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European Technology Platform for Global Animal Health National Mirror Groups UK Update Brussels – Sept 22 2009 Phil Sketchley: Chairman UK Mirror Group Chief Executive : National Office of Animal Health Structure of UK Mirror Group > Secretariat: VMD (Veterinary Medicines Directorate) – – – Professor Steve Dean – Chief Executive Dr Jack Kay – VMD-R&D and Science Policy Manager Gemma Adams – secretary > Chair: Phil Sketchley - NOAH – National Office of Animal Health – representing UK animal medicines industry. Current stakeholders: – – – – – – – – – – – Professor Quintin McKellar - Dean RVC- Royal Vet College Professor Julie FitzPatrick - Chief Executive, Moredun Research Institute. Professor John Preston MRCVS – VMD Board. Professor Martin Shirley, IAH Catherine McLaughlin – Animal Health and Welfare, National Farmers Union, Dr Alex Morrow – Defra Animal Health and Welfare and Eurogap. Professor Jim Scudamore – Liverpool Vet School & ETPGAH consultant. Prof Martin Shirley – Inst. Of Animal Health – Compton Dr Otto Windl –Veterinary Laboratories Agency Prof Andy Peters – ex industry R&D + GALVmed Dr Peter Wells – ex industry R & D and Moredun Progress of UK Mirror Group > 6 meetings held so far –hosted by Defra > July 2007 to Sept 2008 > Key Actions since first meeting: Prioritising GAPS in Research To further assist in developing a common priority list, it was agreed each member would submit details of their perceived priorities: – – – – most important exotic diseases most important endemic diseases most important zoonotic diseases Now combined into one consolidated list of important areas for further research Review of how we assessed the disease priorities for: 1) Exotic 2)Endemic 3)Zoonotic Prioritisation of Exotic, Endemic and Zoonotic Diseases Generic Issues > > > > > > > Each Member Stare has existing research strengths many, including expertise of scientific staff and relevant facilities to undertake work on these diseases. The UK National Mirror group set out to identify and harness these centres of excellence Some diseases may be specific to a single country or region are important not only, for example within the UK, but also the EU (and in many cases worldwide). Naturally the focus is locally/national but all MGs need to be cognisant of the needs of others both within Europe and Internationally – a joined up approach is essential. Technologies are available and evolving rapidly, allowing significant advances in understanding these diseases and developing solutions for therapy and prevention e.g. 3 years ago Blue tongue was not perceived as a real threat in the UK– it is now a real and present danger!! So no one can be complacent about new disease threats Establishing gaps – Priorities for Future Research and Development 1) Infections are hugely important in animals by virtue of their prevalence, diversity and impact. It is not possible, even in advanced societies with buoyant economics to devote sufficient resource to tackling them all adequately. 2) In order to reap greatest benefit from the investment available for infectious disease research it is essential to prioritise and focus sufficient resource to make a difference. 3) Prioritisation is inherently difficult because of the extent of the problem, our incomplete knowledge of true impact and different views on the relative weighting of impact associated with for instance – human health risk, economic impact, animal welfare or threat to wildlife or the environment. Establishing gaps – Priorities for Future Research and Development 4) Nevertheless some criteria can be considered and priorities constructed around known information and expert opinion. Diseases of companion animals, poultry, fish and pigs were not, at this stage, considered and recognition was given to diseases where major initiatives existed elsewhere internationally and it was considered that it would be inappropriate for the UK to replicate effort. 5) It was considered that focus would be achieved best by intially restricting the diseases for priority attention to four in each of three categories – Exotic disease, Endemic disease and Zoonotic disease. Establishing gaps – Priorities for Future Research and Development 6) Diseases were then categorised on the basis of likelihood of occurring (if exotic) or prevalence (if endemic), potential impact on human health, potential or actual economic impact and animal welfare impact. 7) Significant consensus was reached when the above exercise was carried out by members of the Mirror Group blinded to each others results. 8) The outcomes were refined and agreed following general debate within the Mirror Group. Motivators for success? Speed of Access to Market Increase the translation of technologies into applications, which are efficacious in the control of animal disease Remove unnecessary legal and regulatory hurdles, which limit disease control options and decrease competitiveness of the industry Streamline research, development and regulatory efforts in order to ensure consumer safety without compromising the efficiency of product development Identified Priorities from UK Mirror Group Avian Flu FMD Blue Tongue Virus Newcastle Disease Mastitis (multi-agent) Tuberculosis (and paratuberculosis/diagnostic tuberculins) Parasitic gastroenteritis Lameness VTEC0157 Campylobacter Salmonella Antibiotic Resistance Narrative for Exotic Diseases Prioritised on the basis that:> All have caused epidemics in the UK in the last few years (Newcastle Disease 2006; FMD 2007; Avian Flu 2008; Blue Tongue Disease 2007/08) > All have significant detrimental economic effects on the UK in terms of trade restrictions > All diseases are highly infectious and control procedures other than test and slaughter are limited for most diseases > All diseases cause public concern > All diseases are included in the OIE list of notifiable diseases > Avian influenza, a zoonoses, has the potential to cause significant outbreaks of disease in the human population > All diseases require further R&D investment in order to improve preventative measures Narrative for Endemic Diseases Prioritised on the basis that:- > > > > > > > All diseases/conditions are prevalent in the UK (and the EU). All diseases/conditions cause significant economic loss in terms of poor production efficiency and including wasted carbon emissions through morbidity and mortality (or should this be separated into economic and environmental rather than combined the two) All diseases/conditions cause adverse effects on the welfare of livestock All diseases cause public concern All diseases require further R&D investment in order to deliver preventative measures to industry Bovine tuberculosis, included under mycobacterial infections, is spreading rapidly in certain areas in England and Wales, causing great concern in the industry and with the public. Narrative for Zoonotic Diseases Prioritised on the basis that:- > All diseases/infections/issues are present current in the UK (and EU and beyond) > All diseases/infections/issues cause public concern > All diseases/infections could cause adverse effects on the UK economy through hospitalisation of many affected individuals Methodology > Each member of group submitted tables for their scores for the agreed list of diseases – N.B The scoring model used was prior to the latest one from central DISCONTOOLS group. > Group data then complied into a consolidated list for Minimum, Maximum and Average scoring > More detailed statistical analysis now being completed by Liverpool University VTEC0157 Campylobacter Salmonella Antibiotic Resistance 3 5 3 3 5 3 5 3 3 5 3 3 5 3 3 5 4 3 IMPACT ON INTERNATIONAL TRADE Impact on international trade and EU trade due to existing regulation 5 5 3 4 1 2 1 1 1 1 1 1 4 4 2 4 1 3 5 1 3 5 1 3 1 2 4 2 3 4 1 2 3 1 2 3 1 3 3 1 3 3 1 3 3 1 3 3 3 3 2 2 4 4 3 3 4 4 4 4 3 3 2 3 3 4 2 3 3 3 3 3 CONTROL MEASURES Effective prevention and control practices Tools for surveillance Tools for prevention crisis Tools for control and implementation Success of prevention and control in other countries Tuberculosis (and Newcastle Disease Blue Tongue Virus FMD Lameness 4 5 3 gastroenteritis 3 5 3 Parasitic 3 3 4 tuberculins) 3 4 4 paratuberculosis/diagnostic 3 2 5 Mastitis (multi-agent) 5 2 5 Avian Flu IMPACT ON PUBLIC HEALTH Impact on Public Health and Food Safety Risk of occourrence Impact of occourrence VTEC0157 Campylobacter Salmonella Antibiotic Resistance 3 3 4 3 4 4 3 4 1 3 4 3 3 4 3 3 5 4 3 5 4 4 4 4 4 3 3 3 3 4 5 2 2 1 2 1 1 1 1 2 4 4 1 2 1 2 1 2 1 1 1 1 1 2 Wildlife diseases that are a threat Dynamic (temporal, spatial, species variability) 1 1 1 1 5 1 1 1 1 1 1 3 3 1 1 1 1 1 1 1 1 1 Tuberculosis (and Newcastle Disease Blue Tongue Virus FMD 5 Lameness 3 4 4 gastroenteritis 3 3 4 Parasitic 4 3 1 tuberculins) 4 3 4 paratuberculosis/diagnostic 5 4 1 Mastitis (multi-agent) 3 3 1 Avian Flu EPIDEMIOLOGY AND RISK Speed of Risk Number of species involved Persistence of infectious agent Spreading potential to susceptible populations Wildlife diseases risk potential threat to animal health and public health Disease knowledge VTEC0157 Campylobacter Salmonella Antibiotic Resistance 4 3 3 3 3 3 3 5 4 4 4 3 4 3 3 3 3 3 5 5 4 4 3 4 3 3 3 3 3 3 5 5 5 5 3 3 3 3 3 3 3 3 5 5 5 4 1 2 1 1 1 1 1 3 Tuberculosis (and Newcastle Disease Blue Tongue Virus FMD Lameness 3 gastroenteritis 4 Parasitic 4 tuberculins) 4 paratuberculosis/diagnostic 5 Mastitis (multi-agent) 3 Avian Flu IMPACT ON WIDER SOCIETY Diseases impact on production Economic diect impact (including cumulative cost eg enzootic vs epizootic Economic indirect impact (social, trade) Impact on specific production and supply channels Security of food supply/Benefit for developing world Total achieved 4 2 2 4 4 3 3 3 3 3 3 5 5 5 2 5 2 2 5 5 5 5 85 78 72 66 84 62 61 63 64 64 71 Antibiotic Resistance Parasitic gastroenteritis Lameness Tuberculosis (and paratuberculosis/diagnostic tuberculins) Mastitis (multi-agent) Newcastle Disease Blue Tongue Virus FMD Avian Flu Salmonella 81 Campylobacter Points achieved VTEC0157 Technology (Vaccine/Treatment) / Tool Availability 3 Commercial diagnostic tools availability 2 B C D E F G Min Max Average 3 3 3 3 3 3 3 3 3 3.00 1 3 1 3 1 1 1 1 3 1.67 Economic indirect impact (social, trade) 3 3 3 5 2 3 3 2 5 3.22 Impact on specific production and supply channels 3 3 3 5 3 3 3 3 5 3.44 Security of food supply/Benefit for developing world 3 3 3 5 3 3 3 3 5 3.44 3 3 3 5 3 2 3 2 5 3.22 2 2 2 2 1 2 2 1 2 1.78 3 3 3 5 3 2 3 2 5 3.22 3 3 3 5 3 3 3 3 5 3.44 IMPACT ON WIDER SOCIETY Diseases impact on production Economic diect impact (including cumulative cost eg enzootic vs epizootic IMPACT ON PUBLIC HEALTH Impact on Public Health and Food Safety Risk of occourrence Impact of occourrence IMPACT ON INTERNATIONAL TRADE Impact on international trade and EU trade due to existing regulation Consensus A Avian Flu Example of Scoring (Avian Flu) from members of UK workgroup- compiled for comparison of Min Max and Average e.g. Avian Flu (1) B C D E F G Min Max Average Effective prevention and control practices 3 3 3 4 1 2 3 1 4 2.67 Tools for surveillance 2 2 2 4 2 1 2 1 4 2.22 Tools for prevention crisis 3 2 3 2 2 2 3 2 3 2.44 Tools for control and implementation Success of prevention and control in other countries Technology (Vaccine/Treatment) / Tool Availability 2 2 2 3 2 2 2 2 3 2.22 3 2 3 3 2 1 3 1 3 2.33 2 1 2 3 2 2 2 1 3 2.00 Commercial diagnostic tools availability Points achieved 2 1 2 2 2 2 2 1 2 1.78 58 57 56 81 53 54 56 53 81 61.00 CONTROL MEASURES Total achieved Consensus A Avian Flu Example of Scoring (Avian Flu) from members of UK workgroup (2) C D E F G Min Max Speed of Risk 3 3 3 3 3 2 3 2 3 Number of species involved 3 3 3 3 3 3 3 3 3 2.78 3.00 Persistence of infectious agent 1 1 1 1 2 2 1 1 2 1.33 Spreading potential to susceptible populations Wildlife diseases risk potential threat to animal health and public health 3 3 3 3 3 3 3 3 3 3.00 3 2 3 5 3 3 3 2 5 3.22 2 1 2 2 2 2 2 1 2 1.78 Wildlife diseases that are a threat 1 2 0 1 3 0 0 3 1.25 Dynamic (temporal, spatial, species variability) 1 3 0 1 2 0 0 5 1.89 EPIDEMIOLOGY AND RISK Disease knowledge 5 Consensus B Average A Avian Flu Example of Scoring (Avian Flu) from members of UK workgroup (3) AVIAN FLU FMD BTV NEWCASTLE MASTITIS TB PGE LAMENESS VTEC 0157 CAMPYLOBACTER SALMONELLA Speed of Risk 2.78 3.44 2.78 2.88 1.89 2.22 2.00 1.67 1.89 2.00 2.33 Number of species involved 3.00 2.67 2.44 2.50 2.22 2.78 2.78 2.89 2.56 2.78 2.89 Persistence of infectious agent 1.33 2.22 2.78 2.13 3.00 3.22 2.67 2.44 1.89 2.00 2.11 Spreading potential to susceptible populations 3.00 3.44 2.78 3.00 2.89 2.89 2.67 2.00 2.56 2.67 2.56 life diseases risk potential threat to animal health and public health 3.22 1.78 1.44 2.13 1.00 3.22 1.00 1.00 1.33 1.22 2.00 AVERAGES OF ALL PRIORITISED DISEASES EPIDEMIOLOGY AND RISK Disease knowledge 1.78 1.67 1.67 1.38 2.00 2.44 1.56 1.78 1.78 1.56 1.56 Wildlife diseases that are a threat 1.25 1.44 1.44 1.50 0.78 3.00 1.22 1.00 1.22 1.22 1.78 Dynamic (temporal, spatial, species variability) 1.89 2.44 2.44 1.25 1.33 1.78 1.44 1.00 1.67 1.44 1.89 3.00 3.44 2.78 3.25 2.78 2.56 2.78 2.44 1.78 1.78 2.33 mic diect impact (including cumulative cost eg enzootic vs epizootic1.67 3.22 2.89 2.75 2.89 2.33 2.67 2.56 1.78 1.78 2.33 IMPACT ON WIDER SOCIETY Diseases impact on production Economic indirect impact (social, trade) 3.22 3.44 3.00 2.88 1.78 2.33 1.67 1.78 2.11 1.89 2.11 Impact on specific production and supply channels 3.44 3.44 3.22 3.13 1.89 2.11 1.56 1.67 1.78 2.22 2.33 Security of food supply/Benefit for developing world 3.44 2.67 2.89 2.75 1.44 1.78 1.78 1.33 1.56 1.89 2.00 AVIAN FLU FMD BTV NEWCASTLE MASTITIS TB PGE LAMENESS VTEC 0157 CAMPYLOBACTER SALMONELLA Impact on Public Health and Food Safety 3.22 1.56 1.56 1.63 1.56 2.22 1.67 1.44 3.44 3.22 3.11 Risk of occourrence 1.78 1.44 2.11 1.63 2.56 2.44 2.22 2.11 2.00 2.44 2.22 Impact of occourrence 3.22 2.22 2.00 2.13 1.89 2.78 1.67 1.67 2.56 2.44 2.67 3.44 3.44 2.56 2.88 1.00 1.78 1.00 1.22 1.56 1.33 1.67 Effective prevention and control practices 2.67 2.67 3.00 3.25 1.44 1.44 1.89 1.67 1.78 2.00 2.00 Tools for surveillance 2.22 1.67 1.56 1.25 1.67 2.33 1.67 1.78 1.89 2.22 2.00 Tools for prevention crisis 2.44 2.22 1.89 1.75 2.13 2.88 1.75 1.88 2.22 2.25 2.00 Tools for control and implementation 2.22 2.00 1.56 1.38 2.11 2.33 1.89 2.22 2.22 2.67 2.22 Success of prevention and control in other countries 2.33 2.00 1.67 2.13 1.89 2.33 1.44 1.56 1.56 1.78 1.89 Technology (Vaccine/Treatment) / Tool Availability 2.00 2.22 2.00 1.88 2.11 2.44 1.78 2.00 2.22 2.11 2.00 Commercial diagnostic tools availability 1.78 2.44 2.78 2.25 1.67 2.67 1.56 1.78 2.33 2.44 2.33 61.00 59.33 55.56 42.78 46.33 58.56 44.22 42.67 47.11 49.22 52.00 AVERAGES OF ALL PRIORITISED DISEASES IMPACT ON PUBLIC HEALTH IMPACT ON INTERNATIONAL TRADE mpact on international trade and EU trade due toexisting regulation CONTROL MEASURES Points achieved Total achieved Communication at national level > It is important that national mirror groups should have a wide cross section of stakeholders e.g. – – – – – – Research institutes and Universities. Medicine / Vaccine research industry Regulators – medicines and disease control bodies Chief Veterinary Officers Food Industry Farming community and animal species specialists > Knowledge transfer and awareness in essential e.g. Presentations to 2009 conference for AVTRW The Association for Veterinary Teaching and Research Work / VIF Meeting in Denmark etc… Next Stage – 2010 Activities > UK Mirror Group meet last week > Reviewed and approved analysis of data just presented. > Agreed to submit our data to central ETPGAH Mirror Group and DisConTools group > Then decide if we need to repeat our priority template using latest Discontool scoring system > Extend the UK group to a wider audience of interested stakeholders