GALVmed held workshops in South Asia and Africa for stakeholders working in the field of taeniasis and cysticercosis recently to discuss integrated human and animal health approaches to controlling these parasitic zoonotic diseases.

Taeniasis and cysticercosis represent a serious public health issue in the developing world with negative impact on livestock farming households and national economies, causing around five million human infections and 50,000 human deaths each year.

The meetings held in New Delhi , India and Entebbe, Uganda, brought together policy makers and key influencers from the human and animal health sectors, regional and international human and animal health organisations, research, academia, commercial partners, civic society, manufacturers and their local technical representatives plus local pig farmers and traders.

Through presentations from national, regional and international experts, participants were given information and updates on current porcine cysticercosis (PC) control programmes in their territories. In Entebbe, Dr Angie Colston, GALVmed’s Assistant Director for Research and Development, presented results on GALVmed’s activities on PC including findings from GALVmed-commissioned cysticercosis landscaping studies in Africa.

In New Delhi, Dr M I Barbaruah from Vet Helpline India and Dr N P S Karki, an independent veterinary consultant from Nepal, presented the landscaping reports and results for India and Nepal respectively.

Keynote presentations were given by Professor Marshall Lightowlers, Professor of Veterinary Science at The University of Melbourne and Dr Meritxell Donadeu, International Development Professional and Visiting Research Fellow at The University of Melbourne. Professor Lightowlers and his team have developed the first-ever licensed vaccine for PC.

Also in attendance were Mr N S N Bhargav and Dr Baptiste Dungu of Indian Immunologicals Limited, India and MCI Sante Animale, Morocco respectively.

Engaging human and animal health organisations in East and Southern Africa

The Entebbe meeting, organised in collaboration with the Nairobi-based International Livestock Research Institute, was officially opened by Joy Kabatsi, Uganda’s Minister of State for Animal Industry and hosted over 50 participants from Madagascar, Tanzania, South Africa, Uganda and Zambia.

Dr Mwemezi Lutakyawa Kabululu from Tanzania, Dr Chrisostom Ayebazibwe from Uganda and Dr Evans Kabemba Mwape from Zambia, researchers from the three target countries featured in GALVmed’s African cysticercosis landscape and technical reports, gave national perspectives on the effects of the disease in humans and animals.

In addition, participants heard of the experiences of the Pan African Health Organisation (PAHO) on their ‘One Health’ approach to tackling PC and representatives from Madagascar shared their best practices and success stories with an integrated approach to controlling PC.

Commercial partners gave their perspective on the vaccine manufacturing, registration and distribution of vaccines.

Encouraging collaboration among human and animal health organisations in South Asia

In New Delhi, opening remarks were given by Dr A C Dhariwal, Director of the National Centre for Disease Control (NCDC), and Dr G Gongal, World Health Organization, India, to 45 participants from Nepal and the Indian states of Bihar, Meghalaya, Mizoram, Nagaland, Assam, Jharkhand, Tamil Nadu, Uttar Pradesh and New Delhi.

Speakers and delegates at the Suryaa New Delhi

Dr Dhariwal said the economic importance and evidence related to neglected tropical diseases like taeniasis/cysticercosis should be highlighted to encourage collaborations to occur. Dr G Gongal added that taeniasis/cysticercosis affects poor and excluded people more and since we now have PC tools, action must begin on ground.

Neurosurgeons Dr V Rajashekhar from Christian Medical College, Vellore, and Dr Manjari Tripathi, from All India Institute of Medical Sciences, N Delhi, called for programmes to control taeniasis/cysticercosis to be launched as soon as possible.

The need for improved disease surveillance systems to assist policy makers in making informed decisions was also highlighted by Dr Rahman, the head of International Livestock Research Institute for India.

Dr Mamta Dhawan implored all to collaborate so that a beginning could be made through small pilots in different states of India that could be replicated and scaled up once a successful model is identified.

A key outcome of the workshops was a call to target policy makers up to the highest level to create engagement and collaboration using a narrative from a human health perspective to make a compelling case for an integrated ‘One Health’ approach to control taeniasis and cysticercosis.

Raising public awareness of the disease, its prevalence, transmission and control was also emphasised. It is this awareness that will raise demand for vaccines  and dewormers and encourage manufacturers to maintain vaccine production with the overall objective of improving animal health and ultimately human health.

Commenting on the success of the meetings, Lois Muraguri, GALVmed’s Director of Policy and External Affairs, said: “The information and knowledge gained from these presentations and discussions has encouraged taeniasis and cysticercosis stakeholders to uphold a One Health approach as a viable option for the control of porcine cysticercosis and neurocysticercosis.

“I feel the delegates have gone away empowered to explore opportunities for overcoming the challenges by embracing a One Health approach and collaborating in finding integrated practical solutions for taeniasis and cysticercosis control in Africa and South Asia.”

GALVmed welcomes all questions and suggestions regarding taeniasis/cysticercosis and a One Health approach. Please contact: info@galvmed.org.

Further reading

It’s time to eradicate the main cause of preventable epilepsy in the developing world through collaboration

India report

Integrated One Health porcine cysticercosis landscape analysis

Nepal report

Landscape analysis for taeniasis/cysticercosis control

South Africa, Tanzania, Uganda and Zambia report

Landscape analysis: Prevalence and control of Porcine Cysticercosis and Human Taeniasis/Neurocysticercosis

Videos

Controlling Porcine Cysticercosis in Udaipur, Nepal

New tools to tackle Porcine Cysticercosis in rural Uganda

The future of veterinary service delivery in Kenya’s arid and semi-arid lands (ASALs) was recently
discussed by livestock keepers and Kenya’s top animal health experts. The workshop, which was held in
Nanyuki on October 4 and 5, 2017, was attended by 63 participants and was organised by the national
Department of Veterinary Services and Kenya’s Veterinary Board (KVB) in collaboration with the Global
Alliance for Veterinary Medicines (GALVmed), and the Inter-governmental Authority of Development Centre for Pastoral Areas and Livestock Development.

In Kenya, ASALs are home to 70 per cent of the country’s livestock which, according to Kenya’s Department
of Veterinary Services, are worth an estimated Ksh280 billion (US $2.7 billion). But delivery of quality
veterinary services and products in the ASALs is hindered by many challenges, including: the large
remote areas, wide dispersal of livestock herds, poor logistics i.e. rough terrain and inadequate roads and
cold chains, the pastoralists’ nomadic lifestyle, and the limited budget allocated to animal health services
by national and local governments.

The Nanyuki workshop invited ASAL regional stakeholders to discuss how livestock keepers can access
sustainable, affordable and quality veterinary products and services. Traditionally, particularly in the ASAL
regions, the gap in veterinary service provision has been filled by locally available non-veterinarians and
non para-veterinarians, such as community based animal health workers (CBAHWs), who lack veterinary
qualifications but may have received ad hoc training and live with, or in close proximity to, livestock
keepers in these regions. As well as receiving advice from CBAHWs, ASAL livestock keepers tend to treat
animals themselves, based on local knowledge and what they have observed of animal health workers in
the past.

Mark Karbolo, a pastoralist from Olpusimoru region in Narok County, credits CBAHWs with the survival of
30 of his cows and 200 sheep and goats. From his home, the nearest qualified animal health specialists
are located 150 km away in Narok town, and rarely attend pastoralist livestock. To request the assistance
of such specialists to his remote location would also be costly for Karbolo, hence his reliance on locally
available non-veterinarians for guidance. “They live among us and go to the towns to bring us [livestock]
medicines. They are also cheaper, so they really help us,” says Karbolo.

Public and private sector involvement According to Dr Ochieng Odede, Technical Director at Sidai Africa – a social enterprise operating in the livestock sector – the private sector is deterred from setting up animal health provision in the ASALs due to subsidies and issuance of free animal health products from, for example, government or animal health NGOs during emergencies. “If I’m running my shop and farmers who I’m serving get everything for free, I cannot sell to anybody,” says Dr Odede.

“That creates a hostile business environment for the private sector.” However, whilst working in the ASALs, Sidai Africa have observed that pastoralists are willing to pay for good quality animal health products if they see positive results, according to Dr Odede.

Participants at the Nanyuki workshop proposed that the ASAL county governments need to reach out to qualified animal health professionals and create financial incentives that will encourage them to stay in the area. Since devolvement of the Kenyan Government in 2010, county governments have been able to stipulate the number of veterinary surgeons and veterinary paraprofessionals required to meet their county’s needs. The Kenya Veterinary Association (KVA) are also urging county governors to employ more veterinary surgeons in the sub-counties, and more veterinary paraprofessionals in the wards, according to Dr Samuel Kahariri, KVA Chairman. Animal health training institutes are also being encouraged to allocate a certain quota of students from the ASALs to be trained in animal health, and to increase the number of professional animal health workers in these regions.

Filling the gaps

As a signatory of the World Organization for Animal Health (OIE), Kenya is bound by the institution’s guidelines, which call for veterinary services of member countries to be provided by professionals. However, there are currently 2,000 veterinary surgeons and about 8,000 veterinary paraprofessionals registered with the KVB. These numbers are insufficient to meet the needs of the country’s livestock keepers, and their reach is limited to the economically lucrative peri-urban regions where most animal health professionals are based.

As part of efforts to enhance better quality training and to address gaps in veterinary service delivery in Kenya, the Department of Veterinary Services (DVS) began a yearlong internship program in January 2017, with a target of training 1,000 animal health graduates at various training institutes and universities. The programme, which is funded by the Kenyan Government, has since trained 582 interns. Some have been placed in ASAL regions like Turkana County, and are working under experienced veterinarians to provide animal health services to the communities that live there. “They are exposed to the market, where they deliver services and get to know the challenges,” says Dr Dulu Thomas Daido, Deputy Director of Veterinary Services at the DVS.

“CBAHWs were used where there were gaps but with this programme coming in, there will be no gaps, there will be quality health services provided,” Daido continues. Experience in the field gives the graduates credibility, leading to a higher chance of employment following their internship; the programme is also a prerequisite for graduates to be registered with the KVB as veterinary surgeons or veterinary paraprofessionals.

In spite of the current initiatives, it was agreed that the needs of livestock farmers in the ASAL areas are still largely unmet. Due to the uneven distribution of qualified animal health providers, one recommendation from the workshop was to conduct veterinary service delivery mapping in the ASALs, and match this data against the number of livestock in these regions, so that gaps in service provision can be quantified and properly understood before implementing initiatives to fill the gaps. As those gaps are filled, workshop participants also recommended that veterinary services in the ASALs be delivered by qualified personnel, in line with Kenyan laws and OIE guidelines.

Dr Lois Muraguri, Director of Policy and External Affairs at GALVmed asserted in her presentation that livestock and their keepers, irrespective of where they are, deserve access to quality veterinary care, and urged participants to be pragmatic in offering short and long-term options to address lack of access to quality livestock services by livestock keepers in the ASAL areas. “A functional and practical approach should
enhance rather than curtail access, be affordable, and serve the needs of farmers in the ASAL areas,” said Dr Muraguri.

Words and pictures by James Karuga.

On 9 October 2017, the Global Alliance for Livestock and Veterinary Medicines (GALVmed) convened a half day meeting in Nairobi with 22 private sector representatives, including livestock product manufacturers, distributors and importers, to discuss how Kenya’s first animal health industry association should be structured and run.

Participants explored the economic feasibility of forming an animal health association, its name, purpose and aims, in addition to deliberating how an association would best
represent their interests before government regulatory authorities, and the self-regulation of members to ensure adherence to good industrial practices.

Although Kenya has several industry associations that focus on certain aspects of animal health, none deal exclusively with animal health issues, and especially, the provision of veterinary care. The existing associations, for example, focus on pest control, livestock feed or agrochemicals. The animal health industry in Kenya is therefore lacking an association to lobby on their behalf on issues such as the slow registration of new animal health products, and the prevalence of stringent taxes and duties on livestock
product imports.

According to Dr Kenneth Mbogori, Director of Metrovet Kenya Limited, a veterinary pharmaceutical manufacturing company, the absence of an animal health association (AHA) also makes it hard to prevent the circulation of counterfeit livestock products, and weed out rogue practitioners in the industry.

The recent half day meeting was a follow up to earlier events facilitated by GALVmed in 2014 and 2016, which brought animal health actors in Kenya together to discuss constraints in getting products and services to livestock keepers. In both the previous meetings, the formation of an AHA was proposed to represent its members, and raise the issue of inefficient animal health service delivery with regulatory authorities.

Following by example

To provide participants with an idea of how an AHA operates, Andre Westerveld, the President of the South African Animal Health Association (SAAHA), gave a presentation on how and why SAAHA was set up, highlighting the benefits for SAAHA members, such as a reduced cost and time taken to evaluate applications for animal health product
licenses; because of this, SAAHA membership has doubled in the last six months. “Nonmembers are seeing an association that adds commercial value to them, and they are joining it,” says Westerveld.

He explained how Kenyan companies could receive such benefits if a similar association was  formed in the country. Led by an appointed independent general manager who is unaffiliated with of its members, SAAHA has gained credibility among regulatory authorities. The association has also aided the South African Government to form an independent veterinary regulatory body made up of experienced animal health researchers to evaluate dossiers for new products from its members. As a result, the time taken for the registration of new animal health products with regulatory authorities has reduced from about five to six years to about six weeks.

An AHA can also build an online forum to help members understand the market size and their company’s rank within the market, based on the sales data they provide. Members can then work to improve their sales if they have a low ranking, or work to maintain a top position if they are ahead. For Dr Patrick Mugo of Eagle Vet Kenya Limited, the potential of having access to market ranking data via an online forum is an exciting prospect. “Using the market information to know the market size and your position, you can act accordingly,” says Mugo. He also feels that an AHA would cater specifically to the needs of the veterinary industry, unlike the other associations currently in place in Kenya.

The Kenyan animal health industry players resolved to form their own association largely modeled on SAAHA, starting by appointing a 10-member committee. The committee members were drawn from the animal health companies represented at the meeting. It was also agreed by those in attendance that the committee formed would discuss the aims of the AHA, types of memberships to be offered and their costs, and the pros and cons of its formation. The committee would then present its deliberations in a month’s time (November 2017) to all prospective members.

Professional services for producers

Formation of the association comes at a time when the veterinary medicines directorate (VMD) has been authorised to take up the mandate of regulating veterinary medicines in Kenya, which was initially with the Pharmacy and Poisons Board of Kenya. According to Dr Mbogori, the AHA would be able to conduct advocacy activities on members’ including representing their interests before regulatory authorities such as the VMD. This would address challenges such as the lengthy process for registration of animal health products.

According to GALVmed’s Director of Policy and External Affairs, Dr Lois Muraguri, formation of the association will be driven by animal health stakeholders in the country, and GALVmed’s role will be to facilitate their meetings, and bring them together. “Our aim is to have a professional industry where farmers can get quality services delivered to them, because they deserve it,” says Dr Muraguri.

(Words and pictures by James Karuga.)

Goat keepers in the western regions of the north Indian state of Uttar Pradesh have reared ruminants for hundreds of years, with virtually all households owning up to five goats on average. However, many such goat keepers have no understanding of such illnesses affecting goats as Peste de Petits Ruminants (PPR) or goat plague that afflict their herds, accepting the consequent losses  as God’s act.

There are two barriers to addressing these losses. First – a lack of awareness of the disease and vaccine, and second – difficulties in gaining access to animal health products and services in remote areas. Both need to be overcome in order to deliver a robust grassroots disease prevention and treatment service that benefits backyard goat keepers and smallholder farmers.

Local NGO, Sharif Gramodyog Vikas Kendra (Sharif Rural Development Centre), with support from non-profit company, Global Alliance for Livestock Veterinary Medicines (GALVmed), has recently completed a project that addressed some of the challenges faced in delivering such a service and produced solutions that will potentially bridge the gap.

The project focused on:

• Building awareness of good goat health management with the aim of reducing mortality rates through regular vaccination and deworming
• Creating a supply chain network for a PPR vaccine
• Improving rearing practices in the goat keeping community and develop goat rearing as a viable means of making a livelihood

“Any intervention cannot be aimed at short term goals,” said Dr Rahul Srivastava, Market Development Manager, GALVmed (in South Asia).

“By raising awareness of the service through training at the Indian Veterinary Research Institute, it creates a mindset shift among goat keepers. This is the starting point for delivering a sustainable animal health care service.”

“The first thing we had to do was to apprise them of the treatment for goat plague. Before the training, the villagers simply accepted it as a normal phenomenon,” stated Sharif Hussain, President, SGVK.

Several grassroots level veterinary professionals have availed the training and the results are evident on the ground now. By June 2016, the network had sold over 71,300 doses of the PPR or Goat Plague vaccines and 66,540 doses of the dewormers.

Parvez Alam, 43, from rural Moradabad was one of the para-veterinarians who received training. A para-vet since the age of 22, he found out about the campaign via one of the numerous posters that were displayed to publicise it and was motivated, joined the programme. Soon he was joined by his protégé and fellow para-vet 31-year-old Mohammad Owais. The star vaccinators of the campaign, the duo were responsible for vaccinating herds from over 15 villages.

When asked about the problems he faced Parvez said, “Initially there was some hesitation among villagers. They had never heard of vaccination.”

Both Alam and Owais are old hands at the trade and well known in the nearby villages. The villagers were soon convinced and the results were obvious.

“Earlier, every rainy season would see the goats suffering from diarrhoea and soon enough one by one the entire flock would die,” continued Alam.

As part of the awareness building campaign surrounding the available vaccine, over 23,000 posters and over 1,000 banners were displayed in 231 villages.

To create a demand for the vaccine service, smallholder goat keepers received training on good goat rearing practices in the local chaupals (village halls), and in addition, 131 were exposed to first-hand experience and training in goat health, nutrition and management for commercial goat farming at the Indian Veterinary Research Institute (IVRI) in Izatnagar.

Another 264 smallholder farmers were trained in 10 villages across the project area. Veterinary professionals from district veterinary hospitals were involved in every stage of the training process. Goat farming recommendations, which farmers reported were new to them, and interaction with veterinary professionals were also part of the training.

By June 2017, the project had reached a total of nearly 19,000 households in the project area with over 68,000 PPR vaccinations administered plus over 65,000 animals dewormed. Veterinary professionals from district veterinary hospitals were involved in every stage of the process, enabling robust support to the service delivery value chain.  The exposure to these aspects of goat farming and active interaction with veterinary professionals were also given to common farmers as a part of awareness creation. For them, this aspect of goat farming was a new component.

Smallholder goat keepers in the project area have spoken positively about the outcome of the project. For 50-year-old Anisa Begum, livestock is an important source of income for her family. Every year Anisa would feel helpless as her animals succumbed to the disease and died. Though some villagers were hesitant, Anisa readily vaccinated her goats.

“When they told me about the vaccine I was ready to get my animals vaccinated. The vets came here to help us, and we benefitted from their service,” Anisa said. The satisfaction among smallholder farmers with the results of the vaccination programme has increased demand.

“Well informed goat keepers will take good decisions in goat husbandry and create demand for quality products and services at the final mile,” said Dr Srivastava.

While demand among smallholder farmers has increased, raising awareness of the business potential of animal health medicines and vaccines was important to ensure the whole supply chain was on board with the initiative. Wholesale medicine traders and shop owners were made aware of the business opportunities while at the other end of the supply chain, goat meat traders were educated about the benefits of clean and nutritious meat from healthy livestock. The traders soon agreed to buy goats directly from the farmers who were vaccinating thus ensuring that the farmers would get a fair price for their efforts.

Future initiatives will target farmers who are enthusiastic about the small business potential of preventative goat health care and develop the market in vaccines to create a sustainable value chain.

(Written by Deepak Bhadana. Photos by ALTERNATIVES)