What are the costs and benefits of integrated approaches to improve animal health with a focus on vaccina8on strategies Jonathan Rushton

Transcription

1 What are the costs and benefits of integrated approaches to improve animal health with a focus on vaccina8on strategies Jonathan Rushton jrushton@rvc.ac.uk or jrushtonahfse@gmail.com EAAP workshop Integrated strategies for sustainable animal produc@on through improved immunocompetence 31 st August, May 2016 Belfast, Northern Ireland, UK 1

2 Introduc8on - Why animals? According to the geologists we have entered a new age the Anthropocene The world is affected by the ac?ons of people in ways never an?cipated even twenty years ago Yet people have not done this alone Animals have been important in the past for power, clothing and food They remain important today for food, enjoyment and companionship 2

3 Introduc8on - why animal health? Animal health has to be taken seriously because of the sheer numbers of animals kept they share many diseases with people medicines used for humans are also used in animals Yet they way in which we approach animal health is rela?vely unstructured Diseases become priori?es due to epidemic events and remain important for decades 3

4 Introduc8on - what is the problem? There is a general problem with resource alloca?on for animal health (versus health) And a problem of alloca?on between animal diseases In addi?on the way resources are allocated to specific animal diseases and health problems rarely takes into account the costs and benefits of the interven?ons 4

5 Introduc8on - what is the problem? There is a general problem with resource alloca?on for animal health (versus health) And a problem of alloca?on between animal diseases In short there is a need for a different approach to resource alloca?on for animal In addi?on the way resources are allocated to health and within animal health systems specific animal diseases and health problems rarely takes into account the costs and benefits of the interven?ons 5

6 Introduc8on - structure of the presenta@on The presenta?on will examine this issue in four different parts: It will present the context in which we live and why animal health is important The economic impact assessment of animal diseases and health problems will be explored Informa?on on the type of costs and benefits of interven?ons that need to be included for animal health will be discussed Conclusions and requests for a way forward 6

7 Context 7

8 Human world popula8on projec8on (Gerland et al, 2014) Currently 7 billion billion

9 Human popula8on key issues Human popula?on has more than doubled in 50 years - 3 billion in 1961 to 7 billion in 2011 Rural popula?on stabilised at around 3 billion in 1980s Urban popula?on has con?nued to grow and is now larger than the rural popula?on 9

10 Human and domes8cated animals (in livestock unit equivalents based on FAOSTAT data ) Millions 4,000 3,500 3,000 2,500 2,000 1,500 Human Animal 1,

11 Human and domes8cated animals (in livestock unit equivalents based on FAOSTAT data ) Millions 4,000 3,500 Per person this is equivalent to: ,000 livestock units per person 2, kilos of live animals per person! 2,000 3 chickens, a third of a sheep or Human Animal 1,500 goat, a fifth of a cow, a seventh of a 1,000 pig and a tenth of a cat or dog

12 Livestock in society - key issues The role of livestock in society has changed drama8cally over the last fiyy years Livestock are increasingly maintained in systems where grain based food is brought to them Many of the livestock we depend on are invisible to urbanised people, increasing the likely detachment from livestock produc?on 12

13 Simple food chain Family or household Purchased Inputs Inputs $ Product Residues Processing Produc?on Processed Product Labour Fresh Produce Labour Consump?on Fresh product Processed Product $ Products sold to consumers with low demands on quality cer?fica?on and who process the food in their homes

14 Complex food chain Providers of inputs and services Input or Service $ Middlemen, transport, traders Fresh Product $ Processed Product Producer Processor Marketers Middlemen, financial services $ Processed Product $ Products sold to consumers with sophis?cated demands who do very li^le home processing

15 Consumer Food Retailing Food Processing Catering There are only 339,000 people who work on agricultural holdings in the UK (0.6% of the popula8on) yet they can affect the wellbeing of 60 million people Animal health contributions to the food chain Veterinary public health National Production Overseas Production Clinical treatments Epidemiology & Disease Control Diagnostics Immunology Inputs Vaccines Genetic Resistance

16 Pharmaceutical Manufacturer Feed Manufacturer Pharmaceutical Distribution AM Waste Impact on AMR Farmer AM Unused Impact on AMR Pigs Poultry Cattle & Buffalo Sheep & Goats Aquatics Other species Animal and Food Processing AM Residue & AMR AM Excreted Impact on AMR Human Consumers Outcomes on Human, Animal and Environmental Health

17 Food system - key issues Food system has become increasingly complex The complexity is about the geographical loca?on and ins?tu?onal direc?on The food system provides accessible and affordable food, yet can create nega?ves in terms of disease and the environment 17

18 Impact Assessment 18

19 Health Impact Health Losses Expenditure & Reac?on Visible Losses Invisible Losses Addi?onal Costs Lost Revenue Dead people & animals Thin people & animals People & animals poorly developed Low returns Poor quality products Fer?lity problems Change in popula?on structure Increased labour costs Delayed sale of animals and products High prices for livestock and livestock products Medicines Vaccines Insec?cide Time Treatment of products Public health costs Access to be^er markets denied Sub- op?mal use of technology Modified from Rushton et al, 1999; Rushton, 2009

20 Health Impact Health Losses Expenditure & Reac?on Visible Losses Dead people & animals Thin people & animals People & animals poorly developed Low returns Poor quality products Impact Invisible Losses caused by diseases & Fer?lity problems Change in popula?on structure Increased labour costs Delayed sale of animals and products High prices for livestock and livestock products health problems Addi?onal Costs Medicines Vaccines Insec?cide Time Treatment of products Public health costs Lost Revenue Impact caused by human reac?on Access to be^er markets denied Sub- op?mal use of technology

21 Health Impact - Loss versus Expenditure and Reac@on (adapted from McInerney, 1996) No Control Health Losses Optimal control? Towards Eradication? Expenditure and reac?on 21

22 Importance of impact assessments Good impact assessments provide support for advocacy for disease management A series of impact assessments will indicate resource alloca8on between diseases Detailed impact assessments indicate where resources are being used to manage a disease They allow indicates of misalloca8on of resource and where resource use can be improved 22

23 Importance of impact assessments Good impact assessments provide support for advocacy for disease management A series of impact assessments will indicate resource alloca8on between diseases Animal health does not have economic impact assessments for animal diseases Detailed impact assessments indicate where resources are and being health used problems to manage a disease it priori?ses by gut feel! They allow indicates of misalloca8on of resource and where resource use can be improved 23

24 Costs 24

25 Change in technology Disease management with no technology Disease losses A shiy in technology Control expenditure 25

26 Change in technology Disease management with no technology Disease losses FMD vaccines of the 90s with the addi?on of the oil based A shiy in technology adjuvant Control expenditure 26

27 Expenditure issues fixed and variable cost issues The classic way of thinking about technology shiys is through the lens of technological advance There is a tendency to forget that many of our advances have come about through managerial and ins?tu?onal development change And this requires fixed cost investments in health systems across the species Investments that need public funding support alongside private sector engagement 27

28 Animal Produc?on Losses Fixed Costs Variable Costs Animal Health Costs

29 Cost analysis When introducing a vaccine into a farming system the bare minimum would be an es?mate of the cost of delivery This commonly done for human vaccines, yet is rarely available for animal vaccines 29

30 Costs 30 Griffith et al Vaccine 2011

31 Costs Animal health needs to improve the collec?on, capture and analysis of costs of interven?on - We need a library of costs 31 Griffith et al Vaccine 2011

32 Vaccina8on Campaign Process Planning Implementation Population Model(s) Evaluation Epidemiological Model(s) Vaccination Plan Budget Data Collection Procedures Monitoring (vaccine quality, delivery etc.) Vaccine Distribution Vaccination Technical Cost Cost- Effectiveness Long-term Performance Indicators

33 Benefits 33

34 Benefits For vaccine interven?ons there should be a link to epidemiological models that take into account Vaccine efficacy Vaccina?on efficiency Popula?on dynamics Once available a cost analysis can be combined with predicted benefit streams to es?mate economic profitability at the farm level Ideally the models should be stochas8c to indicate the variability in profitability - risk 34

35 Benefits There should also be es?mates of the wider societal benefits of any change that is predicted to be a^rac?ve to producers Increasing livestock product availability and/or reducing variability in product quality and quan8ty will benefit processers and retailers Depending on the market structure these organisa?ons may also pass this benefit to the consumers 35

36 Benefits Vaccina8on could also have a significant impact on an8microbial use leading to changing pressures on an8microbial resistance (AMR) levels The change in livestock product quan?ty, livestock product quality and AMR level changes are all posi8ve externali8es to vaccina?on They should be valued and included in a sector and wider societal cost benefit analysis 36

37 Assessment of interven8ons Economic analysis of vaccina8on should iden8fy who pays: Vaccine research and development Bringing the vaccine to the market Implementa?on of vaccina?on It should iden8fy where benefits accrue: Vaccine sales Animal produc?vity improvements Costs saved or treatments It should determine wider societal benefit - posi8ve externali8es: Food quan?ty and quality Aver?ng health problems disease and AMR 37

38 Assessment of interven8ons Economic analysis of vaccina8on should iden8fy who pays: Vaccine research and development A good Bringing analysis the vaccine to will the market look at equity across Implementa?on of vaccina?on It should society iden8fy in where order benefits to promote accrue: good government Vaccine sales policies and strong private Animal produc?vity improvements Costs saved or treatments strategies It should determine wider societal benefit - posi8ve externali8es: Food quan?ty and quality Aver?ng health problems disease and AMR 38

39 Conclusions 39

40 Health Impact Animal health & welfare burden Costs of surveillance, control & preven?on plus impacts on markets Bio- economy models Bio- economy models Produc?on Parameters Disease Programmes Core Markets Species & Species Popula?on Private Spend Public Spend Chronic Distor?ons Shocks

41 Data on: - Scale popula?ons, farms - Disease - Parameters fer?lity, mortality, sales - Prices - markets Es8mates: - Prices for good and services with no markets Animal Disease Economic Impact Assessment Economic assessment of an interven8on Animal health decisions Animal Popula?on Health Status

42 One Health System Food system Livestock People 42

43 One Health System Food system An integrated approach requires data collection, Livestock capture and analysis in order People to assess costs and benefits and to direct resources to where they are needed 43