TECHNICAL ITEM I (with Questionnaire) Sustainable strengthening of the epidemio-surveillance systems in the Middle East Member Countries Ahmad AL-MAJALI, DVM, PhD Professor of Infectious Diseases and Epidemiology Jordan University of Science and Technology

Contents Introduction Objectives Methodology Presentation of results Conclusion and recommendations

Introduction Veterinary Authorities should deal the new challenges related to animal health and protection, food safety and the environment New challenges for veterinary medicine: Globalisation of trade in animals and animal products Animal trading rules Opportunities Challenges related to environment Relationship between veterinary medicine and humans

Introduction Regional Challenges: Geographical position. This area is at the crossroads. An unstable political situation. The need to restructure and consolidate national Veterinary Services (field activities, extension) and central (diagnosis and research) deficiencies. The diversity of livestock production systems. Major routes of migratory birds, between Europe and Africa. Demographic changes, characterized by a growing human population, desertification and increasingly limited water resources.

Epidemiology & Veterinary Authorities Fast changing world Extraordinary livestock growth Training Integration within policies Trends in Animal Health policies

Fast changing world The world has changed fast over the last three decades New free market economics The SPS of the WTO Use of risk analysis in decision making Revolution in information technology (WAHIS and WAHIS+)

Extraordinary livestock growth Livestock population tremendously increased Change is the region economy Increased exportation of live animals and animal products Veterinary authorities have to respond to this enormous challenge.

Trends in Animal Health policies Efforts towards controlling diseases that affect trading (TADs) Integration of epidemiology services (surveillance, outbreak investigation, early warning) Control strategies and SOPs Networking

Integration within policies Harmonization with International Standards Harmonization with neighbors Including other governmental and academic bodies Involvement of all stakeholders Government awareness and training Advance education in epidemiologic fields and policy making Integration within policies

Training Short and long term training in different field of epidemiology Continuing education Amount of training performed Type of training performed Scholarships for MSc and PhD programs Twining

Objectives Establish baseline information on the current situation in terms of the structure and capacities of epidemio-surveillance systems in Member Countries of the Middle East Region, Identify activities that could help to address the related challenges in a sustainable manner.

Methodology Structured questionnaire was sent by e-mail to the Delegates of the 20 Member Countries of the Region. Members were asked to respond to 26 questions related to three aspects of surveillance systems: Structure of the epidemio-surveillance system within the country; Capacity of the epidemio-surveillance system at the Veterinary Authority; Challenges facing the Veterinary Authority’s epidemio-surveillance system.

Results Out of the 20 Member Countries of the Region, 16 (80%) responded to the questionnaire In all respondent countries, the Veterinary Authority is the main body responsible for performing surveillance A special unit/department for epidemiology exists in 81% of responded countries

Structure of the epidemio-surveillance system

Structure of the epidemio-surveillance system Composition of the outbreak team No. of countries Veterinarian 14 Veterinary para-professional 10 Epidemiologist 7 Microbiologists

Structure of the epidemio-surveillance system

Structure of the epidemio-surveillance system

Structure of the epidemio-surveillance system Type Disease Control strategy FMD Brucellosis HPAI PPR TB MERS-CoV Contingency plan New strains of FMD Rabies Glanders BSE

Capacity of the epidemio-surveillance systems

Capacity of the epidemio-surveillance systems

Capacity of the epidemio-surveillance systems PPP in surveillance: Support early warning Support outbreak investigation Surveillance programs Get involve in making decisions Outsource control programs

Capacity of the epidemio-surveillance systems

Capacity of the epidemio-surveillance systems

Challenges facing the Veterinary Authority’s epidemio-surveillance systems

Challenges facing the Veterinary Authority’s epidemio-surveillance systems

Challenges facing the Veterinary Authority’s epidemio-surveillance systems Success category No. of countries Highly successful Successful 9 Neutral (neither successful nor unsuccessful) 7 Unsuccessful Highly unsuccessful

No of countries that selected as Help requested from OIE to the region OIE actions No of countries that selected as 1st priority 2nd priority 3rd priority Advocating improved transparency 3 1 2 Supporting OIE member countries with building capabilities through OIE PVS Pathway 4 7 Updating relevant OIE standards on surveillance 5 Facilitating twinning projects Training of relevant OIE national Focal Points (Animal Disease Notification, etc.) 8 Facilitating communication between relevant Reference Centres and Member Countries Ensuring WAHIS+ will be more user-friendly and compatible with nation surveillance databases Facilitating links between OIE Member Countries and relevant technical organisations

Conclusion The high response rate to the questionnaire suggest the strong interest of the member countries of the ME region Differences in current situations and expectations in reference to epidemio-surveillance systems in Member Countries of the Region exist VAs in the region is the main responsible agency for performing surveillance.

Conclusion VAs of the ME member countries still need: Epidemiology experts (with post-gradual degrees) Special departments or offices for risk assessments Capacity building of staff (different levels) in surveillance and outbreak investigation Participation in regional networks and better communication with other countries in the region More involvement of the private sector Better link with academia and better emphasis on continuing education in epidemiology High ranked officials’ awareness of the concept of epidemio-surveillance and O/B investigation

Conclusion Among the challenges that face VAs in reference to their epidemio-surveillance systems are: Allocation of budgets Support from high ranked officials Shortages of skilled trained staff Training in different fields Lack of proper policies

Conclusion Member countries of the ME region requested the support of OIE mainly in: Capacity building in different fields of epidemiology and notification Facilitation of communication and networking between countries of the region Updating relevant OIE standards on surveillance Evaluation of their bodies using PVS tools

Recommendations VAs in member countries of the Middle East need to further define their duties in epidemio-surveillance and O/B investigation. This should facilitate the regional initiatives (such as GF-TAD). Member countries of the Middle East region are strongly recommended to benefit from the OIE PVS Process (OIE PVS evaluation, OIE-PVS Gap Analysis, and OIE PVS Follow-Up missions) being the general basis of for evaluating a Vet Authority.

Recommendations Legislation for epidemio-surveillance and strategic planning for disease control need to be formulated and harmonized with those of the international standards. There is a great need for establishing a regional epidemiological training network. Veterinary Authorities at the Member countries of the Middle East are strongly recommended to benefit from academic institutes within their countries and to start a continuing education programs in the field of epidmio-surveillance. To solve budget challenges, regional approach for surveillance and control of TADs is crucial.