1. The role of FMD Reference Centres (RCs) and lab networks in relation to Regional Roadmaps and the Progressive Control Pathway (PCP) for FMD
[1] Prepared by: Sumption K (1) , (1) European Commission for the Control of Foot-and-Mouth Disease (EuFMD), FAO, Rome, Italy, (2) EMPRES Animal Health, FAO, Rome, Italy
Stages 0-3
= infected countries/zones
Risk not controlled Continuous FMDV circulation
Critical risk points identified, strategy being developed
Critical points addressed  incidence
Approaching freedom Outbreaks < once / year
Officially free with vaccination No circulation / containment zones only 1 2 3 4
Officially free without vaccination No circulation / containment zones only 5

2. Progress 2009 – Regional/Global
FMD Roadmaps:
West Eurasia (2 meetings; 14 countries: vision to 2020)
West Eurasia Lab Network
Africa – Nairobi meeting (Jan 09) , Roadmaps for Southern, Eastern and West/Central
Global FMD Conference, Paraguay
supported the Roadmaps approach, and Progressive Control Pathway (PCP)
recommended FAO promote and support networks (inc Lab Networks)
Global Gf-TADS Steering Committee (July):
recommended follow up task force to Paraguay (could become global FMD task force)

3. FMDV distribution: virus pools and FMD reference centres
Regional/National Reference Centres
Reference Laboratories and Collaborating Centres
Reference Centres
(UK, Belgium, Italy, South Africa, India, Russian Fed – at 3/09)
Intermediate, sporadic
Endemic
FMD - Free
Free. Virus present in game parks
Free with vaccination
Countries with multiples zones
Source: Annual OIE/FAO FMD Reference Laboratory Network Report, 2007
Pool 1
O, A, Asia 1
Pool 2
Pool 3
Pool 6
SAT 1, 2, 3
Pool 4
A, O, SAT 1, 2, 3
Pool 5
O, A, SAT 1, 2
Pool 7
O, A

4. GLOBAL FMD Lab network (OIE/FAO):
annual meeting (2009 Delhi; 2010 Pirbright)
annual report (virus surveillance in 2009)
secretariat: WRL Pirbright
funds: FAO
African labs: OVI and BVI. Eastern Africa represented by Sabenzia Wekesa (2009)
Regional/National Reference Centres
Reference Laboratories and Collaborating Centres
Reference Centres
(UK, Belgium, Italy, South Africa, India, Russian Fed – at 3/09)
Intermediate, sporadic
Endemic
FMD - Free
Free. Virus present in game parks
Free with vaccination
Countries with multiples zones
Source: Annual OIE/FAO FMD Reference Laboratory Network Report, 2007
Pool 1
O, A, Asia 1
Pool 2
Pool 3
Pool 6
SAT 1, 2, 3
Pool 4
A, O, SAT 1, 2, 3
Pool 5
O, A, SAT 1, 2
Pool 7
O, A

5. One task for this meeting
GLOBAL FMD Lab network (OIE/FAO) Report for 2009
Drafted by WRL
Sections on each of the 7 virus pools
sent to Ref Labs for comments – January 2010
this meeting should review POOL 5 – EASTERN AFRICA section
revision to be sent to WRL by 11th Feb
Report will be finalised 13th Feb for submission to FAO & OIE

6. The Progressive Control Pathway for FMD (PCP-FMD) and Regional Roadmaps
PCP-FMD: is a set of control program activity stages leading to FMD freedom
developed FAO, will be endorsed by OIE (2010) as part of Global Framework for long term FMD control
Regional Roadmaps (RR) describe the anticipated progress along the PCP at national and regional level over longer term (e.g. to 2020)
PCP at national level and RR at regional level
National FMD labs
essential to support PCP activities
need support - by regional networks

7. Regional FMD Lab networks
Pool 1/East Asia
Active/new
Pakchong, Thailand
Pool 2/South Asia
India (PD-FMD) nominated for SAARC
Pool 3/West Eurasia
Beginning
Naci Bulut, Turkey (SAP Institute) leader
Europe
Active/long term
Pirbright leads, EC and EuFMD support
Pool 4/West Africa
No leader identified
Pool 5/ Eastern Africa
This meeting
Leader(s) for ?
Pool 6/Southern Africa
BVI (Botswana), leads
Pool 7/South America
Panaftosa leads

8. FAO Progressive control pathway - risk reduction approach
not a top down prescribed approach: but each MS encouraged to develop national risk reduction strategies that are supportive to the regional effort
Stages 0-3
= infected countries/zones
Risk not controlled Continuous FMDV circulation
Critical risk points identified, strategy being developed
Critical points addressed  incidence
Approaching freedom Outbreaks < once / year
Officially free with vaccination No circulation / containment zones only 1 2 3 4
Officially free without vaccination No circulation / containment zones only 5

9. Progressive Control Pathway
Stage
Monitoring
Control
Surveillance No 1
Yes 2 3
Monitoring: testing without necessary action
Surveillance: testing with necessary action, i.e. containment of the infection

10. Requirements in various stages
FMD notifiable in stage 1
Lab services needed:
NSP serology in stage 1 for risk identification
FMD identification in stage 1
SP serology in stage 2 if vaccination is used
Timely sending samples to WRL in stage 2
Sensitive virus identification (RT-PCR or VI) in stage 3
Laboratory services can be obtained from others
Other requirements:
Contingency plan in stage 3
Farm e.g. GIS identification in stage 3
Animal identification preferred in stage 3

11. Eastern Africa – FMDV Pool 5
very broad range of serotypes/topotypes circulating
serotypes A, O, SAT1,2,3 ....(type C?)
contains unique topotypes to Eastern Africa
some topotypes shared –or occasionally introduced from – West/Central Africa (across sahel - ).
occasional Eastern African SATs extend to Southern Africa (Tanzania to Malawi/Northern Zambia)
reservoirs of SAT viruses in wildlife in most countries
extent of diversity
challenge for vaccine selection
more epidemic waves/per year than other regions?
→more chance individual has multiple FMD episodes
reason why chronic FMD cases reported (hairy panters syndrome)
impact under-estimated?

12. An Eastern Africa FMD lab network
national FMD labs and their experts isolated but often good links to European Ref Labs
needed for
services to identify FMDV circulation
advice on vaccine suitability
identifying/validating suitable tests for regional strains
assisting capacity building – overcoming common problems
improved risk assessment on new findings (emergent FMDV)
links:
associated with FAO co-ordinated EARLN
a “regional network ”” contributing to the GLOBAL network (OIE/FAO FMD Reference Centre network co-ordinated by Pirbright)

13. Example: West Eurasia – FMD Lab network for countries in the West Eurasia Regional Roadmap
Terms of Reference for the Lab Network
a. the harmonisation of laboratory procedures to improve the confidence of veterinary
services in the results obtained across the region;
b. to improve early detection of emergent viruses, and communicate information to assist
the preparedness of each country for epidemic threats;
c. to build expertise in each country, and improve capacity and performance of
laboratories across the region;
d. to implement in network members a system for ring (proficiency) testing;
e. that one laboratory will serve as a leading facility for gap analysis, training, and
manage proficiency tests (with OIE or FAO reference laboratories), will interface with
Regional Epidemiological Unit, and host a regional laboratory network website.
Main Ref centres involved: WRL, IZSLER Brescia (Lindholm, Denmark)
Lab Network representative on West Eurasia FMD Roadmap Advisory Committee, :
Naci Bulut, SAP Institute Turkey

14. Future support –Eastern Africa FMD lab net
$ enough for annual meeting and co-ordination
EuFMD (FAO)
specialist FMD Commission
Phase I support (2006-9) : Ethiopia, Kenya, Sudan (average US$ 30,000 per lab)
Phase II support ( ): proposals invited for new actions
that fit with objectives of improving virus typing and incidence monitoring (PCP Stage 1 )
grants about 50-95,000 per lab
see Keith Sumption
Eastern Africa Ref Lab Network (EARLN)
possible use of donor funds for African lab/epi networks (current focus on HPAI, needs good proposals)
bilateral /national projects will provide a great deal of the country specific information (e.g. SACIDS project Tanzania)

15. FMD Roadmap development - Africa

16. Expected PCP progression,
Africa Roadmaps
to 2020
Expected PCP progression,
North, West/Central,
East and
Southern Africa
(Nairobi Workshop, Jan 09 and Algiers, Feb 09)

17. FMD Roadmap development – Africa Roadmap progression to – after Nairobi and Algiers Workshops (2009)
2020
2009

18. How to move forward? Stage 1 PCP activities –low cost monitoring
project support - assist countries to achieve Stage 1
proposals encouraged – possible FAO support
at least 2 proposals from Eastern Africa for Stage 1 activities encouraged
possible support (FAO, EuFMD)
should stimulate other projects/countries to achieve Stage 1

19. Conclusions: Roadmaps need regional lab networks
Progressive Control Stages (PCP) :
at most basic, need Ref centres for typing /vaccine matching:
sequential addition of capacity
Stage 1 PCP - NSP ELISA (national level)
Stage 2 PCP – SP ELISA for monitoring vaccination campaigns
Stage 3 PCP - rapid detection/typing for early control (<7 days typing to strain level)
Reference Centres:
provide services not present at National Level
assist risk assessment – threat of new variants
training and introduction of methods
EQA
initiate /support/promote regional supporting studies:
Full genome sequencing for epidemiology (West Eurasia)
specific diagnostic guidance: e.g. rapid strain typing protocols

20. Building up regional lab networks: lets start from here!
start up funds needed – meetings, PT services
make use of/develop support projects
e.g. HPAI – high level of support for networks
each network has range of actors
technical service providers (receive or send biologicals)
animators (make it happen, not always same as service provider!)
regional NRL members
international RC (Global PT services - WRL Pirbright, etc)
other stakeholders (vaccine producers, vet service risk managers)

21. Acknowledgements EUFMD Commission member states
EC (DG-SANCO –Regional workshops)
FAO (J. Domenech, J. Lubroth, G Ferrari, J Pinto)
OIE (G. Bruckner)
African Union-IBAR (Pan African Workshop)
FAO World Reference Laboratory (WRL) Pirbright (D Paton)
Supporting centres:
EUFMD Secretariat staff (Nadia Rumich)
RAHCs in Nairobi, Bamako, Beirut, Tunis, Gaborone, Nepal

22. End here – for discussion
Remaining slides explain the Roadmap and PCP approach – familiar to most participants
Nairobi and Paraguay meetings