1. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 1 GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016 Emerging Pandemic Threats Programme Phase 2 (EPT2) MERS-CoV at the human-animal interface Ahmed El Idrissi Food And Agriculture Organization of the United Nations

2. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 2 EPT2 Programme in brief 5- year global programme (2015-2019) Builds on existing strategic partnership and expanding Surveillance of Ebola, MERS-CoV, Avian Influenza Capacity development (over 31 countries in Asia, Africa and the Middle East Epizonal approach One Health GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

3. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 3 Why MERS-CoV under EPT2 ? Mounting evidence implicates dromedary camels as an intermediate animal reservoir and source of infection –High prevalence of MERS-CoV antibodies in camel populations –Epidemiological links between farm camels and human cases Several unanswered questions remain as to the emergence and the mechanisms of transmission Good science but little known about behavioral aspects that are conducive to transmission Pandemic potential? GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

4. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 4 Policy and regulation issues Case definition for reporting Trade and regulatory implications –Quarantine for PCR positive animals –Reporting of positives during active surveillance –Difference between farm level and cross border implications of positive animals Vaccines – Only to protect public health –Incentives –Who pays?

5. Emerging Threats Program Animal Amplification Overarching EPT-2 Strategic Vision at the “animal-human-ecosystem” interface” CASESCASES TIME SPILL OVER Characterizing Determinants of Pathogen Emergence – biological and behavioral Targeting “Behaviors and Practices” that trigger “spill-over and amplification” “DETECT” “PREVENT” Global Health Security and Development “Respond” Responding to “emergence” at its source

6. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar EPT-2 MERS-COV - Epi-zonal approach EGYPT SUDAN ETHIOPIA KENYA JORDAN GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

7. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 7 EPT2 MERS-CoV - Objectives Objectives Goals Improve understanding of transmission dynamics and pathways Characterize and describe camel value chain and other transmission pathways Identify risky behaviors that lead to exposure Support informed policy decisions Minimize or interrupt animal-to- animal and animal-to-human transmission ( Reduce zoonotic risk) Target risk-mitigation interventions based on where the virus is present and when and how it spreads GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

8. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar Risk Assessment/ Modeling Supply Chain Analysis Surveillance Laboratory Support EPT-2 MERS-CoV Framework Human Behavioral Studies GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

9. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 9 MERS-CoV Programme Components –Value/supply chain studies to inform surveillance –Risk-based cross-sectional studies –Longitudinal surveillance Targeted Localities –Border points, Sea ports, LAMs, Slaughterhouses –Major camel tracts, border crossings, major market hubs Targeted Species –Dromedary Camels (Sudan, East Africa, Resident Camels) –Other livestock species at the interface (Cattle, Sheep, Goats, Buffalo, Equines) –Bats GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

10. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 10 Testing Algorithm for Dromedary Camels Screening Serum Nasal Swabs + UpE rRT-PCR S1 ELISA Fecal swabs Milk Other? UpE rRT-PCR VI + Confirmation BSL2 BSL3 VN BSL3 + Complementary testing S2 region or full genome sequencing Bv CoV- ELISA subset VI GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

11. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 11 Laboratory Capacity Building Guidelines on sampling/testing Training – Sampling – Management of sample flow – Testing – Quality Assurance – Biosafety / Biosecurity Laboratory supplies Laboratory networking GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

12. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 12 Supply chain analysis and behavior studies– what for? Understanding these chains/networks and connected human behaviors and perceptions are crucial to design: – Risk assessment – Risk based surveillance – Risk management interventions – Policies GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

13. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 13 Preliminary studies in Egypt (Mohamed A. Ali et al., 2016 poster communication) GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

14. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 14  Regional consultation on MERS-CoV in animal species (Muscat, May 2014): Muscat Declaration  Regional consultation on MERS-CoV and One Health (Doha, April 2015): Doha Declaration  Technical meeting: Understanding MERS-CoV at the human-animal interface (Rome, January 2016)  Joint assessment missions to affected countries  Capacity building (lab training)  Tripartite  EPT-2 MERS-CoV FAO MERS-CoV activities GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

15. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 15 Partners National – MoA – MoH – Universities – National labs – Professional associations International – WHO, OIE – USDA, US-CDC, US-NAMRU3 – CIRAD, ILRI EPT2 implementing partners (PREDICT2) GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016

16. Regional Workshop on MERS-CoV and “One Health” 27-29 April 2015 Doha, Qatar 16 EPT2 team S. VonDobschuetz B. Diop E. Gardner G. Dauphin Y. Makonnen M. Tibbo S. Morzaria Thank you T GF -TADS Conference on Camel Diseases Abu Dhabi, 14-16 February 2016