Risk analysis is a procedure that we all do intuitively in our everyday life as well as in our professional work. Only recently has it developed into a more formal discipline, which is being used increasingly in many fields of endeavour. In animal health it has perhaps been most widely applied in quarantine. Quarantine risk analyses are used for helping to decide the most appropriate health conditions for imported animals and animal products, and strategies for quarantine operations.
Risk analysis is a tool that can also be used to very good advantage for animal disease emergency preparedness planning. In this context, it is most readily applied to preparedness planning for exotic diseases (or exotic strains of endemic disease agents), and in this section risk analysis will be described for this purpose. However, there is no reason why it could not be applied for other animal health emergency planning.
Risk analysis comprises four components: risk identification; risk assessment; risk mitigation or management; and risk communication.
In this first component, the risks of untoward events or things that may happen in the future are first identified and then described. In the context of animal health emergencies, this would include identification of all high-threat diseases (exotic or otherwise); the factors that might change the level of risk (e.g. new serotypes or biotypes, or changing epidemiological or livestock husbandry patterns); and factors that might impinge on the capacity of the national animal health services to respond effectively to these disease threats.
The likelihood of those risks occurring is then estimated. The potential consequences of the risks if they occur are also evaluated, and are used to modify the assessment of the risk. For example, an exotic disease that had a high risk of entry to a country, but only had a low risk of establishment if it entered or only had trivial potential socio-economic consequences for the country, would only get a low overall rating on a risk assessment. Conversely, a low risk of introduction but high consequence disease would be assigned a higher rating.
The assessment of risks can be done in a quantified, a semi-quantified, or a qualitative way. It is inherently very difficult to quantify (or actually put probability numbers) to risks in many biological systems because of the lack of historical precedents and serious gaps in available biological data. It is recommended that qualitative risk assessments be used for exotic diseases. The risks can be described as extreme, high, medium, or low, or by using a simple scoring system, e.g. 1 to 5 for the level of risk, and 1 to 5 for the level of potential consequences (where 1 = negligible and 5 = maximum).
3.2.2 Risk management
This is the process of identifying, documenting and implementing measures to reduce these risks and their consequences. Risk can never be completely eliminated. The aim is to adopt procedures that will reduce the level of risk to what is deemed to be an acceptable level.
In reality, the whole of this Manual could be regarded as providing the risk management framework for CBPP Contingency Planning.
This is the process of exchange of information and opinions on risk between risk analysts and stakeholders. Stakeholders in this context would include all those who could be affected by the consequences of the risks (i.e. everyone from farmers to politicians). It is important that risk assessment and risk management strategies be fully discussed with such people so that they feel comfortable that no unnecessary risks are being taken and the risk management costs are a worthwhile insurance policy.
To ensure ownership of decisions, risk analysts and decision-makers should consult stakeholders throughout the whole process of risk analysis so that the risk management strategies address stakeholder concerns, and decisions are well understood and broadly supported.
The risk assessment component would best be carried out by the Epidemiological Unit in the National Veterinary Headquarters as part of the national early warning system for transboundary animal diseases (TADs) and other emergency diseases. Risk management and risk communication are tasks for everyone, but should be coordinated by the Chief Veterinary Officer (CVO).
It should be remembered that risks do not stay static. They will change with factors such as evolution and spread of epidemic livestock diseases internationally; emergence of new diseases; and changing international trading patterns for the country. Risk analysis should therefore not be seen as a one-off activity - it should be repeated and updated regularly.
As described above, risk assessment consists of identifying the risks, assessing the likelihood of them being realized, and modifying the perceived level of risk by an evaluation of the potential consequences.
The international status and evolution of outbreaks of CBPP (and of other important TADs), as well as the latest scientific findings, should be constantly monitored. This should be a routine function of the Epidemiological Unit of the National Veterinary Services. Apart from the scientific literature, the most valuable source of information would be from the OIE, through publications such as their weekly disease reports and the annual OIE World Animal Health, and by interrogation of the OIE Handistatus database (http://www.oie.int). Disease intelligence is also available from FAO, including in EMPRES Transboundary Animal Diseases Bulletin, which is published quarterly (and is also available on the Internet at http://www.fao.org/empres).
Promed, an internet mailing service, also currently provides a useful forum for very rapid dissemination of official and unofficial information on animal, plant and human disease occurrences around the world. Animalnet is also a useful source of information.
Having identified and listed the exotic disease threats, the next step is to assess how serious is the threat of entry of each disease to the country, and the routes and mechanisms by which it may enter. Factors that might be taken into account include:
- What is the current geographical distribution and incidence of CBPP around the world?
- Is the distribution fairly static, or has there been a recent history of spread to new countries, regions or continents?
- How close is the disease? What is the status of neighbouring countries, not only in respect to known presence of CBPP, but also confidence in their veterinary services to be able to detect and control outbreaks of the disease?
- If it is present in neighbouring countries, where are the nearest outbreaks to shared borders?
- Is there a past history of introduction of CBPP to the country? Is it possible that it is still present in undetected endemic pockets of infection in cattle?
- Are cattle imported into the country, and do these come from known or suspected infected countries?
- How secure are barrier and border quarantine procedures to prevent unlawful entry of cattle into the country?
- Are there known patterns of unofficial cattle movements across borders from neighbouring countries through transhumance, nomadism or trading practices, which would constitute a risk for entry of CBPP? Where do these occur?
- Is there civil unrest in neighbouring countries that might result in major movements of people and movement or abandonment of livestock?
The next step is to evaluate how serious the socio-economic consequences might be if there were an incursion of the disease. Factors that might be taken into consideration include:
- Is the disease likely to become established in the country? Are there susceptible cattle populations?
- Would it be difficult to recognize the disease quickly in different parts of the country?
- How big are the cattle populations in the country? How important are those livestock industries to the national economy? What is their importance in satisfying nutritional and other needs of communities?
- How is the cattle industry structured within the country: is there a large commercial beef or dairy cattle production industry, or does it consist mainly of subsistence pastoral systems? Are cattle concentrated in just a few areas of the country?
- How serious would the production losses be from the disease? Would food security be threatened?
- What effect would the presence of the disease in the country have for export trade of live cattle, meat or both? What effect would it have on internal trade?
- Are there populations of cattle that are poorly controlled and allowed to roam freely and which might constitute difficult-to-control reservoirs of CBPP infection?
- How difficult and costly would the disease be to control and eradicate? Is it capable of eradication?
Through addressing these questions and issues, it will be possible to build up a risk profile for CBPP, and to make judgements on the magnitude of the risk presented by the disease, in qualitative, if not quantitative, terms. Most importantly, it will be possible to get an idea of how CBPP ranks in relation to other high priority risk diseases, and what resources should be devoted to preparedness for CBPP in comparison with other diseases. It will also be possible to get some idea of where the pressure points may be for entry of the disease, and how veterinary services and contingency planning may need to be strengthened for CBPP.
The type of risk assessment that has been described will be of value for: determining how CBPP ranks in the priority list of serious disease threats for the country and what level of resources should be devoted to preparing for it in comparison with other disease threats; determining where and how quarantine protocols and procedures need to be strengthened; determining how laboratory diagnostic capabilities need to be strengthened; planning training courses for veterinary staff; planning farmer awareness and publicity campaigns; determining how and where active disease surveillance needs to be strengthened; and planning disease response strategies.