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Report (in Spanish, 17 pp, PDF, 1.8 Mb; some sections translated to right)
Regional Center for Zoonoses: PANAFTOSA |
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- Objective
- Prologue
- Conclusions
Objective: Review technical cooperation strategies that emphasize the articulation of joint activities between the ministries of health and veterinary services to reduce the health burden and economic impact of brucellosis and tuberculosis from Mycobacterium bovis.
Prologue by Dr. Albino Belotto, Senior Advisor for Veterinary Public Health and Director of PANAFTOSA
Several countries of the Americas have registered great and promising progress in controlling brucellosis and bovine tuberculosis from M. bovis. Aligned with the strategies promoted by PAHO, two important milestones in this progress were the International Meeting for the Eradication of Bovine Tuberculosis held in Coahuilla, Mexico, from 8–20 November 1991, and that of the Working Group on Prevention, Control, and Eradication of Brucellosis in Latin America and the Caribbean held in Martínez, Argentina, from 14–16 November 1994.
However, these diseases continue to affect asymmetrically those sectors with fewer resources: smallholders and workers from the livestock sector and slaughterhouses. It concerns the unfinished agenda in health, which continues to hinder progress towards achieving the Millennium Development Goals (MDGs).
PAHO, in its Veterinary Public Health project for 2008–2012, established a strategy to promote the preparation of joint agendas among international organizations and the countries, in order to provide support and conduct advocacy aimed at actions that will have a concrete impact on reducing the social, economic, and health-related effects of such neglected zoonoses as brucellosis and tuberculosis from M. bovis.
We hope that together we can establish strategies to articulate the actions of the ministries of health and of veterinary services to reduce the health burden and the economic impact of these diseases.
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- Brucellosis and Tuberculosis Transmitted by Cattle: Management of Infected Animals in National Herds
- Positive experiences have taken place regarding health management (through separation) and certification of herds of cattle free of brucellosis and bovine tuberculosis in the participating countries (e.g. Argentina, Brazil, Mexico, and Peru).
- Nevertheless, the segregation of infected animals has not been achieved in a consistent way in all the countries; this is the main stumbling block in terms of eliminating the disease from national herds and preventing transmission to humans.
- Among other measures, it is necessary that producers—especially subsistence farmers or members of their family members, who have the greatest probability of contagion—to become aware of the importance of confirming the health status of their animals, and particularly of the animals they acquire to avoid having to relocate infected animals into segregated compounds.
- This should be subject to local-level education and health promotion campaigns as recommended by the ministries of health and veterinary services to state (provincial, etc.) and municipal authorities.
- Protective immunity of female calves against brucellosis should be guaranteed on a mass scale.
- Brucellosis from Brucella melitensis: Mobilization of Municipal Resources
- Promising initiatives have taken place as exemplified by Argentina, Mexico, and Peru, where goat and sheep vaccination has been an important instrument.
- The aforementioned initiatives should receive the maximum level of political support from veterinary services and the ministries of health.
- It has been observed that in states of crisis caused by outbreaks of B. melitensis in humans, there was adequate mobilization of local resources, which shows that action is indeed possible. This same effectiveness should be achieved in preventive actions.
- Action by municipal governments involved in these projects has been indispensable, which means that the responsibility for them should be emphasized when seeking a solution to the problem.
- M. bovis in Humans: Obstacles to Tuberculosis Elimination
- Noteworthy is the relative importance of human tuberculosis from M. bovis (as seen in the presentations from Mexico and Argentina).
- This strengthens the importance of tuberculosis elimination among animal reservoirs as a condition for the elimination of human tuberculosis.
- The countries should document the characterization of isolations of human tuberculosis cases and take into account the zoonotic factor in the epidemiological analysis of the disease.
- Lines of Work
- The countries should control these diseases in livestock as a fundamental premise when trying to solve the problem in terms of public health.
- This should involve both the public and the producers in order to prevent contagion and eliminate disease.
- It is very important to obtain and disseminate estimates of the economic and health burden of these diseases in order to achieve action by the public, producers, and governments.
- In addition, indicators should be constructed to confirm program progress.
- It is necessary to promote the exchange of information in the countries among those involved in problems and for epidemiology departments (or their equivalent) in the ministries of health and the animal health divisions (or their equivalent) in veterinary services to plan and evaluate zoonoses programs jointly.
- Coordination among Countries: Integrating Existing Networks
- Progress in the countries has been heterogeneous: the exchange of information and experiences and projects involving technical cooperation among countries (TCC) should be encouraged.
- The coordination of international cooperation, of reference laboratories, and of collaborating centers (network integration) should continue and be strengthened for these and other neglected zoonoses as is being carried out for diseases that cross international borders.
- Immediate Actions Recommended
- Continue to cooperate in evaluating the regional situation (ministries of health, veterinary services, and international organizations).
- Construct, on the basis of the survey, a small set of indicators that allows for monitoring program progress.
- Promote technical cooperation among countries with support from international organizations, in order to evaluate and strengthen national programs.
- Identify experts and resources to conduct a study of the health burden of these diseases following WHO criteria, together with an economic impact assessment in accordance with the lines of work initiated in this regard by the International Organization of Animal Health (OIE).
- Integrate networks and working groups in neglected zoonoses (as part of the neglected disease agenda).
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