Education and training needs to improve animal disease

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

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

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

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

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

Why conduct surveillance? Disease priorities should be based on: § Public health impact § Impact on production § Impact on international trade

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

Surveillance systems International reporting Data analysis Field Level Laboratory networks

Approach Informal survey of veterinarians working in disease surveillance systems and academia

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

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

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

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

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

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

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

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

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

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!

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

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

Population based approaches § Need to shift from individual clinical case emphasis to broader population-based thinking

Epidemiological triad Health Disease

Macro-epidemiology

Temporal Pattern of 2003/4 and 2004/5 AI Epidemics in Vietnam Source: Dirk Pfeiffer

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

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

Acknowledgements § § § § Arnon Shimshony Ian East Christine Power Katharina Stärk Dirk Pfeiffer Jorge Hernández David Hird Mo Salman § § § § Vitor Gonçalves Paulo Duarte Lachlan Mc. Intyre Marc Stevenson Graeme Garner Katsuaki Sugiura Kachen Wongsathapornchai