A Step Forward with FMD Public-Private Partnerships in Eastern Africa

In Eastern Africa, the public sector currently leads efforts to control Foot and Mouth Disease (FMD), a highly contagious viral livestock disease with severe economic repercussions. However, private sector innovation and resources could make a big difference in tackling this disease. The World Organization for Animal Health (OIE), the intergovernmental institution responsible for global animal health, asserts that “public-private partnerships (PPP) is a joint approach in which both sectors agree responsibilities and share resources and risks to achieve common objectives that deliver benefits in a sustainable manner.”  If applied properly, such partnerships that leverage public and private resources could dramatically improve animal health in Eastern Africa — but first, we need to raise awareness of the PPP model and its benefits.

Supported by the Bill & Melinda Gates Foundation, the OIE has recently conducted research across 181 member countries and published a handbook that shows governments and organizations how to develop sustainable and impactful veterinary PPPs. Using the OIE PPP Handbook as a starting point, the AgResults FMD Vaccine Challenge Project aims to catalyze the formation of new PPPs to strengthen the FMD vaccine value chain (VVC) in six target countries: Burundi, Ethiopia, Kenya, Rwanda, Tanzania, and Uganda.

Managed by GALVmed, the Project is a Pay-for-Results prize competition that encourages the development and uptake of high-quality FMD vaccines tailored to meet the needs of Eastern Africa. The competition uses a cost-share to reduce the cost-per-dose for buyers, enabling public and private sector actors to better combat FMD through more consistent purchases of the new vaccines.

Drawing from the OIE PPP Handbook guidelines, our team will develop a PPP framework that will capture the unique challenges and opportunities for establishing partnerships in the FMD VVC in Eastern Africa, including production, purchasing, distribution, vaccination and post-vaccination monitoring. This framework will form the basis for future development and realization of actual PPP arrangements between public and private sector entities in the region to address the inherent challenges in the FMD VVC.   

A first step is to collaborate with EuFMD and OIE  on an online course they’ve developed, entitled “Applying Public-Private Partnerships to the Control of FMD and Similar Transboundary Diseases”. Public and private sector representatives from our six target countries are participating in this course, along with our Project team. The course is enhancing these representatives’ understanding of the benefits and key factors to create successful and long-lasting FMD control partnerships.

In the coming months, our team will engage course participants and other key stakeholders from the region to discuss the opportunities and barriers to PPP formation in each country. This input will form the basis of the PPP Framework, customised to the unique environments of the Project’s target countries. Once the framework is developed and validated, we will further promote its use as a catalyst for development of successful PPPs, beneficial to the FMD VVC in Eastern Africa.

For more information on the FMD Vaccine Challenge Project, visit the project pages on the GALVmed and AgResults websites.

Written by Nina Henning, the Team Lead of the AgResults FMD Vaccine Challenge Project.

Breaking the cycle of the zoonotic disease Neurocysticercosis

Much is being discussed about zoonotic diseases currently as a result of the ongoing COVID-19 pandemic, which scientists predict likely emerged from wholesale food market in Wuhan City in China. Globally, it is estimated that 75 per cent of emerging human diseases in the last three decades have originated from animals, increasing the urgency to identify strategies and control tools that will prevent and control zoonotic diseases.

GALVmed has been working on neglected zoonotic diseases that have the most severe constraints on small-scale agriculture in sub-Saharan Africa and South Asia. Take the case of Porcine Cysticercosis (PC), which is almost exclusively transmitted between humans and pigs. Porcine Cysticercosis is caused by Taenia solium and humans are the definitive hosts for Taenia solium. People can also act as intermediate hosts and develop human cysticercosis or neurocysticercosis, which can cause severe headaches, blindness, convulsions, epileptic seizures and can be fatal. Taenia solium is the cause of 30% of epilepsy cases in many endemic areas where people and roaming pigs live in close proximity. In high risk communities it can be associated with as many as 70% of epilepsy cases.

Porcine cysticercosis also has a devastating effect on the economy. The farmers incur serious financial losses when their infected pigs cannot be sold, are sold at reduced prices, or are condemned without compensation upon slaughter.

Attempts to control this infection through increased public health education, sanitation, improved animal husbandry and meat inspection, have proven largely unsuccessful in eradication of the disease. Hence, GALVmed and partners set out to develop control tools (vaccine, diagnostics and therapeutics) for porcine cysticercosis in a bid to stop the cycle of infections from pigs to humans.

Since the early 2010s, GALVmed worked with University of Melbourne, Australia, and Indian Immunologicals Limited (IIL) to develop the TSOL18 vaccine and make it available for use in endemic countries. The CYSVAX™ vaccine for porcine cycticercosis was licensed for the first time in India in 2016.

As part of this collaboration, GALVmed conducted five field trials in smallholder pigs of different regional settings in Asia and Africa to evaluate how the TSOL18 vaccine and the benzimidazole drug Oxfendazole, a pig de-wormer, can be integrated into effective PC control programmes. All studies showed that the TSOL18 vaccine achieves complete elimination of transmission of the parasite by pigs, when concurrently administered with oxfendazole (Paranthic 10%™). This marked a major step towards the integrated control of this important human disease. In addition, GALVmed explored the status of knowledge, attitudes and practices among pig farmers in smallholder settings and farmers’ willingness to pay for Cysvax® and Paranthic 10%™. And while the ‘added value’ of the porcine cysticercosis vaccine will accrue more to the public health sector than the farmer, the concurrent deworming could potentially give economic benefits to farmers through improved pig weight which give the farmers premium prices when selling their pigs. This addresses both the human health and economic aspects of this zoonotic disease.

Written by Beatrice Ouma

Veterinary Services: Improving Accessibility for Smallholder Farmers

World Veterinary Day provides a great opportunity to celebrate the work of veterinarians and other veterinary service providers around the world. And GALVmed wants to take the opportunity to recognize the contributions of our many veterinary partners for their continued support to our mission of bringing animal health solutions closer to smallholder farmers in developing countries.

As we mark this important day for veterinarians around the world, we also realize that much more work is needed to improve veterinary service provision to smallholder farmers, especially to those in remote, rural communities.

In industrialized countries where livestock production is a commercial business, the veterinary profession is well developed, with public and private veterinary practitioners ensuring disease control, food security, registrations and oversight of distribution and sales of animal health products, safe trade of animals and animal-derived products, production and services to livestock owners. In contrast, many livestock farmers in low-and middle-income countries lack regular access to quality veterinary services. This often leaves farmers with no choice but to self-diagnose, let disease run its course or procure and use veterinary medicines of uncertain origin or quality in unsupervised manner.

Small-scale livestock keepers everywhere recognise the benefits of quality veterinary medicines and advice that veterinary professionals can provide. Africa and South Asia are teeming with young people who could be trained and mentored to provide veterinary care. But a lot needs to be done to make the profession more attractive especially in remote areas, so that young and enterprising veterinarians, certified veterinary paraprofessionals and veterinary health technicians can set up a functioning chain of command linking public and private services in a manner that is efficient and economically viable for all participants.

Finally, I would like to briefly reflect on this year’s theme of environmental protection for improving animal and human health, which could not have been more apt given the global pandemic currently ravaging the world. The outbreak of COVID-19 reminds us why provision of animal health services is increasingly crucial in preventing zoonotic and other infectious diseases and ensuring the global food supply. The health of animals and humans are intrinsically linked. Addressing animal diseases directly improves human health, well-being, and nutrition and is urgently needed everywhere, including in low- and middle-income countries. Now more than ever, GALVmed is determined to play its role within a coordinated global approach among medical, veterinary and other relevant private and public sector players and professionals to prevent disease, human and animal suffering and food scarcity, particularly in the vulnerable southern hemisphere.

This post was written by Carolin Schumacher, Chief Executive, GALVmed

The AgResults Foot and Mouth Disease Vaccine Challenge Project: Stakeholder Views

On 22 January 2020, GALVmed and AgResults launched the   AgResults Foot and Mouth Disease Vaccine Challenge Project,  an eight-year, US$15.8 million prize competition that encourages the development and uptake of high-quality FMD vaccines tailored to meet the needs of Eastern Africa.

The launch, which was held alongside the EuFMD Vaccine Security Meeting at FAO headquarters in Rome, brought together various stakeholders from the animal health industry.

We spoke to representatives from GALVmed, AgResults and several pharmaceutical companies on varying topics – ranging from the impact of FMD to how private vaccine manufacturers can engage with the new project.

This new initiative is funded by AgResults, a collaborative initiative between the governments of Australia, Canada, the UK and the US as well as the Bill & Melinda Gates Foundation. GALVmed is implementing the project.

Initiative specifics:

Focus on FMD:

Vaccine Manufacturers impressions:

Smallholder farmers: ‘We need a game changer in the fight against Foot and Mouth Disease’

45-year-old Paul Mathai looks forlornly at his nearly empty cow shed. A few months ago, all the nine paddocks were occupied. Today, only three of his dairy cows are left. And he has no calves left. He lost them to the dreaded Foot and Mouth Disease (FMD).

“I first started noticing a lot of saliva in the cows’ mouths and also noticed they were not feeding well and were inactive. That is when I called the veterinarian who diagnosed FMD and initiated treatment. But within a span of two days, I had lost the cows,” says Mr Mathai who hails from Bahati sub-county in Nakuru.

Paul is one of the many farmers currently grappling with an outbreak of FMD in the county. Nakuru has especially been hit hard because there has been a recent influx of livestock from neighbouring counties of Laikipia, Baringo and Narok.

FMD is a viral livestock disease that not only causes mortality but also severely limits livestock productivity and disrupts trade of animals and animal products, leading to huge economic losses.

“Before I lost my animals, I was getting over 50 litres of milk, now, I am lucky to get even 10 litres,” says Mr Mathai.
The loss of his cows has left Mr Mathai contemplating his agricultural venture which he spent a lot of money to set up. According to him, this particular outbreak is unprecedented, particularly to farmers keeping zero-grazed animals.

Francis Muiru, also from Bahati sub-county, is still struggling to come to terms with the loss of his eleven cows. He says in the nearly eight years that he has been rearing dairy cows, he has never witnessed such devastation.

“The calves were hit especially hard. Within a short period of time, they all perished. All my high production cows went down, one after the other. I am not milking any cows now, we have to purchase milk for our own consumption,” says Mr Muiru.

Nakuru county veterinary officers are currently conducting mass vaccination of cattle, swine, sheep and goats. But for some farmers, it may be too late for them as they count their losses. Vaccination remains the most effective method of controlling the disease as treatment is usually more costly. It can cost upwards of Kenyan Shillings 2500 (US $ 25) to treat one cow.

Ruth Silantoi, a smallholder farmer in Nakuru, didn’t lose any cattle during the current outbreak. However, she spent a lot of money treating her six cows who became infected with the viral disease. “I spent a total of Kenyan Shillings 15,000 (US $ 148) to treat my six cows. This has really put a big dent on our household income,” noted Ms Silantoi.

Farmers continue to express the need for more vaccine options so that they are able to purchase the vaccine and actively prevent rather than treat the disease. As was voiced by one farmer, “I have spent so much money to buy my improved dairy cattle, if there was a vaccine I could reliably purchase to protect my animals from FMD, I would not hesitate. I would not want my cattle to go through this again, we need more options to fight this disease.”

In responding to this gap, the Global Alliance for Livestock Veterinary Medicines (GALVmed) is implementing a new project that seeks to increase the supply of FMD vaccine through augmenting the government supply with a private sector model for buying and distributing vaccines. The AgResults Foot and Mouth Disease Vaccine Challenge Project will expand the FMD vaccine offering by encouraging pharmaceutical companies around the world to develop, register, and commercialise improved FMD vaccines in Eastern Africa – specifically in Kenya, Uganda, Tanzania, Rwanda, Burundi and Ethiopia. This will enable farmers to have more options for accessing the vaccine and be more active in the control of the disease by vaccinating more regularly even when there is no outbreak.

Written by Beatrice Ouma, Senior Communications Manager, GALVmed

Livestock health provision for smallholder farmers: What will it take to move the needle?

Our professional lives are often so cramped with problems to solve, targets to reach and deadlines to meet that we may find it difficult to think. However, it is when we stop and make time to think that we increase the possibility to gain insights that will “move the needle”. At a recent “Private Sector Meeting” in London organised by Ducker Frontiers, the Bill & Melinda Gates Foundation’s Livestock team created such an opportunity and allowed their private sector partners to “take time out, look back and think about the future”.

Representatives of varying origins and interests discussed the accomplishments achieved since the importance of livestock was approved as a significant component of the BMGF strategy for economic growth for poor people. Since 2012, a strong foundation has been built for animal health deliveries by de-risking market entry and investments into research and development, registration of products and exploring inclusive and innovative business models. More companies are now actively engaged in working with small livestock farmers, and the 2021 targets set for product registration licenses and pharmaceutical products and vaccine doses delivered are likely to be met. In addition, enabling regulatory capacity building, public-private partnerships creation and animal systems facilitation have provided fertile grounds for future private sector entry.

Valuable lessons have been learned and a better understanding of the opportunity and the challenge ahead obtained: Due to its development trajectory, Africa is uniquely placed to offer investors and businesses both high growth from existing business and new, untapped opportunities. By 2050, one-in-four consumers will be African. Double digit growth rates seen in the 2000s are unlikely to return, but sub-Saharan Africa’s growth will still outpace other regions. Investors are prioritizing Africa (+11%) compared to Asia (4%) or developed economies (-27%). Port, rail and road constructions are making previously difficult-to-reach markets more accessible for firms and their distribution partners. Red tape remains a major challenge in sub-Saharan Africa, but regional countries are making swift progress reducing administrative burden. In 2019, the region had more pro-business reforms than other regions. Digital offers new solutions in some markets. 20% of the world’s landmass is located in Africa, representing a vast agricultural potential. Livestock production is expanding rapidly and markets such as Ethiopia, Tanzania and Burkina Faso will create new food sources to respond to the growing middle classes’ appetite for high-protein diets. In short, with the right strategies in place, businesses can capitalize on Africa’s opportunities and growth (source – Ducker Frontiers).

Business strategies and the efforts of the BMGF grantee and partner community will have to focus on overcoming or removing the remaining barriers for animal health investment in Africa: On top of the list stand the lack of distribution networks to cover rural parts of countries and the unpredictable regulatory environment.

Logistical costs of getting products to the end-customer in remote areas are still prohibitively high. The high operating costs for the local organisations affect the final cost and margin of the product and make competition with low-cost offerings and/or parallel imports challenging. Commitment of multinational companies to long-term investment in Africa is still hampered by the perception of high risk, cost and complexity in the African market (source – BMGF private sector survey).

The participants of the BMGF private sector meeting agreed that to achieve economic development and create functioning markets for the poor, there is a big need to break the vicious cycle of poor investment, lack of quality veterinary health care, animal disease burden (estimated at 6% of the total value of the livestock sector in Africa – D. Grace et al. 2015), reduced productivity and livestock market failures. To engage the animal health industry, there needs to be a better understanding of the size of the opportunity and clarity on the level of business risk. Africa is home to the largest livestock population in the world and will witness the greatest animal health market growth (Vetnosis: CAGR% 2018-23 >4.5%). Scale of the addressable animal health market in Africa is large – and growing, but to capture the opportunity, the business environment needs to become more conducive. And companies will have to make bolder investments, recognise smallholder farmers as customers and build smallholder farmer-specific portfolios, and value-added delivery through EDGE (Every-Day-Great-Execution).

Going forward, the objective of the BMGF and its grantee community is to collaborate more deliberately to remove animal health barriers related to availability, access, awareness and affordability of animal health interventions. The plan is to partner with two distinctive families of partners:

  1. Authorities, organisations and academia to strengthen systemic assets such as data and evidence, policies and advocacy, as well as the regulatory environment.
  2. With animal health manufacturers and distributors to foster research and development, registration and segment specific manufacturing, supply chain innovations, off-take markets and reduced cost of unit delivery.

On behalf of GALVmed I would like to express my sincere gratitude to the BMGF’s Livestock team and Ducker Frontiers for the valuable “Time to exchange, learn and think” provided. It was an inspirational gathering and I am looking forward to GALVmed’s continued contribution to solving the future’s pressing problems and making the African animal health market function for the poor.

Written by Dr Carolin Schumacher, Chief Executive, GALVmed

Addressing Nepal’s veterinary needs, one village at a time

In rural communities where most smallholder farmers live, veterinary centres are often located many kilometers away, closer to the semi-urban areas. The result is that many smallholder farmers such as these ones from Mahua village in Nepal, do not always have reliable access to veterinary products for their livestock.

GALVmed is working with Hester Biosciences Ltd in south Asia to create more sustainable distribution centers of veterinary products so that smallholder farmers can have better access to livestock medicines and vaccines. Increased penetration of veterinary products will mean more economic benefit to the smallholder farmers.

Bringing vet services closer to farmers of Bihar

An estimated 600 families live in the village of Makhdumpur, in the state of Bihar, in India. Many of these families are smallholder farmers who are still struggling to get access to essential veterinary products for their livestock. Together with our partner Hester Bisociences Ltd, we are working on making available the most needed veterinary products to smallholder farmers such as those living in Makhdumpur.