12th Conference of the

OIE Regional Commission for the Middle East

23-26 September 2013, Amman, Jordan

Foot And Mouth Disease (FMD) and Peste des Petits Ruminants (PPR)

control programmes in the Middle East and North Africa regions

Joseph Domenech, OIE

Foot and mouth disease distribution by

serotype and zones affected in 2012 and

early 2013

In Karim Ben Jebara Report to the OIE General Assemby, 2013

Intermediate, sporadic

Endemic

Free

Free. Virus present in game parks

Free with vaccination

Countries with multiples zones:

FMD-free, free with vaccination or not free

FMD Situation in 2013

In Gideon Bruckner, OIE General Assembly

May 2013

O 40%

A 23%

SAT1 2%

SAT2 19%

Asia 1 16%

From > 650 samples in 2012 from 25 countries

40% were serotype O

WRLFMD® Serotyping results for 2012- upto 3rd Quarter

Increased Asia 1 activity

Increased SAT 2 activity

Still No Serotype C (not reported since 2004)

In Gideon Bruckner

OIE General Assembly

May 2013

O, A

Pool 7

Pool 5 O, A, SAT 1, 2

Pool 4 A, O, SAT 1, 2, 3

Pool 1 O, A, Asia 1

Pool 2 O, A, Asia 1

Pool 3 O, A, Asia 1

Pool 6 SAT 1, 2, 3

Pool 3

O, A, Asia 1 & SAT 2

Regional Analysis- 2012

Asia 1 and SAT 2 on the move

Foot and mouth disease distribution by serotype

and zones affected in 2012 and early 2013 in Asia In Karim Ben Jebara Report to the OIE General Assembly, 2013

Foot and mouth disease distribution by serotype

and zones affected in 2012 and early 2013 in Africa In Karim Ben Jebara Report to the OIE General Assembly, 2013

FMD in North Africa

- Algeria, Morocco and Tunisia have not notified cases of FMD since 1999. In May 2012, Algeria, Morocco and Tunisia were recognised by the OIE as Member Countries with endorsed official control programme for FMD - Algeria and Tunisia carry out annual vaccination campaigns. Morocco has not implemented a vaccination campaign since 2007. - Mauritania: FMD is considered endemic. No vaccination campaigns have been put into place - Libya and Egypt have reported outbreaks of FMD in 2011 and 2012, particularly related to the introduction of new strains of serotype SAT-2. Vaccination is implemented

Since the 11th OIE Regional Commission for the Middle East held in Beirut in October 2011, the global situation is still worrying: 67 countries in the world are recognised as officially free (66 without vaccination and 1 with vaccination) and 10 have officially free zones (with or without vaccination. Of the OIE’s 178 Member Countries, 101 do not have FMD-free status. In the Middle East region, Cyprus is the only country with officially recognized free status without vaccination and Turkey has an officially free zone with vaccination. 4 countries in the world have officially endorsed national control plans 3 being Northern African countries.

Countries 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020

Jordan

Oman

Kuwait

Lebanon

PAT

Syria

Iraq

KSA

UAE

Qatar

Yemen

Bahrain

GF TADs Fifth Steering Committee meeting April 2012 Dubai

No response

Other

Level 0

Zone National

Level 5

Level 4

Level 3

Level 2

Level 1

State of play after the Bangkok global conference

Country 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021

Algeria OIE-CP

Bahrain 1  2 2  3 3 3  4  4  4  4

Egypt 1 1 1 1  2  2  2  2 3 3

Iran 2 2 2 3 3 3  4  4  4  4

Iraq 2 2 2 2 2 2 2 3 3 3

Jordan  1 1  2 2  3 3  4  4  4  4

Kuwait  2 2  3 3 3  4  4  4  4  4

Lebanon  1 1  2 2  3 3 3  4  4  4

Libya 1 1 1  2  2  2  2  2 3 3

Morocco OIE-CP

Mauritania

Oman  2 2  3 3 3  4  4  4  4  4

Qatar  2 2  3 3 3  4  4  4  4  4

Saudi Arabia 1 1 1 1  2  2 3 3 3  4

Sudan zone A 1  2  2  2  2  2  2 3 3 3

Sudan zone B 1  2  2  2  2  2  2  2  2  2

Sudan zone C 1  2  2  2  2  2  2  2  2  2

Syria 2 3 3 3  4  4  4  4 5 5

Tunisia OIE-CP

UAE 1  2 2  3 3 3  4  4  4  4

Yemen 1 1 1 1 2 2 2 2 3 3

FMD PCP Roadmap for NENA region, 2013

No response

Other

Level 0

Zone Nationa

l

Level 5

Level 4

Level 3

Level 2

Level 1

Important remark: these tables are under consideration by the OIE and FAO regional offices and by the GF TADs Working Group. They are given to show the GF TADs ongoing work but the assessments of the PCP stages are subjected to further finalization of the PCP assessment tools

Head lines of the Global FMD Control Strategy

FMD Control Strategy Component 1

FMD Control Strategy Component 2

Progressive FMD control in developing

countries will go hand in hand with

improvement of Veterinary Services

FMD Control Strategy Component 3

Improvement of VS will create better possibilities to control other major diseases of livestock

To strengthen the vital disease control supporting functions: laboratories, epidemiology (and economics), vaccines (availability, quality), emergency responses, identification of farms and animals, biosecurity, public/private partnerships

The Progressive

Control Pathway for FMD (PCP-FMD)

OIE Terrestrial Code articles

WAHIS WAHID

Laboratories Vaccines

Tools

- OIE Ad Hoc Group on FMD Status Evaluations: 2 to 3 times per year - OIE Scientific Commission for Animal Diseases (SCAD): 2 times per year 14 evaluations of country applications for OIE disease status recognition 14 and 5 for official control programs.

OIE Scientific Commission for Animal diseases (SCAD) and

Ad Hoc Group activities

Finalisation of Handbook on Animal Health Surveillance Joint OIE/FAO technical group to develop guidelines on post vaccination monitoring (PVM) for FMD Review of the OIE Terrestrial Code Chapter on FMD (Chapter 8.5) Expert missions to OIE Member countries (Kazakhstan, Mongolia) OIE/FAO FMD reference laboratory network annual report

- Near future: establishment of an OIE FMD Unit for Central Asia in Astana, Kazakhstan

Overview the procedures for official disease status recognition

Terrestrial Code Chapters 1.6 and 8.5

OIE endorsed official control programme for FMD

Article 1.6.2.

Endorsement by the OIE of an official control programme for FMD.

Members may wish to request an endorsement by the OIE of their official control programme for FMD.

When requesting endorsement by the OIE of an official control programme for FMD, the Member should submit to the OIE Scientific and Technical Department a dossier

providing the information requested in Article 1.6.7.

Article 8.5.48.

OIE endorsed official control programme for FMD

The overall objective of an OIE endorsed official control programme for FMD is for countries to progressively improve the situation and eventually attain free status for FMD.

Meets every two months:

Calendar of events related to FMD, support to and coordination of regional meetings

PCP guide update and Assessment tool preparation with EUFMD

Post Vaccination Monitoring Guidelines

Establishment and training of a group of experts

Bangkok Conference follow up and website development

The joint FAO/OIE FMD

Working Group (GF TADs)

Linkages between OIE procedures and PCP

- Terrestrial Code articles on status: countries that are already at a very advanced stage in eradicating FMD virus circulation. Not directed at infected countries, which come under PCP stages 0 to 3.

- PCP: tool to address the non-FMD-free country situations and for helping them to progress to successive stages in FMD control and ultimate eradication.

- New Articles 1.6.2, 1.6.7 and 8.5.48 on OIE endorsed FMD official control programmes: provide standards specifically addressing the stages prior to country FMD freedom.

At the end of PCP stage 3: a country can engage in a proactive policy of FMD eradication and can prepare and implement their official national programme which are submitted to OIE for endorsement

Clearly defined assessment tools for situation monitoring: PCP and PVS pathway, which consider not only specific FMD control methods but also the contexts in which Veterinary Services operate

To endorse National FMD control plans or to apply for FMD-free status recognition, countries progressing along the PCP Pathway will have to develop their VS to be able to fulfill the criteria.

Relationship between FMD PCP Stages and OIE PVS Critical competency Levels

All countries reaching PCP Stage 3 must at least have reached level 3 Compliancy for the 33 FMD relevant CCs

Post Vaccination Monitoring Guidelines

Coordination:

WG of the OIE-FAO FMD Reference Laboratory Network with the GF-TAD FMD WG and expert team for FAO and OIE

Objective:

To describe methodologies to use PVM in different epidemiological situations with regard to FMD status in a country.

Other WG priorities for 2013/2014

- Guidelines for socioeconomic impact studies

- Support to national and regional control strategies

- Annual report to the Global GF TADs Steering Committee on the implementation of the Global FMD Control Strategy

East Mediterranean countries: Egypt, Iraq, Jordan, Lebanon, Syria, 18 December 2013, Beirut

Gulf Cooperation Council countries+Yemen: Bahrain, KSA, Kuwait, Qatar, Oman, UAE and Yemen, 8 April 2013, Dubai.

4th West Eurasia Annual Roadmap Meeting,

April 2013, Bakou, Azerbaijan

a GF TADs event

GF TADs seminars/sessions on National Project Proposals

e.g. during the 4th West Eurasia Annual Roadmap Meeting, April 2013, Bakou, Azerbaijan

Also during the regional meetings in Beirut

and Dubai

To develop national strategies and program proposals. Activities carried out to convince countries to step up their FMD control activities with GF TADs Working Group support

Objectives of the seminars

To push the preparation of national project proposals within the regional context:

Governments and donors advocacy for more investment in controlling FMD

To present an overview of the Logical Framework approach and discuss it as a possible model for the preparation of national project proposals

To discuss major priorities for investment: Major problems to be solved

Is a planning procedure for complete project cycle management, It is an approach which takes into account the views of all stakeholders, It agrees on the criteria for project success and lists the major assumptions The LOGFRAME MATRIX is a participatory Planning, Monitoring & Evaluation tool It is a tool for summarizing the key features of a programme and is best used to help programme designers and stakeholders

The Logical Framework

LOGICAL FRAMEWORK MATRIX

Narrative Summary

Objectively Verifiable Indicators (OVI)

Means of Verification (MOV)

Important Assumptions

GOAL Overall

objectives

PURPOSE Outcomes

OUTPUTS Expexted

Results

ACTIVITIES Inputs

North Africa region

• In May 2012, Algeria, Morocco and Tunisia were recognised by the OIE as Member Countries with endorsed official control programme for FMD

This is a significant recognition of the

strong efforts of these countries to fight against FMD

• Algeria and Tunisia carry out annual

vaccination campaigns. Morocco has not implemented a vaccination campaign since 2007.

• Algeria, Morocco and Tunisia are committed to achieve the official status of FMD-free countries

• Libya and Mauritania have begun working for official recognition of their control plan A specific meeting to bring support to these countries is to be held in early

November 2013 at the OIE Sub Regional Representation

in Tunis.

2009 : establishment of

REseau MEditerranéen de Santé Animale

• Chiefs Veterinary Officers

• 10 countries

• Joint Cooperation Framework

• Coordination by FAO OIE Regional animal health center in Tunis

REMESA regional networks on diagnostic laboratories, epidemiology teams… A possible EuFMD support is under discussion with OIE, FAO and REMESA responsibles Technical collaboration on FMD between Libya and Italy (OIE Ref lab, IZS Brescia, Italy). FMD Regional meeting of the UMA Permanent Veterinary Committee (FMD control strategy in the Maghreb area, Rabat, July 2012)

Annual meetings of the FMD Reference Laboratory Network

OIE/FAO FMD Ref Lab Network

FAO Initiatives on FMD Global Control (See FAO presentation)

- Support to member countries in response to incursion of FMD outbreaks

- FAO-Wide meeting Dec 2012

- Development of a Near East

and North Africa control strategy

- FAO IAEA research coordination meeting, Rome April 8-12, 2013 - Second regional roadmap workshop for SAARC countries, India, Oct. 2013

Pool

5

Pool

4

Pool

3

See report of the 40th General Assembly, 22-24 April 2013, Rome, Italy

Activities of EUFMD contributing to the control of FMD worldwide besides of reducing the risks from the European neighbourhood

Growth in demand for mutton from

2000 to 2030, Robinson and Pozzi (2011) [i]

• Increasingly important viral

disease of livestock

• One billion small ruminants

are at risk annually

• In developing countries:

Lowers production efficiency

Food insecurity

Poverty at the household level

Particularly on livelihood

poor farmers

Trade impact

Export

restrictions

Peste des Petits Ruminants (PPR)

Epidemiology - Natural disease affects mainly goats and sheep. Usually more severe in goats. There are the only species having a significative role in the epidemiology of PPR - Cattle: generally infected subclinically only . - Buffaloes: PPRV was isolated from an outbreak of rinderpest-like disease in India in 1995. - Camels: suspected to be involved in Ethiopia in 1995–1996 - Wildlife: no significant role But no clinical cases in Sub Saharan Africa In Middle and Near East: morbidity and mortality in semi captive desert ongulates hippotragines, caprines, gazelles, In Central Asia, wild goats in Kurdistan. In South Asia, in free ranging wildlife in Pakistan

1942-1972 1980-1982 1987

2007 2008 2009-2012

Evolution of PPR distribution in the world

Evolution of PPR in Africa, the Middle East and Asia between 2005

and early 2013, and vaccination strategies reported for 2011/2012

In Karim Ben Jebara Report to the OIE General Assemby, 2013

The distribution of PPR has expanded throughout the past eight years. It is now present over a large part of Africa (in 2012 more than 50% of African OIE MCs are infected) and in the Middle East and part of Asia.

Morocco 2008, Tunisia 2009 et 2012, Algeria 2012 et 2013, Egypt 2012 (serological evidence in Libya)

Evolution of the PPR in North Africa

Increasing trend in Reporting: 40% in 2005, 50% in 2007, 60% in 2011, 67% in 2012/2013 - Present for more than 8 years in Afghanistan, Iran, Oman, Palestinian Autonomous Territories, Saudi Arabia, Sudan, Turkey, Yemen - Information for certain years, indicating presence: Iraq, Somalia Absent then present: Kuwait, Lebanon, Bahrain, Egypt Present then absent: UAE, Israel Absent between 2005 and 2013: Djibouti, Jordan, Syria, Qatar Never reported: Cyprus, Libya

See Karim Benjebara presentation, OIE Conf. Amman, 23-26 Sept 2013

Situation in Middle East

Evolution of peste des petits ruminants in the Middle East between 2005 and August 2013, and vaccination strategies applied in 2012

See Karim Benjebara presentation, OIE Conf. Amman, 23-26 Sept 2013

- SCAD, Code Commission and Ad Hoc Groups work - Proposed Standards sent to all OIE Delegates - Comments from all OIE Delegates - Second round of discussions - General Session May: adoption by vote of all Delegates during the World Assembly

Articles of the OIE Terrestrial Code related to PPR

Terrestrial Manual

Chapter 2 . 7 . 1 1 on PPR Summary A. Introduction B. Diagnostic Techniques C. Requirements for vaccines References

Chapter 1.6: Procedures for self declaration

and for official declaration by the OIE:

- Questionnaires for countries which applies for

recognition of status, under Chapter 14.8. of the

Terrestrial Code as a PPR free country or zone

- Questionnaire for countries which applies for the OIE

endorsement of its official control programme for PPR

under Chapter 14.8. of the Terrestrial Code

Chapters of the OIE Terrestrial Code regarding PPR adopted at the

81st General Assembly, Paris, 26-31 May 2013

Chapter 14.8. Peste des petits ruminants 34 articles including :

- 5 articles on country status - 1 9 articles on recommendations for importing commodities, 1 on inactivation of the virus - 7 articles on surveillance - 1 article on endorsed official control programme The articles on surveillance define the principles and provides a guide for the surveillance of PPR in accordance with Chapter 1.4. applicable to Member Countries seeking recognition of country or zonal freedom from PPR or seeking reestablishment of freedom following an outbreak - Introduction, general conditions and methods, surveillance strategies - Wildlife surveillance where a significant susceptible wildlife population exists

Endorsement of official control programs for PPR: a new tool to further progress

towards global PPR control

• Is not a status recognition but an endorsement of the national plan of a Member Country to progressively move towards freedom from PPR (with or without vaccination) in accordance with the requirements of the Code

• Country need not to be already free from PPR but must provide evidence that it already has a national plan in operation to move towards freedom

• Useful tools to help Member Countries to assess compliance with requirements of Article 14.8 and the information required in the Questionnaire in Chapter 1.6 of the Code are the OIE PVS Pathway and possibly the PPR-PCP (to be prepared)

• Endorsement can be suspended if non-compliance with Code requirements

• Is a voluntary decision by a Member Country

• Evidence of capacity of VS (PVS assessment)

• Plan applicable to entire country

• Evidence of disease reporting

• Information on epidemiology of disease in country

• Control measures to prevent PPR introduction

• Surveillance in accordance with the Code

• Detailed plan on future timeline and intended milestones/performance indicators

• Diagnostic access/capabilities

• Vaccination program

FAO OIE GF TADs PPR Working Group meetings

First meeting 21-22 January 2013

PPR has been included in the Regional 5 years Action Plans of Africa, the Middle

East and South Asia Preparation of a

Global PPR Control Strategy

Recommendation N°15 of the 5th Global GF

TADs Steering Committee, Paris, Oct 2012

Consultation process for the elaboration of the

PPR Global Strategy

Similar to the preparation of the FMD Global Strategy - With experts, national and regional authorities, policy-makers, development partners and private industry: Workshop to be organized - Lessons learned from regions - The Global Framework for the Progressive Control of Transboundary Animal Diseases GF-TADs) provides the governance structure to prepare the Strategy - Peer review of the strategy

Inputs from the OIE Scientific Commission and its Ad Hoc Group

- National, regional and global levels - Risk based approaches - Progressive phased approaches: successive steps/phases to be defined, from endemic situation with no control activities to eradication of the virus

PPR Control Strategies principles

The PPR Strategy will include several components such as: 1- Improving global PPR control 2- Strengthening Veterinary Services 3- Improving the prevention and control of other major diseases of livestock (e.g. brucellosis)

Which means that the strategy will combine vertical (disease specific) and transversal

(horizontal) approaches

Evolution of brucellosis due to B. melitensis in the Middle East between 2006 and July 2013, and vaccination

strategies applied in 2012

See Karim Benjebara presentation, OIE Conf. Amman, 23-26 Sept 2013

Regional and country experiences

• Middle East and Central Asia

• Far East Asia

• South Asia: India, SAARC countries

• Africa: see AU-IBAR presentation

Northern Africa: REMESA

Eastern Africa: see FAO presentation

Southern Africa: SADC countries

Western Africa: OIE pilot project

PAN AFRICAN PROGRAM FOR PROGRESSIVE CONTROL OF PESTE DES PETITS RUMINANTS (PPR) IN AFRICA

African Union

Interafrican Bureau

for Animal Resources

See AU-IBAR presentation

FAO Position paper on PPR Control, 2013

“FAO’s approach for supporting livelihoods and building resilience

through the progressive control of PPR and other small ruminant diseases”

Vaccine Standards and Pilot Approach to PPR Control

in Africa (VSPA)

Existing tools to be strengthened or new tools to be developed

- National laboratories and reg. networks

- Nat. epidemiol. teams and reg. networks

- Monitoring and assessment tools

- Post vaccination monitoring and evaluation tool

- OIE PVS Pathway tools

- Global Research and Expertise network

Monitoring tool

- Objectives: To follow the implementation of the

control strategy with a tool which describes the successive steps with the relevant activities and expected outcomes - Principles: Directly constructed from the global PPR control strategy. Several steps from no epidemiology understanding to eradication Combination of disease specific and transversal (Vet. Serv.) approaches.

Global Research and Expertise Network (OFFLU type network)

Objectives: To support the Global PPR Control Strategy implementation, to offer technical advice and veterinary expertise to Member Countries, exchange scientific data and biological materials between veterinary labs, promote development and ensure coordination of PPR research needs with close link and interactions with strategy development

Research and knowledge development to be supported (Research Group)

Socio economics, Epidemiology knowledge, Vaccine delivery systems, Vaccines and vaccination, Diagnostic tests…

Centre de coopération internationale en recherche agronomique pour le développement Dr Geneviève Libeau Montpellier, FRANCE

Institute for Animal Health Dr Michael Baron Pirbright , UNITED KINGDOM

OIE and FAO Collaborating Centers in Epidemiology: around 10 centres could work on PPR and related issues

Workshop for the formulation of a strategy for the control of PPR in the Arabian Peninsula, April 2013 Riyadh - Kingdom of Saudi Arabia (See FAO presentation)

Meetings to come

- Two GF TADs Regional Meetings in the Middle East for the Control of Peste des

Petits Ruminants, 2014

International Technical meeting December 2014

Meetings

North Africa

- Algeria, Libya, Mauritania, Morocco and Tunisia have begun working for official recognition of their control plan - A specific meeting to bring support to these countries is to be held in OIE SRR in Tunis: OIE Workshop on PPR and FMD Tunis, November 2013

- Workshop on PPR in the SADC Region 10-12 June 2013, Dar es Salam, Tanzania

Ongoing activities on PPR

« Vaccine Standards and Pilot Approach to PPR Control in Africa (VSPA) »

An OIE project funded by the

Bill and Melinda Gates Foundation

61

Launching meeting, Addis Ababa, Ethiopia, 11-12 February2013

Three components of the project: vaccine bank, Vaccine QC (PANVAC), Pilot field programme

Other regional and country PPR control programs in Africa

See FAO and AU-IBAR presentations

• VACNADA. 2011: 17,4 millions vaccination in 14 pays concernés, diagnostic and vaccine production

• LEISOM: 2,4 millions vaccination in Somalie

• AU-IBAR with ILRI, 2012 (pilot studies in two Eastern African countries)

• IAEA: support to 10 African laboratories (sequencing)

• AU-IBAR, IGAD and FAO initiative in Eastern Africa: the SHARE programme in IGAD Region

• FAO: support to countries (emergency vaccination, epidemiology surveillance, diagnostic, socio-économics, delivery systems)

Thank you for

your attention