Category Archives: CRP4

CRP on agriculture and health

Battling bird flu: Taking developing countries and their contexts into account is an imperative for success

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Fighting deadly bird flu in the developing world is more complex and difficult than in the industrialized west. To be effective, global control strategies must take developing-country contexts and perspectives into account.

A recent consultation on highly pathogenic avian influenza (HPAI) highlighted the complexities of fighting bird flu in the South. The consultation, held in Nairobi 14–16 June 2006, was organized by the International Livestock Research Institute (ILRI) and the International Food Policy Research Institute (IFPRI). Participants worked towards identifying how the research community can best assist developing countries and frontline personnel in the fight against bird flu both now and in the medium to longer terms.

 

The consultation report, How Research Can Support Efforts to Control Avian Influenza in Developing Countries: First Steps Toward a Research Action Plan, is now available. The report contains a comprehensive list of service and research needs identified by participants. The next step will involve validating and prioritizing these lists in a broader email-based consultation.

Battling Bird Flu: Developing Country Context & Perspectives
Developing countries have large numbers of widely dispersed small-scale and backyard poultry keepers. This makes detecting and controlling the disease difficult. In addition, these countries generally have insufficient numbers of professional in disease control and communication work and insufficient institutional support for controlling disease. All of this makes it difficult to communicate the risks of the disease and to get people to comply with control efforts. ‘Stamping-out’ (mass culling of poultry infected or suspected to be infected) is routinely adopted in industrialized countries, but this approach is likely to be impractical in developing countries. If our strategies to fight bird flu don’t take developing-country contexts into account, we will fail to control bird flu globally.

As important, John McDermott, ILRI’s Deputy Director General for Research, warns, ‘In the battle against bird flu, the world’s poorest people could become the main victims of the disease. They have little voice in how we control the disease and the burden of controlling it falls disproportionately on the rural poor, who both consume their own poultry and rely on it for their livelihoods.’

McDermott and his colleagues at ILRI and partner institutions in Africa and Asia are saying, in effect, that ‘one size does not fit all’. What works in the North will not necessarily work in the South. To fight bird flu successfully, we must attend to social as well as to economic and technical issues, we must learn from frontline experience, and we must understand the developing-country context for disease control. If we do these things, we will help develop control strategies that countries can tailor to their conditions and circumstances.

The Consultation: Experiences from the Front Line
The Nairobi Consultation opened with interviews of scientists with direct field experience in Asia and Africa. These experts with first-hand knowledge of fighting the disease identified illegal cross-border trade and live bird markets as key vehicles for the spread of bird flu within and between countries. Constraining early notification of disease outbreaks and subsequent control of the disease, they reported, were insufficient or total lack of compensation for lost birds, lack of trust in governments, and the common  farmer experience of losing lots of birds to Newcastle Disease and other, endemic, diseases.

Key Issues Highlighted
Compensation

  • Well-publicized and carefully thought out compensation plans are critical to achieving early notification of outbreaks and effective control of bird flu. Lessons from the front-line tell us that compensation plans should consider more than just direct compensation for birds lost to the disease or culling operations. While some countries have provided poultry owners with compensation, others have not done so or do not intend to offer any form of compensation. A key message from the experts at this consultation was that compensation matters, and it matters a great deal to millions of poor small-scale farmers.
  • In India, for example, although farmers received compensation within a few hours of their birds being culled, they were compensated for no associated investments. Many farmers had cash tied up in grain bought to feed their chickens and had no other use for the grain once their chickens were gone. India’s experience suggests that a broader view of compensation is required. The bird flu scare in India caused people to panic, poultry prices plummeted, and those directly and indirectly involved with poultry and grain lost their livelihoods as their industry crashed.
  • Implementing different compensation levels for different sizes and/or ages of birds lost could create new problems. Farmers might be tempted, for example, to hide their young birds until they grew to a size that would attract the highest price, thus putting people and animals at greater risk of the disease.


Major threats

  • Migrating birds: Many participants believed that migrating wild birds were not the greatest threat to the spread of bird flu in developing countries. Although southern Africa had not at the time of the consultation had any confirmed cases of the highly pathogenic H5N1 virus, different forms of bird flu have been present there for some years, typically infecting ostriches. Experts there are concerned about possible introduction of new strains from ostriches and introduction by illegal cross-border movement of people, birds, and avian products, as well as the wild birds who migrate from nothern Europe to this region.

 

  • Trade: Illegal cross-border transfers of both live poultry and carcasses was identified as one of the biggest threats to the spread of bird flu and a key route for transmission within and between countries. Live birds and poultry carcasses are already being smuggled across borders and this is likely to increase if widespread culling is implemented and little or no compensation is offered. The borders of many developing countries are large and porous with only certain parts patrolled, making illegal cross-border transportation of birds relatively easy.
  • Markets: Live bird markets represent another key route for transmission of bird flu. In some countries, farmers are being advised not to take home any live birds that they are unable to sell at market to avoid infecting flocks at home, but what they should do with their live unsold birds is not specified. And where live bird markets are being made illegal, some are simply going underground.


Diagnosis and control

  • Poor farmers are familiar with dead and dying chickens – this is a fairly regular occurrence for them. Newcastle disease is endemic in many developing countries and can kill many birds fast. Confusion in the diagnosis of poultry diseases – notably in distinguishing the Newcastle disease from HPAI and other diseases  – is a further obstacle to early notification and identification of bird flu. Needed are clear communication and information about the physical signs and symptoms of poultry diseases, what to do if the farmer sees these, and the risks the farmer faces if he or she does nothing about the disease.
  • People’s lack of trust in their governments and/or promises of compensation were identified as key constraints to implementing emergency response and control procedures such as mass culling. The utility of employing mass culling as a means to control the spread of bird flu in developing countries was also questioned by these experts.
  • Most smallholders keep only a few birds in their backyards. Mass culling of all poultry infected and suspected to be infected would be impractical. If no incentives are provided to the smallholders for complying with culling operations, and if most of the smallholders do not recognize the risks of not culling, it is likely that many of them would simply hide their chickens or try to sell them quickly. The incentives provided to poultry keepers have to be sufficient to encourage people to be extra vigilant and to report any suspected cases of bird flu immediately.


Poultry to human transmission

  • Many poor people live close to their livestock, with household members and their chickens often sharing the same small dwelling at night. This increases the potential for transmission of bird flu from poultry to humans. How do you educate people about the dangers of poultry-to-human transmission when practices such as sleeping in the same room with your chickens are widespread? What alternatives do people living in great material poverty have that will ensure their poultry are safe from predators or theft?


The value of chickens to the poor

  • For many small farmers, chickens are ‘coins’ in the bank used for small emergencies: the birds can be sold quickly to raise money for such essentials as food, school fees and medicines.
  • Chicken and eggs are relatively cheap sources of animal protein for the poor. If eggs and chicken become unavailable to the poor, the nutrition and health of many children, women of childbearing age, and other vulnerable groups will be put at risk.
  • Poor people value chickens for more than their market value. For many, chickens represent the first step on the ‘livestock ladder’ out of poverty. Compensation schemes based on market rates are thus unlikely to satisfy farmers or provide them with sufficient incentive to report suspected cases of bird flu.


Alternative investment strategies

  • If chickens are culled and people advised not to restock, what livestock can replace the chickens? Larger livestock are out of the reach of many poor people. And even financial compensation at market values for a small number of chickens would be insufficient to enable the poor to reinvest in other types of livestock. Thus, the living assets of the poor would be liquidized with few alternative (livestock) reinvestment options on offer; other livelihood options would have to be explored.


Information, education and communication

  • Information, Education and Communication has been the mantra working well in Vietnam, one of the first countries to suffer from bird flu. Vietnam has been continually developing, refining and improving its communications to make them relevant to the local communities.
  • Many communications concerning bird flu have been written in English and/or other European languages and do not translate well into local languages. To be effective, communications must consider social and cultural contexts and be open to continual revisions.
  • The bird flu outbreak in Laos highlighted the lack of basic science education and lack of veterinary infrastructure. No veterinarians had been trained there since 1975, leaving only nine veterinarians to serve the whole country. Laos is now working hard, however, to build capacity. The bird flu outbreaks in Laos were largely in commercial poultry farms in urban areas and there were only a few commercial poultry farmers with large numbers of birds. This is in stark contrast to other developing countries in Asia and Africa, where the poultry structure is made up of very large numbers of widely distributed small commercial operations.
  • Community and religious leaders were identified as key players to raise awareness of the dangers of bird flu. Having a series of clear, simple messages conveyed in local languages to communities by trusted sources was viewed as vital to preparedness, emergency response and control. Community action worked well in communities that were relatively stable, and where people were regularly informed and involved and had a vested interest in working together to protect the community as a whole.


According to Dr Carlos Seré, ILRI’s Director General: ‘The global fight against bird flu has to equitable as well as effective – protecting the livelihoods of the world’s poor as well as lives worldwide.

‘To be more effective, efficient and sustainable, bird flu control technologies and strategies must be adapted to the particular realities and constraints of developing countries, including the need to balance public health and poverty reduction objectives. Otherwise, bird flu control will not work in developing countries, and poor control there will continue to threaten the North.’

Short Movie
Robyn Alders of the Kyeema Foundation on The difficulties of diagnosing bird flu in developing countries.

Resource guide now available for research on agriculture-health linkages

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A new initiative aims to improve health, reduce malnutrition and food insecurity and promote pro-poor agricultural development through closer collaboration between the agriculture and health sectors.

Research at the crossroads of agriculture and health conducted by the 15 centers of the Consultative Group on International Research (CGIAR) has been building and increasing in recent years. The CGIAR centers have a long tradition of working on nutrition, and now conduct a wide range of health-related work in the context of agriculture, such as malaria, HIV/AIDS, food safety and the health effects of pesticide use.

Since 2004, steps have been taken to co-ordinate the health-related work conducted by the 15 centers. This included the founding of a committee of the directors general of the centers, a stock-take of the centers existing health-related work, a workshop on agriculture-health research in the CGIAR and the publication of a series of briefs on ‘Understanding the Linkages between Agriculture and Health’.

In 2006, the Alliance Executive of the CGIAR endorsed the concept of a research platform on Agriculture and Health as a way to move forward.

The ‘Resource Guide on CGIAR Research on Agriculture-Health Linkages’, hosted on the website of the International Food and Policy Research Institute, is a portal to the work conducted in this area by different CGIAR centers, showing who is doing what on health.

The International Livestock Research Institute (ILRI) now has a webpage on IFPRI's website highlighting the following areas of ILRI's research in relation to human health:

Livestock keeping and human health
As part of its People, Livestock and the Environment Theme, ILRI conducts research to protect and enhance the physical human capital of the poor by developing strategies to reduce health risks and improve nutritional benefits associated with livestock keeping. Other projects focused on the use of water and feed for livestock also consider human health impacts.

Impact of livestock production on human health and nutrition
ILRI is working to improve understanding of the links between livestock keeping and the health and nutrition of poor people, particularly those engaging in smallholder livestock production and marketing. Activities under way include field studies, literature reviews and explorations of the ways in which livestock keeping might benefit the care of people with HIV/AIDS.

Zoonotic diseases
Poor people in developing countries have a high risk of exposure to zoonoses—diseases transmitted from animals to people. ILRI is helping to bridge the artificial divide between animal and human health. With over 75% of human infections having a zoonotic origin, the need to examine the epidemiological relationships between pathogens and their animal and human hosts is paramount. ILRI is putting specifically focusing on a major neglected zoonoses, Cysticercosis, a highly complex disease affecting both people and pigs. ILRI is participating in a Cysticercosis Working Group of Eastern and Southern Africa (CWGESA), which promotes effective communication, collaboration and coordination of integrated research and control activities aimed at combating cysticercosis. CWGESA and ILRI have recently developed a Cysticercosis Prevention Poster which is currently available in English, Xhosa and Afrikaans. This poster is being used for a rapid information campaign in Eastern Cape Province, South Africa where a neurocysticercosis outbreak among children has been reported.

Livestock, water quality, and human health
ILRI has recently initiated limited research on water-mediated impacts on human health and on INRM approaches to reducing health risks. Most of this research falls within ILRI’s collaboration with the CGIAR Challenge Program on Water and Food and the CGIAR Comprehensive Assessment of Water Management and Agriculture. Key issues include the transmission of water-borne pathogens such as coliform bacteria, cryptosporidium, and Fasciola that result from animal manure contaminating domestic water supplies and where simple remedial interventions are feasible

Wastewater is increasingly used for irrigation of fodder crops that fuel the growing urban and peri-urban dairy production in mega cities such as Hyderabad (India) and Faisalabad (Pakistan). ILRI in collaboration with IWMI and Indian and Pakistani public health institutions and municipal water authorities is investigating the relationship between water – soil – produce quality (fodder and milk) to assess the chain of possible contaminations (heavy metals, nitrate, parasites) and ultimately the hazards to producers (farmers, dairy producers) and consumers of livestock products in these urban areas.

Livestock feed quality and human health
Aflatoxin in milk – a possible hazard to human health: ILRI in collaboration with ICRISAT is investigating aflatoxin contamination of fodder (mainly crop residues) as a source of aflatoxin content in milk. In selected sites in Andhra Pradesh, India, close to 50% of the milk samples contained non-permissible levels of aflatoxin. At the same time, only one of the collected fodder samples (groundnut cake) contained non-permissible levels of alflatoxin. Aflatoxin in milk can clearly present a health hazard to the consumer.

Food safety associated with livestock and livestock products
This research program has focused on identifying the public health risks associated with the marketing of unpasteurized milk, with an emphasis on developing policies and technologies for improved quality and safety without jeopardizing market access for the poor. An outcome of this work has been changes in government policies towards more acceptance of raw milk marketing in several East African countries, based on the identified low risks and high dependence of resource poor people on these markets. This work is being expanded, in cooperation with IFPRI, to examine the marketing of other livestock and livestock products, particularly in South Asia. Studies provide policy-relevant analyses of the risks and economic benefits to poor farmers, market agents, and resource-poor consumers.

Demand for better quality and safe food is increasing among urban consumers, especially among affluent ones. This poses threats to the market opportunities of smallholder producers who often are unable to access technology, inputs and services to produce high quality products demanded by the market chains serving high-end consumers. ILRI research is trying to understand the nature of quality and safety attributes demanded by consumers, their willingness to pay for such attributes and how smallholders may respond to these through participation in market chains.

Vaccines, diagnostics and disease resistance
ILRI research on livestock vaccines has direct and indirect links to medical vaccine and diagnostic research. One aspect of this work involves host functional genomics as it relates to livestock diseases that can be transmitted to humans.

A project investigating resistance to trypanosomosis in cattle is shedding light on some of the basic questions of disease resistance, which may have implications for human medical treatment. ILRI researchers first identified several regions of the cattle genome in which genes contributing to resistance or susceptibility must lie. They then identified genes within a part of the bovine genome that affects anemia, a characteristic of the disease. Remarkably, significant differences between cattle breeds that are susceptible and resistant to the disease were found in one of the candidate genes. Such a result makes it possible that the gene in question is responsible for the difference in susceptibility to anemia in the two breeds. This is now being further investigated. More recent results of this trypanosomosis genomics research appear to have implications for medical research on cholesterol. For more information, contact ILRI’s Steve Kemp at s.kemp@cgiar.org

Initiatives and Networks
Urban Harvest Programme
ILRI is a member of Urban Harvest, a CGIAR initiative to use the collective knowledge and technologies of the CGIAR Centers to strengthen urban and peri-urban agriculture (UPA) practiced by the poor.

System-wide Initiative on Malaria in Agriculture (SIMA)
ILRI backstops a CGIAR-wide initiative addressing malaria in agricultural communities. The System-wide Initiative on Malaria in Agriculture (SIMA) focuses the combined skills and abilities of the agricultural and health research communities, government agencies and community-based organizations. Water- and land-use and crop- and livestock-production practices are studied across a range of agro-ecosystems in Africa to identify farming activities that encourage and discourage the breeding of the mosquito vector or alter the transmission of the disease. Research-based guidelines and tools are developed and tested for use by poor communities and the non-governmental organizations and governments that serve them.

Outreach and Events
CGIAR Challenge Program on Water and Food
ILRI, IWMI and the CGIAR Challenge Program on Water and Food is inviting individuals and organizations located in any of the ten riparian countries of the Nile River Basin to submit short well-written case studies describing traditional or contemporary innovations in technologies, in community and household practices, and in policies that result in better management of water and livestock resources. Relevant topics include the prevention of transmission of waterborne and water related zoonotic and animal diseases such as Cryptosporidiosis and Fasciolosis. This contest is offering USD 1000 for first prize, USD 500 for second prize and USD 250 for third prize. For more information, contact ILRI’s Don Peden at d.peden@cgiar.org

CGIAR Science Award for Promising Young Scientist
In 2005, ILRI scientist Simon Graham won the CGIAR Science Award for Promising Young Scientist for research leading to the development of a sensitive and robust system for identifying vaccine candidate molecules from Theileria parva that causes East Coast fever, a fatal disease of cattle in sub-Saharan Africa. Graham’s research may also contribute to ongoing efforts to control tropical theileriosis, a cattle disease which puts 250 million cattle around the world at risk. Furthermore, by using genomics to understand and fight T. parva, scientists may make advances against related parasites that cause malaria, tuberculosis, and other diseases in which killer T cells also play a role in immunity. And because T. parva launches a cancer-like illness inside the white blood cells of cattle, it may provide a model system for understanding the mechanics of cancer biology.

Visit http://www.ifpri.org/themes/aghealth/aghealthrg.asp for the resource guide on IFPRI's website.

Future directions for livestock research for development

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A new paper by ILRI describes new scientific tools and platforms to tackle new issues emerging in collaborative livestock research for development.

The International Livestock Research Institute (ILRI) recently reviewed its strategy, evolution and research agenda. The resulting paper, Knowledge to Action—Strategy and Future Directions of ILRI, answers four questions:

  1. What is ILRI doing and why does it matter?
  2. How is ILRI responding to dynamic livestock, science and development environments?
  3. What are the future research directions and frontiers for ILRI?
  4. Why invest in international livestock research?

This analysis included an assessment of ILRI’s achievements over the past five years: ILRI’s Achievements: 2000–2006.

Dynamic growth of the livestock sector in the developing world is creating new opportunities. The challenge is to use the ‘livestock revolution’ driver to achieve pro-poor growth. Rapidly changing consumer demands, expanding markets for livestock products, changing food quality and safety demands, new technologies, and institutional innovations such as the supermarket revolution all create both opportunities and challenges for reducing poverty through livestock interventions.

ILRI’s Knowledge to Action paper describes the evolution of ILRI’s research program, new directions for each of the institute’s five research themes, and research areas ILRI and its partners recently established to address global issues such as emerging and zoonotic diseases, increasingly stringent food quality and safety standards, and the environmental impacts and trade-offs of changing livestock systems. ILRI and its partners are developing research platforms to enable all stakeholders in livestock development to apply the tools of new science and technology in pursuit of a shared livestock-research-for-development agenda.
 

Bird flu consultation

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ILRI and IFPRI are convening a consultation in Nairobi from 14 to 16 June 2006 to determine how the research community can best assist developing countries in the fight against bird flu.
 
The International Livestock Research Institute (ILRI) and the International Food Policy Research Institute (IFPRI) are convening a consultation to explore how research can support efforts to control the highly contagious avian influenza, with special emphasis on the needs of developing countries and the poor. The consultation is a response to requests from donors on priorities for targeting their research investments for Asia and Africa.

The consultation has four main objectives:

  1. To share the experiences of those in the front-line of avian influenza outbreaks to provide a realistic, objective, and up-to-date backdrop for the consultation.
  2. To identify and prioritize immediate service needs that research can provide in support of preparedness and emergency responses.
  3. To identify and prioritize medium-and long-term research needs.
  4. To develop an action plan and decide how to put it in place, including the possibility of forming an inter-institutional task force.

Much of the present effort in fighting bird flu is focused on immediate actions – emergency preparedness and response. The research community, however, also has a critical role to play in anticipating and addressing medium-and longer-term issues associated with bird flu in developing countries.

One of the greatest concerns is that bird flu could eventually become endemic in developing countries due to large poultry populations, weak infrastructure, scarce veterinary expertise and a general lack of resources. Poor poultry keepers in developing countries are also at a high risk of contracting bird flu, because they live in such close proximity to their livestock. Those who keep poultry and are desperately poor have the most to lose – and many may choose to save or eat sick chickens. This could put all family members and their other livestock at risk of contracting the deadly bird flu. The impacts on poor livestock keepers in Africa are highlighted in a recent article in the New Agriculturist.

New Agriculturist news article


 

Falling fowl of avian flu? New Agriculturist 1 May 2006

Members of the international development community wishing for more information about the ILRI-IFPRI Avian Influenza Consultation should contact Keith Sones ksones@africaonline.co.ke.

Further information about bird flu is available at ILRI’s Livestock in the News: Bird Flu page.

One world, one health

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Holistic approaches to controlling the 'perfect storm' of health problems in poor countries, particularly Africa's catastrophic disease burden, must include better control of diseases transmitted between animals and people.

A paper to be published this May 2006 in the Public Library of Science (PLoS) journal PLoS Medicine, a peer-reviewed open-access journal (available online at www.plosmedicine.org) advocates linking integrated work on ‘neglected’ tropical diseases with major global health partnerships recently formed to tackle the three most devastating diseases of the poor: malaria, TB and AIDS. The authors of the paper, which include development economist Jeffrey Sachs, argue that while new partnerships and initiatives have significantly raised funding and awareness of the need to scale up the fight against the ‘big three’ diseases, conspicuously absent is work on a group of ‘neglected tropical diseases’ that may threaten the poor as much as malaria, TB and AIDS and for which there are already cheap and effective control strategies. The authors propose that our success in controlling the big three may depend on a concurrent attack on this group of neglected diseases, which include three vector-borne protozoan infections (leishmaniasis, human African trypanosomosis and Chagas disease), three bacterial infections and seven kinds of helminth (worm) infections.

The potential benefits of taking a more holistic approach to disease control are being popularized in complementary initiatives advocating ‘one health’ strategies that simultaneously address human and animal health. (See, for example, a new book exploring grass roots ideas from East and Southern Africa on how to integrate wildlife, livestock and human health for both conservation and development: ‘One World, One Health’ is available online from LEAD, the Livestock, Environment and Development Initiative.

ILRI supports these holistic health approaches and further argues that another class of neglected diseases of the poor—‘zoonotic’ diseases, or those transmitted between people and animals—should be included. Zoonotic diseases account for a remarkable 75% of all human diseases and include such emerging diseases as avian influenza. Esther Schelling, a veterinary epidemiologist on joint appointment with the International Livestock Research Institute (ILRI) and the Swiss Tropical Institute, points out that zoonotic diseases are virtually excluded from most health initiatives ‘because they’re simply not accounted for’. ILRI is helping to ensure that they are accounted for and that methods to control them are friendly to the poor.

Two papers on this topic by Schelling and colleagues are available online:
British Medical Journal article
Lancet article

Carlos Seré, director general of ILRI, says that with the sequence in recent years of BSE (‘mad cow disease’), foot-and-mouth disease, and now bird flu, there is definitely increasing interest in zoonotic diseases.

‘Donors like the Welcome Trust’, he says, ‘are increasing their investment in tropical animal disease research. Our own strategy is to develop appropriate methods for researchers and policy-makers to evaluate the risk of these zoonotic diseases and together identify the most promising strategies and policies that can help to reduce such risk, particularly for the poor. We have activities specifically looking at zoonoses such as brucellosis and bovine TB, and we are building up our expertise in food safety issues. Strengthening our expertise on food safety and the risks posed by zoonoses is central to two of ILRI’s strategic research themes, the first on sustaining lands and livelihoods which involves protecting human health, and the second on improving livestock-related market opportunities in domestic and international markets, which are increasingly threatened by such food safety concerns.’

In relation to bird flu, Dr Seré explains, ‘ILRI will not be the virologists or poultry specialists. But we have comparative strength in systems analysis, which combines social science with epidemiology and animal genetics and other lab bench research to address complex health problems. We do this in conjunction with partners who bring more specific expertise, such as in poultry or vaccines. What we specifically bring to the picture is a “poverty lens” to understand the implications of health problems, issues and control strategies on the poorest populations in the world.’

‘Clearly, research is not a “rapid deployment tool”’, he says. ‘There are other organizations—such as the World Health Organisation (www.who.org), the Food and Agriculture Organization of the United Nations (www.fao.org), and the World Animal Health Organisation (www.oie.org) —that have a regulatory mandate and policy responsibility and are linked directly to governments. ILRI’s comparative advantage is in the longer term: in understanding the issues and in providing sound technical research to back these agencies which are doing the short-term response work. As we see more and more that boundaries don’t work, that disease is a global problem, we encourage industrialized countries to share their resources with developing countries, not just out of enlightened self-interest, but also, for example, to ensure food safety for their domestic consumers. And finally, we are particularly interested in helping developing countries to build their own research capacity to understand, model and control complex disease problems.

CDC expert updates Kenya on Avian Influenza

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Kenyan CDC expert Dr Kariuki Njenga tells of Kenya's preparedness for bird flu. "The best way to manage the threat is to control the disease at its source – in birds."

Dr Kariuki Njenga, a Kenyan expert working with the International Emerging Infections Programme in the Kenya office of the US Center for Diseases Control (CDC), delivered a seminar on avian influenza to staff of the International Livestock Research Institute (ILRI) at their Nairobi headquarters on Thursday, 25 November 2005.

Dr Njenga said that the influenza viruses are some of the most intriguing and elusive in the world. Special characteristics of the highly pathogenic avian flu virus strain known as H5N1 increase the likelihood that there will be increased emergence of chimeric (new) viruses, one or more of which could cross over to humans and be transmitted from human to human and cause a flu pandemic.

Increased associations between animals and people, Dr Njenga said, especially in Southeast Asia, is providing a conduit for the avian influenza virus to come into contact with people as they handle dead or dying infected birds. Most of the 122 human cases of the disease, with 62 deaths, so far reported to the World Health Organization have occurred on backyard farms where poultry are kept.

‘Our main concern right now in Kenya and other countries in Africa along the migratory bird flyways’, said Dr Njenga, ‘are backyard chicken farmers’. More than three-quarters of Kenyans are rural farmers and it is estimated that more than 90 percent of them keep chickens. The fear is that wild birds infected with the deadly H5N1 virus strain now migrating to Kenya for the European winter might come in contact with domestic water birds, such as ducks, which then might contact free-scavenging chickens kept by poor rural people, and so the virus could be passed from birds to people. If this happens, the country would have to act within 21 days to contain the infection to prevent the outbreak spreading wide.

ILRI and CDC staff are part of a national task force that has been assembled in Kenya to deal with bird flu. This task force is providing early warning of bird die-offs and strengthening surveillance nationwide, developing a communications network and stock-piling anti-virals so that these are on handle to contain any outbreak. There is no effective vaccine to prevent a pandemic caused by the H5N1 flu strain.

The task force is instructing Kenyans to note any sick or dead birds. They should report these to veterinary or government authorities or they may collect dead birds in plastic bags, using plastic bags to protect their hands as they do so, and take them to their local veterinary officer.
 

ILRI and WHO agree to work together more closely for better human health

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ILRI and WHO sign a memorandum of understanding to promote human health and the control of zoonotic diseases.

In September 2005, a memorandum of understanding was signed between the International Livestock Research Institute (ILRI) and the World Health Organization (WHO). The agreement was signed by executives from both organizations in recognition of the need to better understand the links between livestock keeping and the health and general well-being of poor people in poor countries.

This agreement makes possible more effective collaboration and coordination between ILRI and WHO on human health and the control of diseases transmitted between animals and people (zoonoses) and associated with livestock and livestock products.

The agreement facilitates collective action on issues of concern to both organizations. WHO is involved in the surveillance and response to health problems of its member countries while ILRI obtains evidence on the impact of zoonotic diseases on the health and livelihood of poor people.

“We want to make sure that our research activities are integrated with the surveillance and control needs at the international level. Otherwise, why do research if there is no demand for it?", says Dr. Lee Willingham, a research scientist on parasitic zoonoses at ILRI.

The general objective of this agreement is to maximize synergies in the work of the two organizations in the following areas.

  1. Exchange of information on technical areas of common interest to achieve complementarity and coordination between relevant activities and programmes.
  2. Development of joint activities to address issues of mutual interest that are designed to foster and promote  a greater capacity for research and technology application in developing countries and to facilitate the building and consolidation of global partnerships in the scientific community. The joint projects will be supported through special supplemental project proposals and may involve secondment of staff from one organization to the other or other appropriate administrative arrangements.
  3. Promotion of synergies and elaboration of collaborative programs in areas where the two organizations can best employ their comparative advantages.

Epilepsy, brain cysts and tapeworms

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Ten pigs went to market, some pigs stayed at home, all pigs ate human faeces… and so a deadly tale begins. Poor sanitation, poor hygiene practices, poor pig husbandry and poor meat inspection all fuel a vicious cycle that is destroying lives and livelihoods in many developing countries. A potentially deadly parasite, Taenia solium, known as the pork tapeworm, is being transmitted from pigs to people, people to pigs and from people to people. The disease Cysticercosis has been dubbed one of the neglected diseases of neglected populations. It is considered by the World Health Organization to be one of the few potentially eradicable diseases, yet it is now an emerging disease of eastern and southern Africa. Awareness and training activities are being organised in eastern and southern Africa to help combat the parasite that causes intestinal taeniasis in humans, cysticercosis in pigs and humans, and the potentially deadly human disease neurocysticercosis, which is the formation of (T. solium) cysts in the brain. Neurocysticercosis affects millions of people in Asia, Latin America and Africa. It is rarely found in industrialized countries or in countries where pork is not consumed for religious or cultural reasons. However, even in these countries more cases are being seen due to immigration, increased travel and importation of domestic workers from endemic countries. It is a disease associated with poverty and underdevelopment, and is endemic in many developing countries where raising pigs and eating pork are popular. Neurocysticercosis infection may remain non-symptomatic for years before manifesting as seizures, severe headaches or other neurological problems. It is also a major cause of acquired epilepsy in developing countries. It affects agility, concentration and in severe cases can result in death. The true extent of the problem is not known because tapeworm carriers often do not know that they are carrying the parasite. It can lie in the human gut for years without causing any symptoms. Major advances are being made in the diagnosis and treatment of people and pigs infected with pork tapeworm, but these diagnostic tools and medical treatments are not yet widely available in many endemic countries. A vaccine to prevent pigs from contracting the disease is also being developed. How it is spread Since the mid 1990s, more and more people in rural areas in eastern and southern Africa are keeping pigs, fuelled in part by a significant increase in the consumption of pork in both rural and urban areas. To poor smallholders in these regions, pigs represent a new opportunity in livestock keeping worth exploiting. In Africa cattle are highly prized, but they can be problematic – protecting them from disease and theft requires constant vigilance and sometimes round-the-clock surveillance. Pigs, however, are comparatively easy to manage, and are therefore becoming increasingly popular and important, especially in rural smallholder communities. Pigs, like so many livestock, can serve as a 'mobile bank', with one adult pig fetching upwards of US$100 at markets in this region. Many farmers will keep between one to three pigs and sell an adult pig at the beginning of the school year to provide for school fees. However, the increasing number of pigs being kept in eastern and southern Africa is raising its own set of problems, with a vicious cycle of infection and reinfection. This is not just a problem for rural areas, where most pigs are kept, but it is also a problem for urban areas where infected pork can be consumed, and where human carriers of the parasite can infect other people. Most worrying is the fact that people do not have to eat pork or keep pigs to become infected with cysticercosis. They can be exposed to the eggs from a human tapeworm carrier. Disease and poverty go hand in hand. Poor sanitation and poor hygiene practices all increase the risk of contracting diseases. In many developing countries, particularly in rural areas, human waste is generally disposed off in a pit or out in the fields, or in some cases it is simply thrown into the garden. In many poor areas, livestock keeping is rudimentary and pigs, like many livestock, wander about freely. When the livestock keepers and family members go out to the fields to defecate, their pigs will follow. Pigs like to eat human faeces and will trail out to where people have defecated to eat the stool. If these people are carriers of the tapeworm they will produce thousands of highly contagious eggs in their stool. These eggs are hardy and may survive more than eight months in the environment, particularly in tropical conditions; the climate in Africa is ideal for the parasite to thrive. This presents a health hazard not only for pigs, but also for people. If pigs ingest the eggs, they develop into the immature larval form of the parasite (cysticercosis) that can result in the formation of hundreds to thousands of cysts in the muscles of the animal. In areas where meat inspection and control is lacking, infected pigs are often slaughtered and the pork sold for human consumption. Eating infected raw or undercooked pork can cause people to become infected with the adult tapeworm form of the parasite (taeniasis). The parasite will remain in their gut, but eggs of the tapeworm will be expelled through their faeces. This does not, however, cause neurocysticercosis, which requires transfer of the contagious eggs from the infected person’s faeces to the same or another person. If humans come into contact with infected human stool and accidentally ingest the eggs, the eggs develop into the larval form of the tapeworm, which targets the muscles, the eyes and most commonly the brain (neurocysticercosis), manifesting as cysts. This may occur through direct contact with a tapeworm carrier’s infested stool, by putting contaminated fingers in the mouth, or through ingestion of water or foods that have become contaminated with the infected faeces. Awareness and control Pig traders have become aware of the heightened problem of cysticercosis in pigs. Many were finding that when the pigs they had purchased were slaughtered and inspected, they had cysts and were therefore condemned. As a result, some pig traders have become extremely vigilant and now routinely carry out checks on pigs before purchase. Examining the underside of the pig’s tongue is a quick, easy and cheap way of checking for positive signs of infection, but may only detect about 50% of the pigs infected. Visual observation of the pork meat can also be used to determine the presence or absence of the parasite. However, in areas where livestock and meat inspection are not so vigilant, infected pigs can be slaughtered and sold for human consumption. The increasing consumption of pork in urban areas means that infected pigs can be transported into densely populated areas, where the infected pork finds its way into human diets. These unwitting consumers then become carriers of the parasite. In poor rural communities where people are carriers of the intestinal tapeworm and pigs are allowed to roam and consume human faeces, it is likely that pigs will become infected with the parasite. For these poor livestock keepers, their losses are threefold – they lose the income they expected to receive from the sale of their pigs; they and their families lose a valuable protein source when the pig carcasses are condemned, thus increasing the likelihood of family malnutrition; and their own health and productivity are at risk from cysticercosis infection. There is also the risk of tapeworm carriers transmitting the parasite to other people. Prevention Cysticercosis can be prevented by interrupting the life cycle of the parasite at one or more points. Good pig husbandry, including preventing pigs access to human faeces, is one way to break the cycle. Total confinement of pigs is a possibility but only sustainable if integrated with other management practices such as housing and feeding with locally available materials and feedstuffs. Strict meat inspec

tion and control also helps to break the cycle, preventing infected meat from being consumed by people. Good hygiene practices and thorough cooking of pork can prevent people getting infected, or reinfecting themselves and/or infecting others. These measures require education and training of all involved, including pig keepers and their families, pig traders, meat sellers, and the general public – whether they eat pork or not.