Presented at the

1
Transboundary Diseases, Agriculture and Health
Policy Implications and Research Priorities

• Presented at the
• Global Ministerial Forum on Research for Health
• Bamako, Mali 17-19 November 2008
• Gabriel Rugalema and Giulia Muir
• Food and Agriculture Organization of the United
  Nations

2
What are Transboundary diseases?

• diseases of significant economic, trade and/or
  food security importance for a considerable
  number of countries
• diseases which can easily spread between
  countries and reach epidemic proportions
• the environment in which these diseases are found
  and the human activities which facilitate their
  spread straddle common borders
• their control/management, including exclusion,
  requires co-operation between several countries.
  

3
Some examples of Transboundary diseases of
agricultural importance
4
The Burden of Disease a global snapshot
5
HIV and AIDS

• Number of people living with HIV 33 million
  people 3036 million
• New infections in 2007 2.7 million
• Deaths due to AIDS in 2007 2 million
• Source UNAIDS 2008 Report on the Global AIDS
  epidemic

6
Malaria

• Percentage of the worlds population at risk
  40
• Cases of Clinical Malaria each year 300
  million
• Malaria cases resulting in death each year 1
  million (some studies indicate
• as many as 3 million)
• Source http//www.theglobalfund.org/en/files/ab
  out/replenishment/disease_report_malaria_en.pdf

7
Tuberculosis

• People carrying the bacterium that causes
  Tuberculosis globally 2 billion
• Deaths due to Tuberculosis each year 1.6
  million
• Estimated number of people who will become sick
  from TB between 2000 and 2020 200 million
  Source http//tballiance.org/why/tb-threat.php

8
H5N1 Avian Influenza
9
Severe Acute Respiratory Syndrome (SARS)
10
Cholera
11
Peste des Petits Ruminants (PPR)
FAO, 2008
12
Factors making diseases transboundary What we
know

• 1. Ecological and Environmental changes
• 2. Human mobility and migration
• 3. Internal and International Trade
• 4. Unregulated movement of animals and plants
• 5. Interaction between humans and animals

13
Consequences of Transboundary Diseases

• Direct health impact (illness, death, disability)
• Costs related of prevention, treatment and care
• Economic loss at household and national level
• Disruption of trade and employment
• Barriers to entry into international commodity
  markets
• International trade and traffic may spread
  transboundary diseases
• Potential for exacerbation of political tensions
  between countries

14
Macro-economic costs of diseases

• According to recent macro-economic estimates, the
  growth rate per capita GDP in highly Malarious
  countries (0.25-1.3 points lower than
  non-endemic countries) can amount to almost half
  of the per capita GDP of poor countries over a
  period of 25 years. (Malaeny and Sachs, 2004)
• During the two months after the first outbreaks
  in Nigeria (February 2006) about 440,000 birds
  were destroyed. Assuming the disease follows the
  same course for the remaining year, compensation
  for 2.64 million birds will have to be paid in
  the first year. The Nigerian government has
  announced a compensation rate of US 1.95 per
  culled chicken, which would result into a
  compensation bill of about US 5.15 million for
  one year. (Hinrichs, Sims and McLeod, 2006)

15
Research Priorities, Capacity, Conduct and
Translation

• Why is further research called for?
• Extent of the problem not well known
• Dynamic environment (including climate change)
• Differentiated (social, geographical) cost of
  transboundary diseases not well known nor
  appreciated
• Control measures not always evaluated for their
  efficiency and effectiveness
• Etc

16
Research prioritieswhat we need to know

• Identify factors and channels facilitating the
  establishment and spread of transboundary
  diseases in different areas
• Epidemiological studies to examine and identify
  microbial types and sub-types, their prevalence
  and distribution in time and space
• Economic analyses of impact of diseases at micro,
  meso and macro economic levels
• Analysing existing disease surveillance systems,
  their strengths and weaknesses
• Examine international disease control efforts,
  gaps and lessons learned over the years.

17
Research Capacity

• Assess capacity building needs of institutions in
  areas considered as hotspots for disease
  outbreaks.
• Assess effectiveness of disease-control
  infrastructure and identify weaknesses.
• Assess the role and potential for use of modern
  technology in disease surveillance (mobile
  phones, PDA, computers).

18
Research Conduct

• Who will conduct the research? International
  Organizations like the FAO Local and
  international research institutions.
• Collective, multi-sectoral efforts are necessary
  through coordination and joint planning.
• Need for a common set of research tools and
  instruments.
• Need for both bottom-up and top-down approaches.

19
Research Translation

• Translating research into ACTION
• Need for frequent dialogue between researchers
  and end users of research (policy makers, local
  communities).
• Research should be policy orientated.
• International collaboration in research, policy
  development and implementation.
• Strong coordination of activities related to
  human health.
• Stimulate culture of evidence-based policy
  formulation.

20
Future Scenarios Transboundary diseases require
Transboundary solutions

• Given factors such as climate change, increased
  human mobility/travel and agricultural change, it
  is likely that Transboundary diseases will
  continue to pose a serious challenge.
• Transboundary disease challenges respect no
  internal, national or international borders they
  hence require global perspectives and responses,
  conceptually and geographically.
• Human activities are the most potent factors
  driving disease emergence our response or lack
  thereof will determine their persistence.