Zoonotic and Food-Borne Disease Challenges in a Globalized World

Transcription

1 Joint APHCA-OIE Regional Workshop on Zoonoses, Food-Borne Diseases and Antimicrobial Resistance Thimphu, Bhutan, September 2013 Zoonotic and Food-Borne Disease Challenges in a Globalized World Dirk Pfeiffer Professor of Veterinary Epidemiology Honorary Professor at London School of Health & Tropical Medicine United Nations - Food and Agriculture Organisation Reference Centre for Veterinary Epidemiology

2 Outline Introduction Context Global connectivity and complexity Animal disease emergence and spread Challenges Science Systems perspective Policy development Conclusions 2

3 INTRODUCTION 3

4 Global Megatrends More from less Great expectations Going, going gone Virtually here The silk highway Forever young from CSIRO Our Future World

5 Meat Production per Sqkm of Agricultural Land ( ) Source: FAOSTAT 6

6 Expected Growth in Poultry Meat Demand between 2000 and 2030 Source: FAO Geonetwork

7 Concentrated Animal Feeding Operations (CAFOs) Artist: Salvador Saenz 8

8 Food Zones for Food Security 9 From: Straits Times

9 Context GLOBAL CONNECTIVITY AND COMPLEXITY 10

10 Travel Time to Major Cities 500/mg _1000.jpg 13

11 More Connectivity to Come From: Economist 14

12 Global Value Chains or Commodity Flows for Shrimp in Vietnam From: Nhuong Tran, Conner Bailey, Norbert Wilson, Michael Phillips (2013): Governance of Global Value Chains in Response to Food Safety and Certification Standards: The Case of Shrimp from Vietnam. World Development Volume

13 Global Agro-Food Trade Network in 2007 (44 country nodes with largest import+export activity) Ercsey-Ravasz M, Toroczkai Z, Lakner Z, Baranyi J (2012) Complexity of the International Agro-Food Trade Network and Its Impact on Food Safety. PLoS ONE 7(5): e doi: /journal.pone :doi/ /journal.pone

14 This Man Delivers 35 Food Products 60 Countries 5 Continents in 1 Box (from Reilly FSAI)

15 Horse Meat Trade Scandal

16 Context ANIMAL DISEASE EMERGENCE AND SPREAD 21

17 Chronology of a Couple of Selected Disease Emergence and Spread Events PRRS PMWS BSE UK (1986 -> 2004+) CSF Netherlands, Germany, Belgium (1997 -> 1998) H5N1 East Asia (2004 -> today) Nipah Malaysia (1998 -> 1999) FMD UK (2001) SARS (2003) Bluetongue serotype 8 Northern Europe (2006 -> today) H7N7 Netherlands (2003) African swine fever Eastern Europe (2007 -> today) Hendra virus Australia (1994) Equine Influenza Australia (2007) Q fever Netherlands (2007 -> 2010) Schmallenberg virus Northern Europe (2011 -> today)

18 Cases BSE Epidemic Curve for UK First report Feed ban SBO ban Mammalian MBM ban SBO = specified bovine offals (brain, spinal cord, thymus, tonsil, spleen, and intestines from cattle >6 months of age); MBM = meat and bone meal (protein residue produced by rendering) 23

19 Movement of Infected Animals in 2001 UK FMD Outbreak between February 7 and 23 prior to movement standstill (first reported case on Feb 20) 24

20 Bluetongue Incursions into Europe BTV-8 BTV-9 BTV-4 EHDV BTV-1 BTV-2 & BTV-4 BTV-4 BTV-16 BTV-15 EHDV BTV-1 From: EFSA Bluetongue Epi report 2006

21 Schmallenberg Virus (by Nov 2012) 26

22 Challenge SCIENCE 27

23 (adapted from Wilcox 2011) Science Philosophy of Modern Medical/ Veterinary Medicine Biomedical science follows reductionistic, mechanical paradigm Reductionist thinking based on classical mechanics Basis for many well-developed areas of modern science, including physics, chemistry and cell biology Digesting Duck of Vaucanson, 1736 Cardiovascular system

24 Source: NSF/SBR

25 Linking between Different Knowledge Perspectives Professionals Individual & local knowledge Scientific disciplines Integrated understanding Communities & cultures Sectors Units of governance adapted from: Parkes et al EcoHEALTH 30

26 (adapted from Wilcox 2011) From Reductionistic to Systems Thinking Health sciences training largely based on Biomedical model Multidisciplinary studies Focused on organism level and below Current and future challenges such as emerging infectious diseases require Go beyond biomedical model Include environmental and social aspects Learn to work across disciplines and integrate them Use systems thinking

27 Challenge SYSTEMS PERSPECTIVE (ECOHEALTH / ONE HEALTH) 32

28 Transmission of HPAI H5N1 in SE-Asia adapted from V. Martin, FAO-AGA

29 Systems Perspective on AM Usage From: Comprehensive Reviews in Food Science and Food Safety - Antimicrobial Resistance: Implications for the Food System. Pages , 2 AUG 2006 DOI: /j x

30 Population Natural Landscape community Ecosystem Perspective on Disease Emergence Population growth, technology, consumption Regional environmental change Urbanization Forest habitat alteration Agricultural intensification Species ecological-evolutionary dynamics Host-pathogen dynamics Adapted from Wilcox & Ellis 2006 Disease emergence 35

31 Challenge POLICY DEVELOPMENT 36

32 Factors influencing Risk Management legislation, governance variation of values within society policy measures stakeholder acceptance Risk Management policy impact availability of resources uncertainty risk assessment scientific knowledge 37

33 Risk Analysis or Risk-Based Decision Making Scientific Knowledgebase Hazard Identification Risk Assessment Risk Management Risk Communication after OIE Animal Health Code 38

34 Actors involved in Risk Management Public bodies Standard setters Experts Academics Single issue groups Legal Regulators Public servants Ministers Other politicians Insurers Public Media Business adapted from UK Risk and Regulation Advisory Council

35 Different States of Knowledge about Event Occurrence and Outcomes Knowledge about Likelihood of Occurrence Likely Outcome Greater (non-problematic) Lesser (Problematic) Greater (non-problematic) Risk Lesser (Problematic) Uncertainty Ambiguity Ignorance Adapted from: Miles Parker Defra UK and Stirling Nature

36 Examples for Different States of Knowledge about Event Occurrence and Outcomes Risk Ambiguity Flooding (normal) Endemic diseases Uncertainty Flooding (under CC) Exotic diseases Global warming Ignorance Novel chemicals BSE in 1986 Adapted from: Miles Parker Defra UK and Stirling Nature

37 Suitable Approaches for different Knowledge Situations Risk Ambiguity Quantitative risk assessment Normal science Uncertainty Expert opinion Modelling and scenarios Open debate Expert opinion Open debate Comparative processes analogies Ignorance Observational & Descriptive approaches Open debate Values play an important part Adapted from: Miles Parker Defra UK and Stirling Nature

38 adapted from UK House of Lords 2011 Behaviour Change Typology of Policy Interventions directed at Individual s Behaviour Guide and enable choice Non-fiscal incentives or disincentives Persuasion Eliminate choice Regulation of individual Restrict choice Fiscal measures directed at individual Choice architecture (nudges) Fiscal disincentives Fiscal incentives Provision of information Changes of physical environment Changes to default policy Use of social norms and salience

39 Risk Governance Framework (from IGRC 2005) What is to be done and how? Preassessment Broad description of risk Management Communi - cation Appraisal Evaluate acceptability Characterisa tion / Evaluation Analyse knowledge, estimate risk, express complexity and uncertainty 44

40 Acceptable, Tolerable or Intolerable Risks (from IGRC 2005) 45

41 CONCLUSIONS 46

42 Conclusions Increased demand in food quantity and variety Increased global connectivity and dependence Beware of still accelerating speed of change Need for shift Science Towards systems thinking and integrated approaches Link biological and environmental with social sciences Policy development Take account of complexity and implement participation In addition to regulation and fiscal measures consider alternative methods for guiding and enabling behavioural choice amongst stakeholders 47

43 Did that guy just cough? I hope that sore throat is not swine flu Should I chance the subway? How am I to avoid this? Is he ok? What did the school nurse say? Why is she wearing a mask? Do we need one? I forgot my hand sanitizer Should get cough checked out from Time Magazine I wish people would use a tissue! As long as I am fit and healthy, everything will be alright? Bless you! Should I cancel my vacation? THANK YOU VERY MUCH 48