramme. These are the mst imprtant cmpnents f early warning systems. Regular surveys shuld be planned and implemented t detect the intrductin f a transbundary animal disease and/r t determine unusual utbreaks f endemic diseases. Therefre, cntingency plans shuld include prgrammes fr surveillance. The questinnaire shwed that the cuntries in the Middle East have been cnducting surveys at least against majr diseases. It seems that mre attentin shuld be given t active surveillance and better rganised surveys shuld be planned against all high risk diseases in mst f the cuntries. REFERENCES 1. Animal Health Australia (2002). Australian Veterinary Emergency Plan (AUSVETPLAN), Editin 3, Animal Health Australia, Canberra, ACT. 2. FAO (1999). New technlgies in the fight against transbundary animal diseases. FAO, Rme. 3. FAO (1997). Preventin and cntrl f transbundary animal diseases. FAO, Rme. 4. FAO (1997). Develping natinal emergency preventin systems fr transbundary animal diseases. FAO, Rme. 5. Ft and Muth Disease Cntingency Plan (2001). DEFRA, UK. 6. Geering W.A., Reder P.L. & Obi T.U. (1999). Manual n the preparatin f natinal animal disease emergency preparedness plans. FAO, Rme. 7. Obi T.U., Reder P.L. & Geering W.A. (1999). Manual n the preparatin f rinderpest cntingency plans. FAO, Rme.