By Medard KakuruMedard 1

About 50 districts in Uganda have been experiencing Foot and mouth (FMD) outbreaks in the past years, forcing Government through the Ministry of Agriculture, Animal Industry and Fisheries (MAAIF) to impose quarantine restrictions in an attempt to avert the disease. Uganda’s approach of preventing and controlling FMD involves imposing quarantine restrictions, vaccination and sensitization. Indeed, these approaches are the most effective in the prevention and control of FMD. What is worrisome, however, is that despite government adopting the recommended practices (quarantine, vaccination and sensitisation), FMD has remained uncontainable. Consequently, the quarantines are unending in some areas and take long to be lifted in other areas, due to FMD re-occurrences.

During quarantine, trade in animals and animal products is prohibited by law, and all livestock markets, butcheries, milk collection centres are closed. This has dire economic implications particularly on the districts that depend on cattle trade and products for revenue and food, and the country at large.  For instance, some districts collect up to 75 percent of the entire local revenue from cattle markets, which is foregone during quarantine. Individual farmers and traders are deprived of revenue which impacts household income and hence ability to access basic amenities like education and health services. Uganda encounters trade bans for livestock and livestock products from regional and international markets in line with the World Trade Organisation Sanitary and Phytosanitary agreement, which at a macro level, affects the country’s foreign exchange earnings. In a nutshell, long standing quarantines impoverish the country, districts, individual traders and farmers; and may result into defiance to quarantine restrictions by local district leaders.

The unending quarantine restrictions or delayed lifting of the restrictions is attributed to government’s failure to enforce quarantine restrictions. The question, therefore, is that “why is government failing to implement the quarantine restrictions?”

The ministry of agriculture has always raised quarantine implementation challenges including: inadequate animal movement infrastructure such as quarantine stations, animal holding grounds and tyre baths; inadequate funding to procure sufficient FMD vaccine; lack of stakeholder awareness of veterinary laws, regulations and standards; and lack of support from local district administrators who have on a number of occasions mobilised communities to defy quarantine restrictions. These are pertinent reasons but tackling these challenges holistically might be far beyond the reach of government’s financial might. For instance, it is extremely expensive to vaccinate all animals in the country. Currently, the cost of vaccinating one cow is UGX 7,000. This cost multiplied by the country’s cattle population of 13.6 million (UBOS, 2019) gives a total of UGX 95.2 billion for one round of vaccination. Given the short term immunity provided by the vaccine, vaccination should ideally be done after every 6 months (twice a year). Two rounds of vaccination would raise the cost to UGX 190.4 billion.

Because of the cost implication of the vaccine, vaccination has not been effectively[1] done. Effective vaccination should cover at least 90 percent of the national herd and should be done before the onset of the disease, or at worst, within the first two weeks after the onset. A study by Muleme et al. (2013) in Uganda revealed that the proportion of cattle vaccinated per year in districts that reported outbreaks ranged between 2.1 to 21.2 percent (i.e. 10.3 % average). The same study found out that the average time from onset of FMD outbreaks to intervention or response through vaccination is 7.5 weeks, which is too long. According to Chowell et al. (2006), the appropriate time for effective post outbreak vaccination is at day 5 for high potency vaccines and day 12 for regular vaccines. Only marginal reductions in FMD cases can be achieved if vaccination is done after the 15th day into the outbreak (Chowell et al., 2006). The implication of delayed response is that substantial losses may have already occurred by the time vaccination takes place. Secondly, it is possible that the outbreak is already declining naturally by the time vaccination takes place, hence giving a wrong impression that vaccination is stopping the outbreak, which is not necessarily the case (Abebe, 2016).

In addition to the high vaccine cost, government needs to establish quarantine stations, holding grounds, patrol vehicles and strict control of animal movements, which all require funding. In light of these challenges, there is need for government to craft avenues of obtaining adequate funding needed to facilitate effective and efficient management of FMD. 

One such avenue is cost-sharing. Much as FMD is a government controlled disease, government should develop public-private-community partnership to leverage on its resources. This is in line with the recommendations of the Global Action Plan on Antimicrobial resistance, which advocates for such partnerships to enhance access to interventions that could reduce the prevalence of such diseases (Mariner, ElIdrissi & Raizman, 2019). The FAO/OIE/AU-IBAR[2]  Consultative Group also proposed engaging the private sector in delivery of services related to management of such infectious diseases (Onono et al., 2017). Among other things, government should subsidize the vaccine for smallholder farmers (owning 1- 5 heads of cattle) but let the farmers with larger herds pay for the vaccine. Studies (Campbell et al., 2019; Donadeu et al., 2019; Terfa et al., 2015; Kairu-Wanyoike et al., 2014) have shown that farmers do value vaccines, hence they are willing to pay for them. It is easier for farmers to pay for a vaccine if they know that it prevents a disease that causes a clear economic or production loss (Donadeu et al., 2019). The payment is done in such a way that livestock farmers do not perceive it as a form of tax, otherwise they won’t pay. Farmers are grouped in a cooperative or Institutional platforms (IPs)[3] to ensure that the payments are retained at the local level to facilitate FMD management activities at that level. Such an arrangement stimulates greater activity on the part of the service delivery value chain and empowers farmers to demand timely and quality services. Payment for the vaccine also enhances both participation and compliance to disease management programs (Mariner, ElIdrissi & Raizman, 2019). Box 1 demonstrates a cost-sharing scheme.

Kakuru snip

In conclusion, the longstanding quarantine restrictions have been perpetuated by inadequate public financing of the recommended set of FMD prevention and control interventions. This has in turn led to ineffective vaccination programs and hence failure to control the disease. Vaccination coverage remains low and response to outbreaks is often late. The hurdle of funding could be addressed through cost-sharing under innovative arrangements such as public-community partnership. Cost-sharing is being advocated for by International bodies after realizing that developing countries cannot adequately fund animal disease control programs. It allows the financial burden of managing the disease to be shouldered equitably by government the cattle farmers.

References

Abebe, D. (2016). Veterinary Services in Karamoja, Uganda: A Review. Karamoja Resilience Support Unit, USAID/Uganda, Kampala.

Campbell, Z. A., Otieno, L., Shirima, G. M., Marsh, T. L. & Palmer, G. H. (2019). Drivers of vaccination preferences to protect a low-value livestock resource: Willingness to pay for Newcastle disease vaccines by smallholder households. Vaccine 3:  11–18

Chowell, G., Rivas, A. L., Hengartner, N. W., Hyman, J. M. & Castillo-Chavez, C. (2006). Critical response to post-outbreak vaccination against foot-and-mouth disease. In: Gomel, B. A., Castillo-Chavez, C., Mickens, R. E. & Clemence, P.D. (eds). Mathematical studies on human disease dynamics: Emerging paradigms and challenges. American Mathematical Society. Contemporary Mathematics, 410:  73–87

Donadeu, M., Nwankpa, N., Abela-Ridder, B. & Dungu, B. (2019). Strategies to increase adoption of animal vaccines by smallholder farmers with focus on neglected diseases and marginalized populations. PLoS Neglected Tropical Diseases, 13(2): e0006989.

Kairu-Wanyoike, S. W., Kaitibie, S. Heffernan, C. Taylor, N. M. Gitau, G. K., Kiara, H. & McKeever, D. (2014). Willingness to pay for contagious bovine pleuropneumonia vaccination in Narok South District of Kenya. Preventive Veterinary Medicine 115: 130–142

Mariner, J.; ElIdrissi, A. & Raizman, E. (2019). Control of contagious bovine pleuropneumonia – A policy for coordinated actions. FAO Animal Production and Health Paper no. 180. Rome, FAO. 52 pp.

Muleme, M., Barigye, R., Khaitsa, M. L., Berry, E., Wamono, A. W. & Ayebazibwe, C. (2013). Effectiveness of vaccines and vaccination programs for the control of foot-and-mouth disease in Uganda, 2001–2010. Tropical Animal Health Production, 45: 35–43

Onono, J. O., Wieland, B., Suleiman, A. & Rushton, J. (2017). Policy analysis for delivery of contagious bovine pleuropneumonia control strategies in sub-Saharan Africa. Revue scientifique et technique (International Office of Epizootics), 36 (1): 195-205

Terfa, Z. G., Garikipati, S., Dessie, T., Lynch, S., Wigley, P., Bettridge, J. M. & Christley, R. M. (2015). Farmers’ willingness to pay for a village poultry vaccine service in Ethiopia: prospect for enhancing rural livelihoods. Food Security, 7: 905–917

 

[1] The effectiveness of vaccination programs is judged on three parameters - the proportion of cattle vaccinated, minimum time between outbreaks and vaccination onset, and cost of FMD vaccines (Muleme et al., 2013).

[2] AU-IBAR is African Union Interafrican Bureau for Animal Resources

[3] Innovation Platform is a physical or virtual forum established to facilitate interaction and learning among stakeholders of a commodity value chain.

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