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

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)

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

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

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

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

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 2010-11? Pool 6/Southern Africa BVI (Botswana), leads Pool 7/South America Panaftosa leads

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

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

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

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?

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)

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, 2009-2010: Naci Bulut, SAP Institute Turkey

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 (2010-12): 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)

FMD Roadmap development - Africa

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)

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

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) 2010-12 should stimulate other projects/countries to achieve Stage 1

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

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)

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

End here – for discussion Remaining slides explain the Roadmap and PCP approach – familiar to most participants Nairobi and Paraguay meetings - 2009