1. Ireland’s TB Eradication Policy Margaret Good SSVI Margaret Good SSVI

2. Topics History Programme History Programme Recap (where we’ve been) Recap (where we’ve been) Current programme (where we are) Current programme (where we are) Future (where we are going) Future (where we are going)

3. Recap Programme commenced 1950 Programme commenced 1950 Herd and individual animal identification since then Herd and individual animal identification since then Initial good progress before ‘stall’ Initial good progress before ‘stall’ Many reviews essentially all expressing incredulity that the programme that worked elsewhere in Europe wasn’t working in Ireland – the recommendations reflected the belief that it must be that something involving the tuberculin test itself wasn’t being done right!! Many reviews essentially all expressing incredulity that the programme that worked elsewhere in Europe wasn’t working in Ireland – the recommendations reflected the belief that it must be that something involving the tuberculin test itself wasn’t being done right!! ERAD - established ERAD - established

4. LESSONS LEARNED by ERAD & Conclusions All Programme Elements recommended by any ‘experts’ have been tried and evaluated over the past eighteen years – and All Programme Elements recommended by any ‘experts’ have been tried and evaluated over the past eighteen years – and many retained as cost effective control measures many retained as cost effective control measures Others have been quietly allowed to lapse Others have been quietly allowed to lapse Measures determined ineffective will not be re-incorporated unless the situation changes Measures determined ineffective will not be re-incorporated unless the situation changes Most current Programme Elements have been optimised Most current Programme Elements have been optimised The requirement for a Lab based screening test is primarily socio-economic (not now seen as a constraint to eradication) The requirement for a Lab based screening test is primarily socio-economic (not now seen as a constraint to eradication) Wildlife resevoir recognised as the primary remaining constraint to progress Wildlife resevoir recognised as the primary remaining constraint to progress

5. Constraint to Progress Primarily it would appear that the existence of an infected wildlife source in which infection with M. bovis is endemic and which share the environment with cattle is the main constraint to sustainable progress. Primarily it would appear that the existence of an infected wildlife source in which infection with M. bovis is endemic and which share the environment with cattle is the main constraint to sustainable progress. Evidenced by EOP Evidenced by EOP and confirmed by and confirmed by 4-area study 4-area study

6. Realistic Expectations ERAD ‘End of Term Review’ of Percieved Constraints 1. Need for Comprehensive Computer Movement Control System √ √ CMMS However little or no apparent effect on disease control (tracing faster) 2. Need for Lab based Diagnostic Test √ γ- IFN No change in primary use of Field Screening Test SICTT shown to work very effectively where wildlife removed and R factor reduced below 1 3. Need for Vaccine to address the Wildlife Problem -> considerable investment Substantive Progress being made

7. Irelands Strategy R & DR & D Address the Wildlife ConstraintAddress the Wildlife Constraint Improve efficacy of Bovine TB EradicationImprove efficacy of Bovine TB Eradication Operate lowest cost interim effective strategy consistent with the goal of EradicationOperate lowest cost interim effective strategy consistent with the goal of Eradication Use improved tools as they become available & therebyUse improved tools as they become available & thereby Accelerate the Eradication ProgrammeAccelerate the Eradication Programme

8. Badger Vaccination Strategy the development of a vaccine for use in badgers is a long term control measure aimed at the protection of badgers in known areas of high risk in which other control measures are also in place the primary aim of a strategic vaccination programme is to limit the severity of tuberculosis in badgers so exposed so as to reduce the risk of infectivity for other animals, viz. badgers, deer and cattle

9. Tuberculosis in Cattle – outbreak investigation

10. ERAD TB Research Wildlife Wildlife Contribution assessment Contribution assessment EOP & 4-Area study √√√√√ EOP & 4-Area study √√√√√ Vaccine Development Project √√√ Vaccine Development Project √√√ Badger Population and ecology studies√√√ Badger Population and ecology studies√√√ Diagnostic Diagnostic Blood testing – gIFN, ELISA, LPA, other√√ Blood testing – gIFN, ELISA, LPA, other√√ Strain typing √√ Strain typing √√ Tuberculin Potency & Comparison Trials√√√√ Tuberculin Potency & Comparison Trials√√√√ Epidemiology/Data Analysis Epidemiology/Data Analysis CVERA√√√√ CVERA√√√√ Other Other Genetics√ Genetics√ TB in other species Deer, Alpaca, Sheep√√ TB in other species Deer, Alpaca, Sheep√√

11. Routine Programme elements Routine Programme elements Disease Detection – Disease Detection – Annual Test – SICCT all herds & all animals Annual Test – SICCT all herds & all animals Slaughter checks – under DAF control Slaughter checks – under DAF control Tracing Tracing Backward to identify source of infection & detect ‘Bought-in’ reactors Backward to identify source of infection & detect ‘Bought-in’ reactors Onward to identify other risk herds Identified risk animals moved from infected herds Onward to identify other risk herds Identified risk animals moved from infected herds Extra Diagnostics = IFN-γ Assay, AnELISA Extra Diagnostics = IFN-γ Assay, AnELISA

12. ‘Quarantine’ Confine & Remove Restriction of herd Restriction of herd Isolation and removal of identified risk animals Isolation and removal of identified risk animals Removal co- ordinated and arranged by DAF Removal co- ordinated and arranged by DAF Cleanse & Disinfect, as appropriate Cleanse & Disinfect, as appropriate

13. ‘Treatment’ of ‘infected’ herd Testing programme – including supplementary tests as necessary Testing programme – including supplementary tests as necessary Epidemiological investigation, as appropriate Epidemiological investigation, as appropriate Advice to Keeper – Animal Health and Public Health Advice to Keeper – Animal Health and Public Health Compensation – individual animal ceiling Compensation – individual animal ceiling Seek to establish source(s) of infection & Wildlife Investigation if implicated Seek to establish source(s) of infection & Wildlife Investigation if implicated Return to trade only in compliance with Directive Return to trade only in compliance with Directive

14. Investigate close contact risk herds Targeted risk-based testing for for Contiguous herd Contiguous herd Associated herds Associated herds

15. ~ 66% of reactors were disclosed in herds in ~ 30% of the agricultural land WU Task = where badgers are confirmed as possibly a factor the local density will be reduced subject to two important constraints. There is likely to be a higher cull in the 30% of the country where TB is consistently recurring in the cattle herds, than in the remaining 70% of the country (targeted intervention policy) A minimum of 70% of the Jan 2004 estimated of the national population of badgers will be retained. Tuberculosis in Cattle – Geographic Distribution In the years 1998 - 2000,

16. Implement system of QC on various aspects of programme Computerisation Computerisation Data Collection Data Collection Tuberculin Tuberculin Test systems/procedures Test systems/procedures Operatives Operatives Identity & database (Tags/CMMS) Identity & database (Tags/CMMS)

17. Programme Evaluation Programme effectiveness Programme effectiveness Programme delivery/efficiency Programme delivery/efficiency Doing the ‘right’ things Doing the ‘right’ things Are our original objectives still valid? Are our original objectives still valid? Is there any new/additional knowledge? Is there any new/additional knowledge? Are there new/additional tools? Are there new/additional tools? Are all the actions/activities still necessary – cost/benefit? Are all the actions/activities still necessary – cost/benefit? Can we achieve objectives in more efficient/effective ways? Can we achieve objectives in more efficient/effective ways? Is what we are doing going to deliver on our goals in the most efficient manner? Is what we are doing going to deliver on our goals in the most efficient manner? Doing things ‘right’ Doing things ‘right’ Carrying out all determined functions in most efficient way? Carrying out all determined functions in most efficient way? Value for Money Audit Value for Money Audit

18. Improved Tools Using GIS technology to focus resources according to risk Using GIS technology to focus resources according to risk Using computer technology and linking databases to manage programme efficiently and gather data for further studies. Using computer technology and linking databases to manage programme efficiently and gather data for further studies.