EUFMD |
33rd Session - Appendix 16 |
|
Appendix 16 |
Appendix 11 - Report on the status of Contingency Planning in Member Countries.John Ryan & Yves LeforbanIntroductionAt the 32nd Session of the Commission it was decided that the Secretariat was to be informed of the status of member countries’ contingency plans and that the executive committee should follow up on the report of the situation. The contingency plans were assessed by questionnaire prepared in English and in French. This report will initially take a look at the response rates to the questionnaire. This will be followed by an analysis of these responses. Then a special section will outline the specific constraints mentioned by member states. This will be followed by an analysis of the role of EUFMD in relation to contingency planning and finally the conclusions.
Response RatesResultsThe response rate was good with 30 responses and only 3 countries not responding. Of these responses 21 countries supplied a copy of their plan while 9 did not. Of the 15 EU countries, 14 responded to the questionnaire, and all included a copy of their plan. Of the 18 non-EU countries, 16 responded to the questionnaire, but only 7 included a copy of their plan. Four countries have plans in preparation but 5 did not supply a copy of the plan.
CommentThe importance of having a contingency plan to deal with a crisis situation cannot be over emphasised, as the quality of decision-making under such crisis situations is directly proportional to the amount of planning and information gathering which has taken place before the outbreak.
Analysis of ResponsesThe questionnaire examined all aspects of the contingency planning process:
1) Legal Powers ResultsThis section of the questionnaire analysed whether the necessary legal powers are available to the Veterinary Services to adequately deal with an outbreak situation. All of the 30 countries that replied can enlist the help of the police and other authorities, can impose restrictions on animal movements and can initiate emergency vaccination. All but 2, i.e. 28 countries, can impose compulsory slaughter of infected and in-contact animals and can subsequently destroy the infected and in-contact animal carcasses. Legal provisions for the compensation of farmers following compulsory slaughter are in place in 26 countries. Constraints specific to the legal aspects of contingency planning were mentioned by four countries. These included not having enough funds to implement the law, difficulties in defining control zones, difficulties in modifying the legislation to allow compensation payments, existing legislation allowing local authorities to act independently, and social factors and constitutional clauses preventing prolonged and complete animal movement restrictions.
CommentIn general the legal powers are adequate. All or part of the countries which don’t allow compulsory slaughter lie outside Europe and practice preventative vaccination and ring vaccination around an outbreak. The constraints mentioned are specific to certain countries are not generalised problems.
2) Financial ProvisionsResultsThe number of responses to this section was lower than that for other sections as only 23 member countries provided financial details. Only 13 countries have emergency funds permanently available, 6 more countries need to get governmental approval. The total budget for animal health in member countries ranged from $400 million to 1 million with a mean of $33.3 million. This corresponds to a range of $25 to $0.36 (mean=$6.2) per head of susceptible livestock. Twelve countries reserved funds for payment of compensation and these funds ranged from $16 million to $10,000 (mean=$3.2 million). This corresponds to a range of $5 to $0.50 (mean=$1.6) per head of susceptible livestock. The cost of maintaining an emergency vaccine/antigen stock was given by two countries. The total costs were given as US$580,000 and US$ 9 million, which corresponds to $0.21 and $0.32 per head of susceptible livestock.
CommentGetting governmental approval for the necessary funds can be slow and add additional delay in an emergency situation. The figures per head of livestock are only indicative of the level of preparedness and financial commitment of member countries’ governments and they do not allow for the large variation in size of the member countries. The available funds per head of livestock and the costs of maintaining a vaccine bank per head of livestock are useful for comparison between countries of equivalent size and can be used to justify the case for more funds when petitioning governments. Comparing these budgets is difficult as the cost of implementing a contingency plan (labour, transport, communications, vaccine, facilities, equipment, disposables, compensation to farmers etc.) and the costs associated with the implications of an outbreak (effects on international trade, social impact, loss of production, loss of genetic resources etc.) vary greatly between countries and even between regions within countries. For example, the total cost of all the control measures required to deal with an outbreak, and therefore the amount of funding required (for vaccine stocks, equipment, compensation funds etc.), varies significantly between an outbreak in densely populated pig exporting region of high cost western Europe, and an outbreak in sheep in a sparsely populated region of lower cost eastern countries. In conclusion, the response to this section could be better. Much more data is required to make an assessment on whether there is sufficient funds available to deal with an outbreak. Compensation funds are highly recommended as they are critical in ensuring that farmer vigilance is the first line of defence. There are 3 categories of costs which should be clearly calculated and up-dated regularly when securing funding for FMD (and other OIE listed diseases) from the political decision-makers:
It is recommended that the total of Control costs (2) and Implication costs (3) are used to justify adequate funds to cover Prevention costs (1). In justifying the availability of funding for Control costs (2) , it is suggested that the costs are calculated for several scenarios (worst case, best case, & a range of more probable scenarios) and a weighted average is calculated of these costs (the weights can be derived from probabilities suggested by a thorough risk analysis). This weighted average cost of controlling an outbreak can justify the provision of an emergency fund, when it is compared to greater costs like lost trade for longer periods, or the cost of not containing an outbreak. In the larger countries, it would be useful if each region undertook this same economic analysis. As the agricultural industry gains the greatest benefit from effective prevention and control of FMD, state veterinary services should explore any arrangements where the substantial costs involved could be shared with the industry. This may be essential in the future as European tax payers become less willing to support agriculture either directly or indirectly. Two ways which could be explored are the creation of revolving funds administered by the industry, or a system of insurance against the costs involved in an outbreak, where the premiums to be paid by each enterprise are based on the risk associated with their activities i.e. an importer of pigs for fattening in a densely populated region would pay more than a combined breeding-fattening enterprise in a region with a low population of pigs. It is because the industry doesn’t pay for the disease prevention costs incurred by its activities in international trade that such trade is so attractive and offers the potential for increased profits at the tax payers expense. Disease prevention and control costs are real and significant, if mechanisms were put in place where the full costs of disease control were allocated to those activities which carried the greatest risks, then such costs would act as a deterrent and help to reduce the overall risk of introduction of FMD. As veterinary services are under increasing pressure to remove barriers to trade under GATT and WTO agreements, new mechanisms must be found to protect the livestock populations under their care and new mechanisms of financing this increased workload must also be found. This is why these options should be fully explored and supported.
3) Chain of commandResultsA direct chain of command exists 29 countries. A National Disease Control Centre (NDCC) exists in all countries. It is headed by the CVO in 19 countries, by another officer in 6 countries, by the minister in 1 country and it is not clear who heads the other 4 NDCC’s. In one country representatives of the 5 Ministries involved in emergency situations have representatives at the NDCC. The organisation of the NDCC varies greatly between countries. The number of staff within the Centre varies from 3 to 12. The equipment listed in the questionnaire is available in 22 countries. Regional Disease Control Centres (RDCC) and/or Local Disease Control Centres (LDCC) exist in 24 countries. The number of RDCC and LDCC varies from 0 to 500. The structure and arrangements between national and regional disease control centres varies considerably across countries.
CommentThe different arrangements and structure of disease control centres in the countries reflects differences in size, administrative history, power distribution, etc. It is not correct to judge a "right" or "wrong" structure, the only issue is whether any given structure is appropriate to the size of a country, the culture of the staff etc. What is really important its that the correct decisions are made. Clear leadership and rapid decision making are required in a crisis and often structures can have an undue influence on the flow of essential information to the decision makers and on the implementation of those decisions. It is recommended that all countries recognise the shortcomings of whatever structure is in place i.e. it might be prudent to decentralise decision making and control in large countries, as long as a clear chain of command is still functioning and the regions can be trusted with correct decision making, while in smaller countries it may be more prudent to centralise the decision making and maximise the use of scarce expertise.
4) Resources required for disease emergenciesThe questionnaire enquired about the various resources needed to deal with an outbreak, i.e. personnel - in terms of manpower and expert teams - equipment, materials and communications. The actual manpower available in the veterinary services to deal with an outbreak varies from 40 to 3,000 persons. This labour pool can be supplemented with private veterinarians and practitioners in 7 countries. Personnel issues are decided and organised at national level in 12 countries, at regional level in 6 countries and at both levels in 6 countries. Shortage of manpower was listed as being due to budgetary restrictions, difficulties involving private vets and a lack of any practical experience of FMD amongst the great majority of personnel. In response to these constraints, other possibilities which could be explored are hiring national or international consultants for the period of the outbreak, sub-contractors - veterinary or other specialists or commandeering staff from other governmental departments. One or several teams of experts exist in 21 countries. In 4 countries there are several teams who can operate at the same time. Each team consists of 3 to 6 experts who are specialists in virology, epidemiology, weather forecasting, communications, an economist etc. In 2 countries these teams meet regularly even during periods of absence from the disease. Equipment for collection and transport of samples is available in 29 countries, it is available in the national laboratory in 20 countries, in the regional laboratories in 5 countries and in the RVO or DVO in 9 countries. In terms of equipment for humane slaughter, special vehicles for the humane killing of pigs are available in 3 countries, electric devices for the humane killing of animals are available in 7 countries and captive bolt guns are available in 12 countries. However, no special equipment for humane killing is available in 12 countries. Slaughtermen with their own equipment can be involved in 13 countries, and equipment for disinfection is available in 10 countries. In terms of materials, 23 countries have protective clothing available, but in 12 countries, this is limited to expert teams or Disease Control Centre (DCC) staff only. Stocks of chemical products or disinfectants are available in 19 countries and an additional 3 countries have special contracts with private manufacturers. In 11 countries additional equipment for cleaning , disinfection and for burying animals (excavators) can be obtained by leasing. Advance arrangements or service contracts are made in only three countries. Communication Equipment exists in all countries at the national (NDCC) and regional levels (RDCC, LDCC). Fax facilities are present in all centres and 12 NDCC are equipped with mobile phones. It is safe to conclude that communication is no longer a major problem in member countries. The specific constraints mentioned in regard to resources were a lack of funding and a lack of standing arrangements for sanitation, while the more general constraints were a lack of advance contracts and a lack of facilities for humane slaughter.
5) Procedures
ProtocolsResultsWritten instructions for dealing with FMD outbreaks exist in only 21 countries but were updated in 1997 or 1998 in only 12 countries. Eight countries updated them between 1995 and 1996 and 2 countries updated them pre-1994.
CommentThe importance of written protocols/plans that are updated regularly cannot be too highly emphasised. There is also no conclusive evidence from the questionnaire that these documents/manuals are in place.
Collection of SamplesResultsThe collection of samples is also very varied with the National Laboratory responsible in 7 countries, the regional laboratory in 2 countries, a team of experts in 5 countries, the DVO in 9 countries and the local veterinarian in 5 countries. Standing arrangements for sending suspected material to the WRL exist in only 10 countries and of these only 2 countries have pre-printed export permits and standing arrangements with air companies.
CommentOnce again the method of collection of samples is not as important as the result which should be: rapid sampling by well-equipped competent vets or technicians in the field. The 1996 outbreak in the Balkans showed that in the absence of standing arrangements with air companies and the WRL transporting samples may take some time. Rapid diagnosis and characterisation of the virus strain by a competent laboratory and/or the WRL is highly recommended but the results do not suggest that sufficient advance arrangements have been made in this regard. It must be recalled that this commitment to provide the WRL with all new isolates - ideally all index cases - is included in Paragraph 4, Article II of the Constitution of the Commission.
6) TrainingResultsOnly 20 countries organised training workshops and their number varied from 1 to 20 per year. Simulation exercises were organised in 17 countries and were combined with the training workshop in 8 countries. Material for training is prepared in 17 countries and videos for training are prepared in 9 countries. Constraints for training were mentioned in 11 countries, and include the increase in the official tasks of veterinary service, a lack of training material, the cost, a lack of personnel, and a lack of experience in organising simulation exercises.
CommentTraining programmes are not a strong enough feature in the plans, and should be increased. Simulations are needed to keep awareness and freshness. Assistance can be provided in designing and organising these simulations. The constraints as regards training are generalised problems but may be overcome by giving a higher priority to FMD, committing more resources to FMD and getting assistance from EUFMD or other countries with more experience in specific areas. This can be justified as simulations and training for FMD can also have benefits in the control of other exotic diseases.
7) Awareness campaignsResultsIn the period 1995 to 1997 there were 11 countries where a suspicion of vesicular disease has been reported, there were 12 countries with no suspicions of vesicular disease and in 7 countries there was no answer to the question. In total, 110 false suspicions for vesicular diseases were notified that is an average of 35 suspicions per annum that were ruled out by national experts and in some cases after laboratory testing. Awareness campaigns are conducted for vets in 22 countries, for farmers in 18, for farmers associations or the industry in 19, and for the public and consumers in 14. The media used depends on the target group, sanitary bulletins, and professional magazines for veterinarians, professional magazines and farmers journals for farmers and the industry and TV and the printed press for the general public. One country also uses the internet to disseminate FMD information. One country also arranges a special programme for airlines serving infected countries. The absence of FMD for many years in the great majority of countries is reported as a major constraint for awareness campaigns as private vets and farmers become de-sensitised to the campaigns.
CommentWhere no suspicions are reported it may be due to low levels of awareness or surveillance or particularly in countries that are free of the disease, that the reporting procedures are too complex i.e. the costs and consequences of reporting false suspicions are too high for the farmer and the vet. When it comes to awareness, all national veterinary services have limited resources in terms of man-hours and funds, therefore it is all the more important that strategic use is made of them. Some countries only organise campaigns at the time when the disease has entered neighbouring countries, this may be too late!!! It is suggested that a basal awareness campaign should be maintained at all times, and in the case of increased threat, that this campaign should be boosted. The aims of an awareness campaign should be to sensitise all citizens to the dangers of FMD, while targeting sub-groups of the population with more specific knowledge when required. A strategic awareness plan should build the general awareness of the population over time. A suggestion is as follows: The short term goal would be an awareness campaign to target any group dealing with infected countries (tourists, traders, transport companies) and give them a basic awareness of the do’s & don’ts. A medium term goal would be to target all relevant professionals/technicians (vets, agriculturists, customs professionals, police etc.) and ensure that they are given a full appreciation of the dangers, the economic impact and the control methods for FMD and other OIE listed diseases. They should be thoroughly educated as to their role and responsibilities in the control of these diseases, and this includes regular refresher courses for all these professionals. The long term goal is to raise the general awareness among the population, and activities can be taken to target young people in schools to give them a basic appreciation of the importance of the OIE-listed diseases and outline their civic duties regarding disease prevention and control. This may overcome the problem of ignorance when tourists illegally import animal products from infected countries and will mean that warnings given later in their lives will have a greater impact. As the volume of international travel and trade continues to grow, there is a need for veterinary services to modify their view of exotic diseases. It may no longer be possible to police and control all the movements of people, animals and animal products which can impact on a country’s disease status. In this scenario, prevention of animal diseases becomes a concern for everybody.
8) Arrangements for Emergency VaccinationResultsThe decision to vaccinate is taken by the CVO in 14 countries, by the minister in 7 countries and by a committee in 9 countries. Whether there will be rapid access to a vaccine bank with the relevant strain and to the necessary vaccination equipment is not clear from the results of the questionnaire.
CommentClear rules on the scenarios, criteria and thresholds when emergency vaccination should be implemented and on the procedure for arriving at this decision should be included in the contingency plan. Consulting with trading partners and international organisations is also highly recommended as it can clarify and simplify the process for re-instating trade when the country or region is free from the disease again. This is reflected in the recent history of outbreaks in Europe, when decisions to vaccinate were not taken at purely national level but in a committee which included representatives of international organisations. An examination of the whole information system leading to such a big decision is suggested, i.e. the arrangements for reporting, gathering data, processing the information, the role of decision support programmes, thresholds, scenarios, computer models etc.
ConstraintsSpecific problems with the whole process of contingency planning are: the absence of disease for several decades de-sensitising farmers and vets, the shortage of funds, the lack of personnel, the disposal of cadavers while respecting the environment, access to vaccine banks, the involvement of other authorities/associations/police/industry, involvement of private veterinary personnel, the limited number of experts and staff with experience in FMD and the difficulty in giving contingency planning a high priority among the many other tasks of the veterinary service.
Role of EUFMDThe role of EUFMD got a very mixed bag of responses and this was due to the open nature of the question where countries were free to suggest any response. The most popular role identified was to inform and co-ordinate FMD surveillance and control suggested by 19 countries, followed by dissemination of information (10 countries), and the organisation of meetings/training courses and promoting regional co-operation suggested by 9 countries. There was some support for the roles of advising on contingency plans (8 countries), of preparing guidelines (4 countries), of providing equipment and vaccine (3 countries) and of helping countries gain access to vaccine banks (2 countries). This mixed bag of responses probably reflects the different status of member countries in terms of their economic and political circumstances as well as their disease status. As countries needs differ so do their expectations from EUFMD. This is also reflected in the replies to the question on which particular aspects of contingency planning that the support of EUFMD is expected. 11 countries expected technical advice and co-ordination, 9 countries expected training and simulation exercises, 8 countries wanted a team of experts from EUFMD to assist in outbreaks of FMD, 2 countries expected EUFMD to help non-EU countries, 2 countries expected grant-aid for their National Diagnostic Laboratory, and 6 countries expected EUFMD to create publicity and disease awareness. All 30 countries agreed that their contingency plans and the other information that they provided could be circulated to other member countries. All countries also agreed to share their experience and provide support to other member countries in the preparation of their plans.
ConclusionsFor EUFMD we conclude that the questionnaire was a useful exercise and that it should be repeated regularly to track improvements or slippages in contingency planning. It is hoped for a better response from non-EU countries and an increase in the number of plans submitted. Assistance can be given to any member country in the preparation or validation of a plan. A small stock of non-perishable equipment has been ordered for Rome as agreed. There will always be resource constraints even in the richest countries. What must be remembered is that finance is only one resource of many, yet it seems to get most of the attention. Leadership, good planning and sound management are far more important resources which should not be forgotten. As the only true measure of a contingency plan is its success when confronted with a real outbreak, validation by simulation should be a priority for all countries. This cannot be emphasised too strongly. To follow up this report it is suggested that EUFMD:
|
© European Commission for the Control of Foot-and-Mouth Disease
|
Back to
|
