Education and training needs to improve animal disease surveillance systems

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Education and training needs to improve animal
disease surveillance systems
Cristóbal Zepeda MVZ, MSc, PhD USDA-APHIS-VS
Centers for Epidemiology and Animal Health /
Animal Population Health Institute, Colorado
State University
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Objectives

• Identify problems affecting the efficiency of
  surveillance systems
• Describe skills required at different levels
  within disease surveillance systems
• Propose possible solutions

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Animal health surveillance

• Collection, analysis and interpretation of data
  to determine
• Distribution of diseases in time and space
• Presence or absence of disease
• Tool for decision-making
• Directed at the control and eradication of
  diseases

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The challenge

• SPS measures under the spotlight
• Increasing demands on the veterinary
  infrastructure
• Need to demonstrate the animal health status
• Effective surveillance systems central to the
  process

• However...
• Reduction of public spending
• Veterinary services often not top priority
• Decreasing budgets for veterinary services
• Weak infrastructures
• Difficulty to obtain funding for surveillance

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Increased demands

• Disease freedom
• Initial declaration
• Maintenance
• Compartmentalization
• Internal and external surveillance
• Outbreak surveillance
• Large number of samples
• Increased loads on surveillance systems and Dx
  laboratories

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Why conduct surveillance?

• Disease priorities should be based on
• Public health impact
• Impact on production
• Impact on international trade

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Surveillance and monitoring

• Surveillance
• Transforms data into information
• Implies an action
• Essential for diseases under a program

• Monitoring
• Overview of disease occurrence
• Does not imply an action
• Basis for the development of a program

Both activities require the support of competent
diagnostic laboratories
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Surveillance systems
International reporting
Data analysis
Laboratory networks
Field Level
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Approach
Informal survey of veterinarians working in
disease surveillance systems and academia
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Veterinary presence in the field

• Many developed countries are experiencing a
  shortage of veterinarians working with production
  animals
• Preference for small animal practice
• Lifestyle choices
• Gap in coverage
• May become a critical problem in the near future
• The same is true for some developing countries
• But not all

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Veterinary presence in the field

• In some developing countries there are sufficient
  veterinarians in the field
• Varying quality
• Excessive number of veterinary schools
• Coverage may vary by production system

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Factors affecting the coverage of surveillance
systems

• Geographic coverage
• Awareness of field veterinarians and farmers
• What to report? To whom? What happens if I do?
• Economic incentives
• Possible consequences of disease reporting
• Conflicts of interest
• Compensation
• Inadequate or inexistent programs

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Factors affecting the coverage of surveillance
systems

• Inability to directly link the benefits of animal
  health surveillance with better production,
  market access and public health

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Skills

• Do new graduates have adequate skills to
  understand the importance of surveillance and
  their role in surveillance systems?
• In many countries training in epidemiology has
  increased in veterinary schools
• Not necessarily true in all countries
• Emphasis is still on individual clinical cases

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Changes in veterinary curricula

• Increased training in applied epidemiology at the
  undergraduate level
• Practical applications
• Emphasis on the human-livestock-wildlife
  interface
• Increased awareness on the importance of
  surveillance at graduate programs in epidemiology
• National and international obligations
• Exposure to animal health officials

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Graduate level programs

• Increased offer in graduate-level programs
• Expensive
• Funding sources are critical
• Long term commitment
• Problem to secure the current position when the
  trainee returns

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Possible approaches

• Modular approaches
• Diploma and MSc
• Distance education
• Mixed delivery modes
• Possibility to accumulate credits from multiple
  institutions
• Across international borders

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Role of international organizations

• Veterinary education extends beyond university
• Continuing education programs
• Essential to hone and update skills
• Role of OIE collaborating centers
• Applied epidemiology courses

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Short courses

• Very useful
• Targeted to a specific objective(s)
• e.g. surveillance, biosecurity, risk analysis
• Allow participants to return to their work and
  apply new knowledge
• Do not replace postgraduate training
• There are no shortcuts!

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Diagnostic capabilities

• Fewer veterinarians have an interest
• What is the role of the veterinarian in the lab?
• Provide the big picture
• Increased dialogue between epidemiologists and
  the lab
• Eliminate the us and them mentality

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Increased understanding of

• Population based approaches
• Estimation of population parameters
• Interpretation of diagnostic tests
• Understanding of surveillance objectives and
  approaches
• Link to public health

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Population based approaches

• Need to shift from individual clinical case
  emphasis to broader population-based thinking

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Epidemiological triad
Health
Disease
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Macro-epidemiology
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Temporal Pattern of 2003/4 and 2004/5 AI
Epidemics in Vietnam
Source Dirk Pfeiffer
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Veterinarians in public service

• Main objective is public health, through
• Prevention of zoonotic diseases
• Direct animal to human transmission
• Food security
• Safe, sufficient and nutritious food supply
• True for all veterinarians
• Including small animal practitioners

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• Overall, there is a need to shift from a
  veterinarian with a syringe to a veterinarian
  with a strategy

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Acknowledgements

• Arnon Shimshony
• Ian East
• Christine Power
• Katharina Stärk
• Dirk Pfeiffer
• Jorge Hernández
• David Hird
• Mo Salman

• Vitor Gonçalves
• Paulo Duarte
• Lachlan McIntyre
• Marc Stevenson
• Graeme Garner
• Katsuaki Sugiura
• Kachen Wongsathapornchai