Quantifying cost of disease in livestock: a new metric for the Global Burden of Animal Diseases.

BACKGROUND: Increasing awareness of the environmental and public health impacts of expanding and intensifying animal-based food and farming systems creates discord, with the reliance of much of the world's population on animals for livelihoods and essential nutrition. Increasing the efficiency of food production through improved animal health has been identified as a step towards minimising these negative effects without compromising global food security. The Global Burden of Animal Diseases (GBADs) programme aims to provide data and analytical methods to support positive change in animal health across all livestock and aquaculture animal populations. METHODS: In this study, we present a metric that begins the process of disease burden estimation by converting the physical consequences of disease on animal performance to farm-level costs of disease, and calculates a metric termed the Animal Health Loss Envelope (AHLE) via comparison between the status quo and a disease-free ideal. An example calculation of the AHLE metric for meat production from broiler chickens is provided. FINDINGS: The AHLE presents the direct financial costs of disease at farm-level for all causes by estimating losses and expenditure in a given farming system. The general specification of the model measures productivity change at farm-level and provides an upper bound on productivity change in the absence of disease. On its own, it gives an indication of the scale of total disease cost at farm-level. INTERPRETATION: The AHLE is an essential stepping stone within the GBADs programme because it connects the physical performance of animals in farming systems under different environmental and management conditions and different health states to farm economics. Moving forward, AHLE results will be an important step in calculating the wider monetary consequences of changes in animal health as part of the GBADs programme. FUNDING: Bill & Melinda Gates Foundation, the UK Foreign, Commonwealth and Development Office, EU Horizon 2020 Research and Innovation Programme.

The Public Health Importance and Management of Infectious Poultry Diseases in Smallholder Systems in Africa.

Poultry diseases pose major constraints on smallholder production in Africa, causing high flock mortality and economic hardship. Infectious diseases, especially viral diseases like Newcastle disease and highly pathogenic avian influenza (HPAI) and bacterial diseases, especially colibacillosis and salmonellosis, are responsible for most chicken losses, with downstream effects on human nutrition and health. Beyond production impacts, poultry diseases directly harm public health if zoonotic, can give rise to epidemics and pandemics, and facilitate antimicrobial resistance through treatment attempts. HPAI, campylobacteriosis, and salmonellosis are the priority zoonoses. Sustainable solutions for poultry health remain elusive despite recognition of the problem. This review summarises current knowledge on major poultry diseases in smallholder systems, their impacts, and options for prevention and control. We find biosecurity, vaccination, good husbandry, and disease-resistant breeds can reduce disease burden, but practical limitations exist in implementing these measures across smallholder systems. Treatment is often inefficient for viral diseases, and treatment for bacterial diseases risks antimicrobial resistance. Ethnoveterinary practices offer accessible alternatives but require more rigorous evaluation. Multisectoral collaboration and policies that reach smallholder poultry keepers are essential to alleviate disease constraints. Successful control will improve livelihoods, nutrition, and gender equity for millions of rural families. This review concludes that sustainable, scalable solutions for smallholder poultry disease control remain a critical unmet need in Africa.

Rationalising development of classification systems describing livestock production systems for disease burden analysis within the Global Burden of Animal Diseases programme.

The heterogeneity that exists across the global spectrum of livestock production means that livestock productivity, efficiency, health expenditure and health outcomes vary across production systems. To ensure that burden of disease estimates are specific to the represented livestock population and people reliant upon them, livestock populations need to be systematically classified into different types of production system, reflective of the heterogeneity across production systems. This paper explores the data currently available of livestock production system classifications and animal health through a scoping review as a foundation for the development of a framework that facilitates more specific estimates of livestock disease burdens. A top-down framework to classification is outlined based on a systematic review of existing classification methods and provides a basis for simple grouping of livestock at global scale. The proposed top-down classification framework, which is dominated by commodity focus of production along with intensity of resource use, may have less relevance at the sub-national level in some jurisdictions and will need to be informed and adapted with information on how countries themselves categorize livestock and their production systems. The findings in this study provide a foundation for analysing animal health burdens across a broad level of production systems. The developed framework will fill a major gap in how livestock production and health are currently approached and analysed.

Population, biomass, and economic value of small ruminants in Ethiopia.

Ethiopia has a large population of small ruminants (sheep and goats) which are mostly kept in traditional subsistence production systems that are poorly described. Understanding these different systems, their population structure, biomass, production, and economic value is essential for further analysis and effective policy making. The objective of this study was to quantify these parameters for small ruminant production systems in Ethiopia to use them as a basis for analysis of disease burden within the Global Burden of Animal Diseases program. Population structure and trends of small ruminants were analyzed using data from ten annual national agriculture surveys. A stochastic herd model was used to simulate the small ruminant population, biomass, and economic value. The model was parameterised stochastically using data from statistical databases and the literature, and sensitivity analysis of main model outputs to the stochastic inputs was done. Small ruminants are held across the country mainly managed under two major production systems: the crop-livestock mixed system and the pastoral system. The small ruminant population has grown in the past 10 years with an average annual growth rate of 4.6% for sheep and 6.7% for goats. The national average small ruminant population for 2021 was projected at 96.4 (range 95.3-97.7) million heads and the mean stock biomass was about 2,129 (range 1,680-2,686) million kilograms. The monetary value of the small ruminant population was estimated at USD 5,953 (range 4,369-7,765) million. The annual monetary value of small ruminant production outputs was estimated at USD 1,969 (range 1,245-2,857) million. Although the small ruminant population is large and rapidly growing, contributing about 2% of national annual GDP, the sub-sector is characterized by low productivity, low offtake rates, and a limited range of production outputs with no signs of intensification. Efforts should be made to reduce small ruminant mortality, improve fertility, and better utilize products such as milk to improve the livelihoods of rural households and to benefit the national economy. The approaches developed in this study can be replicated in other systems and countries to reveal trends in the size and value of livestock systems, providing a better understanding of its economic importance and performance.

Incidence and Predictors of Calf Morbidity and Mortality From Birth to 6-Months of Age in Dairy Farms of Northwestern Ethiopia.

The Ethiopian government has initiatives for expanding the commercial and smallholder market-oriented urban and peri-urban dairy production systems to meet the demands for dairy products. However, there have been only limited on-farm studies on the health performance of commercial dairy breeds. The aim of this longitudinal study was to quantify the incidence and identify predictors of calf morbidity and mortality from birth to 6 months of age in urban and peri-urban dairy farms of Northwest Ethiopia. A total of 439 calves aged below 6 months from 174 dairy farms were included in the study. We collected data on 35 potential risk factors to determine their effect on calf morbidity and mortality in the area. Kaplan-Meier survival analysis was used to summarize survival probability. The Cox proportional hazard regression model with shared frailty to account for unmeasured herd-specific heterogeneity was also used to identify and quantify factors associated with time to morbidity and mortality. Among 439 calves enrolled for 6 months of follow-up period, a total of 141 morbidities and 54 mortality events were recorded. This gives an overall morbidity and mortality incidence rates of 64 per 100-calf 6-months at risk (risk rate of 47.3%) and 19 per 100-calf 6-months at risk (risk rate of 17.9%), respectively. Diarrhea was the most frequent calf health problem with a risk rate of 25.2%. It was the cause of death for 33.3% of all the 54 calf deaths. Next to diarrhea, pneumonia ranked second with risk rate of 8.6% and was responsible for death of 12.9% of all the 54 calf deaths. Among 35 potential risk factors, calf age, vigor status at birth, calf breed, colostrum ingestion, and herd size were significant (p < 0.05) predictors of calf morbidity and mortality. The Cox-shared frailty model revealed that the herd frailty component had no significant effect on hazard estimates of the covariates of all-cause morbidity and mortality. This implies that the dairy herds participated in the study were homogeneous in the distribution of unmeasured random effects. In conclusion, the magnitude of calf morbidity and mortality was higher and above economically tolerable level in this study. This could impede the success of Ethiopia's dairy development initiative in general, and the livelihood of smallholder dairy producers in particular. Therefore, educating farmers aimed at mitigating the identified risk factors can reduce calf morbidity and mortality in the study areas.

Spatio-temporal patterns and risk factors of foot-and-mouth disease in Malawi between 1957 and 2019.

Foot-and-mouth disease (FMD) is an important livestock disease causing short-term and long-term production losses and hindering local and international trade. To gain access to lucrative foreign markets and also improve local trade, there is a need to employ effective preventive and control strategies. Although FMD has been present in Malawi for over 60 years, little knowledge is available concerning the dynamics and drivers of FMD in the country. A modelling study based on retrospective data was conducted to establish the spatio-temporal distribution and determine the risk factors associated with FMD in Malawi. A retrospective space-time analysis was performed and a matched case-control study was carried out to investigate risk factors. The number of reported FMD outbreaks has descriptively increased after 2000 and the disease has spread to previously unaffected areas. Two significant spatio-temporal clusters of FMD were identified; one in the southern region and the other in the northern region. An analysis of only index cases (first detected locations) also detected two clusters with one in the northern region and the other in the southern region. Higher beef cattle density (p = 0.023), higher pig density (p = 0.043) and increased distance to wildlife protected areas (p = 0.036) were positively associated with the risk of FMD while increased distances to international borders (p = 0.008) and roads (p = 0.034) were associated with reduced risk of FMD. High FMD risk areas were observed in the southern and northern regions but not in the central region during the early years (1957-1981). The more recent increase in FMD risk at the end of the study period (2019) in the central region might be attributed to increases in livestock density in this region. These findings provide insight into the pattern of FMD occurrence that will promote informed decisions for the progressive control of FMD in the region.

Economic impact of a peste des petits ruminants outbreak and vaccination cost in northwest Ethiopia.

Peste des petits ruminants (PPR) is an important endemic disease of small ruminants in Ethiopia. While vaccination is widely used in the country to control the disease, quantitative estimates of the actual economic losses due to outbreaks and costs of vaccination are scarce. This study assessed the economic impact and costs of PPR vaccination in Metema district, northwest Ethiopia. The economic impact of the disease was estimated from an outbreak investigation including interviews with 233 smallholder farmers in PPR-affected kebeles (subdistricts). The cost of PPR vaccination was obtained from vaccination programs in six kebeles of the district and from secondary data in the district veterinary office. In the investigated PPR outbreak, animal-level PPR morbidity and mortality rates were 51% and 22%, respectively, in sheep and 51% and 25%, respectively, in goats. The flock level morbidity rate was 83% for sheep flocks and 87% for goat flocks. The mean flock level loss was Ethiopian Birr (ETB) 7835 (USD 329 in 2018 average exchange rate) (95% CI: 5954-9718) for affected sheep flocks and ETB 7136 (USD 300) (95% CI: 5869-8404) for affected goat flocks. The losses in all study flocks during the outbreak were ETB 319 (USD 13.4) per sheep and ETB 306 (USD 12.9) per goat. Mortality accounted for more than 70% of the total losses in both sheep and goat flocks. Vaccination costs for PPR were estimated at ETB 3 per correctly vaccinated animal. Based on the estimated animal-level direct economic losses and vaccination cost, it can be conjectured that vaccination will pay if a district PPR outbreak occurs more than once every 13 years. This does not account for additional benefits from vaccine-derived herd immunity reducing disease burden in the wider population. In conclusion, PPR caused high morbidity and mortality in the affected flocks and resulted in high economic losses, equivalent to 14% of annual household income, dramatically affecting the livelihoods of affected flock owners. The vaccination practised in the district is likely to have a positive economic return, with strengthened vaccination programmes bringing reduced economic impact and improved livelihoods.

Estimating the Economic Impact and Assessing Owners' Knowledge and Practices of Epizootic Lymphangitis in Equine Cart Animals in Central and South Gondar Zones, Amhara Region, Ethiopia.

Epizootic lymphangitis (EL) is a chronic, contagious, fungal disease of equids. The disease is highly prevalent in cart pulling equines of Ethiopia affecting the livelihood of the cart owning households and welfare of the cart animals. This study estimated the economic impacts of EL and assessed cart owners' knowledge and practices related to the disease in northwest Ethiopia. A multistage cluster sampling approach was implemented to select cart animal owners for the study. A total of 274 cart animal owners were interviewed to collect data for the study. The average annual economic loss per cart owner was estimated at Ethiopian Birr (ETB) 8447. Of this loss, the ETB 4364, 2838, and 1245 were due to mortality, working power loss, and treatment costs, respectively. When the loss was computed only for affected car owners, it was on average ETB 9835 per affected cart owner. The average annual animal level loss was estimated at ETB 6587 per cart animal. Mortality was the largest contributor of the overall economic losses. There was a statistically significant difference in average economic losses per household between study towns (P < 0.05). The knowledge and practice study revealed that 51.2% of the respondents had good knowledge level (knowledge score above the mean score) of EL, but only 45.2% of the respondents had a good practice related to EL. A multivariable logistic regression analysis revealed that socio-demographic factors such as educational level and town of residence were significantly associated with EL knowledge level of the respondents (P < 0.05), and on the other hand, knowledge level and residence of the respondents were significantly associated with EL practice level (P < 0.05). The study generally indicates that EL causes significant economic impact on the cart business, but cart owners had insufficient knowledge and poor control and preventive practices to combat the disease. Attention should be accorded to control the disease and reduce its impact on the livelihood of cart owners. As part of the control measure, more awareness creation about the disease and its preventive and management measures for cart owners will very important.

Farmers' willingness to pay for foot and mouth disease vaccine in different cattle production systems in Amhara region of Ethiopia.

Although foot and mouth disease (FMD) is endemic in Ethiopia, use of vaccines to control the disease has been practiced sparingly. This is due to perceived high cost of good quality FMD vaccine, and consequently limited availability of the vaccine in the market. This study was conducted to assess farmers' willingness to pay (WTP) for a quality FMD vaccine and identify factors that could potentially influence their WTP in Amhara region of Ethiopia. A total of 398 farmers from four districts that represent the mixed crop-livestock and market oriented production systems were enrolled for the study. The WTP was estimated using contingent valuation method with a double-bound dichotomous choice bid design. Interval regression analysis was used to estimate mean WTP and identify factors that influence it. The results showed that the mean WTP of all farmers was Ethiopian Birr (ETB) 58.23 (95% CI: 56.20-60.26)/annual dose. It was ETB 75.23 (95% CI: 72. 97-74.49) for market oriented farmers and ETB 42.6 (95%CI: 41.24-43.96) for mixed crop livestock farmers. Willingness to pay for the vaccine was significantly higher for farmers in market oriented system than in mixed crop livestock system. It was also significantly higher for farmers whose main livelihood is livestock than those whose main livelihood is other than livestock, and for farmers who keep exotic breed cattle and their crosses than those who keep only local cattle breeds. Willingness to pay significantly increased with increase in FMD impact perception and vaccine knowledge scores of farmers. The high mean WTP estimates showed that farmers are enthusiastic about using the FMD vaccine. Market-oriented farmers with higher willingness to pay may be more likely to pay full cost if official FMD vaccination is planned in the country than mixed crop livestock farmers. Animal health extension about livestock diseases impact and vaccines has a potential to increase farmers' uptake of vaccines for disease control.

A randomized controlled field trial assessing foot and mouth disease vaccine effectiveness in Gondar Zuria district, Northwest Ethiopia.

Foot and mouth disease (FMD) is a highly transmissible viral disease of cloven-hoofed animals, which is endemic in many developing countries. Vaccination is the main tool for FMD control in resource limited endemic countries like Ethiopia. Vaccine quality, which is often questionable in developing countries, is a critical element for effective disease control. The present study was aimed at evaluating the field effectiveness of a trivalent FMD vaccine (containing serotypes O, A and SAT 2), produced and widely used in Ethiopia, in terms of preventing clinical infection and severe disease. A randomized controlled field trial design was employed in the study in which the attack rate of clinical FMD infection in vaccinated cattle was compared with the attack rate in unvaccinated controls in cattle population of 16 villages in Gondar Zuria district, Northwest Ethiopia. The vaccine was administered as a single dose course in the face of an impending FMD outbreak and the trial groups were monitored for clinical infection until the end of the outbreak. The attack rate of clinical FMD 20 days post vaccination in the vaccinated cattle (34 %) was significantly lower than the attack rate in the unvaccinated controls (49 %) (p < 0.001). However, the effectiveness of the vaccine was only 31 % (95 %CI: 20-40 %). This vaccine effectiveness increased to 52 % ((95 %CI: 33-66 %) 42 days post vaccination. The proportion of severely affected cattle in the vaccinated group (5.7 %) was significantly lower than in the unvaccinated group (9.4 %) (p < 0.001), resulting in 39 % (95 %CI: 18-55 %) vaccine effectiveness against severe disease. Generally, the observed level of vaccine effectiveness was lower than the internationally recommended 75 % plus expected percentage of protection for a standard potency 3PD50/dose FMD vaccine. Moreover, the level of effectiveness was insufficient to provide herd immunity to control the disease at the population level. Nevertheless, given the significant difference in the incidence of clinical disease and severity between vaccinated and unvaccinated cattle, it might still be worth using the current vaccine to reduce production losses associated with the disease provided it is cost effective and affordable for the farmers. Factors that cause low effectiveness of the vaccine need to be identified and addressed for effective control of the disease at population level.

Modeling the transmission dynamics of foot and mouth disease in Amhara region, Ethiopia.

Foot and mouth disease (FMD) is contagious, acute viral disease of all cloven-hoofed animals. The disease is endemic in Ethiopia and causes multiple outbreak every year all over the country. While it is important to understand to the transmission dynamics of FMD outbreaks for appropriate control intervention, no such study has been done in Ethiopia. Thus, the aims of this study were to estimate the basic reproduction number (R0) of FMD and simulate FMD transmission dynamics of FMD in Amhara region of Ethiopia. Basic reproduction number (R0) was estimated from age stratified sero-prevalence data through maximum likelihood estimation. A stochastic SIR (susceptible-infectious-recovered) compartmental FMD model was formulated and parameterized using literature and age stratified sero-prevalence field data. The R0 of FMD in the region was estimated to be 1.27 (95%CI: 1.20-1.34). The simulation of the SIR model showed only 24% (95% CI: 16-32%) of the infection introduced in the region caused major outbreaks. Out of the major outbreaks 25% of them tend to persist in the region. Major outbreaks cause 38.9% (95% CI: 38.8-39.1%) morbidity and 0.0019% (95% CI: 0.0018-0.0020%) mortality in cattle and the outbreaks stayed for an average of 690 days (95%CI: 655-727). Validation of the model prediction with farmer's field experience indicated a fairly similar result especially for the predicted morbidity caused by outbreaks. This study revealed low transmission of FMD within the Amhara region cattle population indicating not very high vaccination coverage is needed, if control through vaccination is envisaged at regional level. However, owing to several simplified assumptions made during the modeling, this conclusion should be taken cautiously.

Post-vaccination herd immunity against peste des petits ruminants and inter-vaccination population turnover in small ruminant flocks in northwest Ethiopia.

Vaccination is the main tool for control of peste des petits ruminants (PPR) because of the availability of effective and safe vaccines that provide long lasting protection. However vaccination campaigns may not always provide sufficient herd immunity needed to prevent disease outbreaks because of logistic problems with vaccination such as inappropriate cold chain and vaccine delivery methods, and the rapid population turnover of small ruminants. This study was carried out to assess post-vaccination herd immunity against PPR and inter-vaccination population turnover in small ruminant flocks in Metema district, northwest Ethiopia where frequent PPR outbreaks occur despite regular vaccination. A total of 412 serum samples were collected from selected small ruminants in 72 flocks (average flock size of 33.4 and standard deviation of 30) above three months of age in three kebeles immediately before a vaccination program. One month after the vaccination using freeze dried live attenuated vaccine, 359 serum samples were collected from randomly selected small ruminants in the same flocks. The collected serum samples were analyzed to determine the seropositivity using a monoclonal antibody-based C-ELISA. The pre-vaccination seropositivity of 72.3% (95% CI: 67.8-76.4) increased to 93.9% (95% CI: 90.9-95.9) post-vaccination (P < 0.001). The observed seropositivity following vaccination was above the recommended herd immunity threshold (80%) required to reduce the transmission of infection in the population sufficient to eliminate virus. A survey of sampled flocks six months post-sampling indicated only 68% of animals were still present in these flocks. This population turnover reduces the herd immunity to about 64% which is below the required threshold for control. The high level of herd immunity achieved post-vaccination indicates good vaccine quality, cold chain maintenance and effective vaccine delivery in the district's vaccination campaigns. The decrease in herd immunity associated with population turnover and annual vaccination intervals represents a challenge to effective control and suggests changes to the timing or frequency of the vaccination is required.

Foot and mouth disease outbreak investigation and estimation of its economic impact in selected districts in northwest Ethiopia.

Foot and mouth disease (FMD), a highly contagious and economically important disease of cloven-hoofed animals, is endemic in Ethiopia. Foot and mouth disease outbreak investigation and follow-up studies were undertaken to identify the causative serotype, determine the morbidity and mortality, and estimate the economic impact of the outbreaks in selected districts of Northwest Ethiopia. The serotype of FMD virus involved in the outbreaks was identified by antigen detection ELISA from clinical samples. Morbidity, mortality and economic impact of the outbreaks were assessed based on data collected from 738 smallholder farmers in a mixed crop-livestock (MCL) production system and from five dairy farms in the commercial dairy production system. The outbreaks were confirmed to be due to FMD virus serotype O. The animal level morbidity in clinically affected cattle herds was 68.1% for MCL production system and 54.5% for commercial dairy farms. The mortality in cattle in the MCL system was 0.4% and no mortality was recorded in the commercial dairy farms. The animal level morbidity in sheep and goats in the infected flocks was 35.7% but no mortality was seen in these species. The herd/flock level morbidity of FMD in outbreak affected kebeles of MCL system was 57.2% for cattle and 8% for sheep and goats. The economic losses due to milk loss, draught power loss, mortality and treatment cost were on average USD 34 (interquartile range: 9.4-44.4) per affected herd in the MCL system and this was statistically significantly lower than the USD 459.1 (interquartile range: 400.0-486.2) per affected farm in the commercial dairy farms (p < .05). These economic losses have significant impact in the livelihood and income of affected farmers in both production systems. Future work should focus on the implementation of control measures that mitigate the economic impact of the disease.

Sero-Epidemiology of Foot and Mouth Disease in Domestic Ruminants in Amhara Region, Ethiopia.

This study involved cross-sectional serological and questionnaire-based surveys to investigate the sero-epidemiology of foot and mouth disease (FMD) in domestic ruminants, and farmers' knowledge and practices about the disease in the Amhara region of Ethiopia. A multistage cluster sampling was carried out to select domestic ruminants for serological sampling and for the interview with farmers. A total of 1,672 sera samples were collected and tested using a 3ABC-Enzyme Linked Immunosorbent Assay, and 170 farmers were interviewed. An overall FMD apparent seroprevalence of 11.48% (95% CI: 7.52-17.14%) was recorded in the domestic ruminants. The overall true prevalence was 12.04%. The seroprevalence of FMD was higher in cattle (14.37%) than in goats (7.10%) and sheep (7.07%). The age stratified seroprevalence in the districts showed that 66.67% of the districts studied experienced a FMD outbreak within the preceding year of the study time. A mixed effect logistic regression analysis revealed that agroecology, the production system and the age of the animal was significantly associated with FMD seropositivity in cattle (P < 0.05). A statistically significant (P < 0.05) positive correlation (r = 0.93) was observed between cattle and small ruminant FMD seroprevalences. About 82% of the farmers interviewed knew of FMD and 85% of them had experienced the disease in their own herds before. The farmers mostly employ traditional means to control FMD. In conclusion, the findings of the study indicated that FMD is a prevalent disease in the Amhara region with more importance in the intensive production systems and the lowlands of the region. High correlation in seroprevalence between small and large ruminants indicated a possible cross transmission between these species. Therefore, small ruminants should not be overlooked in FMD control. Farmers in the region have a good level of knowledge about the disease; however, currently they heavily rely on traditional practices primarily focused on treating wounds of infected animals. This calls for extension work on available effective preventive measures of the disease, such as vaccination and movement restriction.

Field-derived estimates of costs for Peste des Petits Ruminants vaccination in Ethiopia.

In 2015, the OIE and FAO launched a global eradication programme for Peste des Petits Ruminants (PPR). Vaccination is a major component of this strategy yet the costs of implementing a campaign are unknown or based on assumptions without field-based verification necessary for effective economic planning. This study used experiences of attending four PPR vaccination campaigns in Ethiopia to estimate various cost components in pastoral and mixed-crop livestock systems. These components included: cost of vaccine; vaccine transport from the producer to the local storage facility; storage of vaccine at the local facility; delivery and administration of vaccine in the field; opportunity cost of farmer's time to attend the vaccination; co-ordination of vaccination campaign; publicity and mobilisation costs; vaccine wastage from missed shots and vaccine discard. The overall cost of vaccination was approximately 6 Ethiopian birr (ETB) or US$0.2 per animal in the mixed-crop livestock system compared to approximately 3ETB or US$0.1 in pastoral areas. The relative importance of cost components varied in the two systems with farmer time being the largest contributor in the mixed-crop livestock system while field delivery was the main cost in pastoral areas. Notable vaccine wastage was observed particularly through missed shots that were typically between 0 and 10% but as high as 33%. At the national level, the output of the stochastic model showed the cost of vaccination to be highly variable particularly in the mixed-crop livestock system. These results highlight the importance of doing economic assessments of vaccination campaigns and issues that may be compromising efficiency of delivery and vaccine coverage. It is recommended that the framework be used for further economic evaluations of vaccination for PPR and other livestock diseases particularly when limited public or donor funds are being used, and that the approach be expanded to other countries and regions.

Cost-benefit analysis of foot and mouth disease control in Ethiopia.

Foot and mouth disease (FMD) occurs endemically in Ethiopia. Quantitative insights on its national economic impact and on the costs and benefits of control options are, however, lacking to support decision making in its control. The objectives of this study were, therefore, to estimate the annual costs of FMD in cattle production systems of Ethiopia, and to conduct an ex ante cost-benefit analysis of potential control alternatives. The annual costs of FMD were assessed based on production losses, export losses and control costs. The total annual costs of FMD under the current status quo of no official control program were estimated at 1354 (90% CR: 864-2042) million birr. The major cost (94%) was due to production losses. The costs and benefits of three potential control strategies: 1) ring vaccination (reactive vaccination around outbreak area supported by animal movement restrictions, 2) targeted vaccination (annual preventive vaccination in high risk areas plus ring vaccination in the rest of the country), and 3) preventive mass vaccination (annual preventive vaccination of the whole national cattle population) were compared with the baseline scenario of no official control program. Experts were elicited to estimate the influence of each of the control strategies on outbreak incidence and number of cases per outbreak. Based on these estimates, the incidence of the disease was simulated stochastically for 10 years. Preventive mass vaccination was epidemiologically the most efficient control strategy by reducing the national outbreak incidence below 5% with a median time interval of 3 years, followed by targeted vaccination strategy with a corresponding median time interval of 5 years. On average, all evaluated control strategies resulted in positive net present values. The ranges in the net present values were, however, very wide, including negative values. The targeted vaccination strategy was the most economic strategy with a median benefit cost ratio of 4.29 (90%CR: 0.29-9.63). It was also the least risky strategy with 11% chance of a benefit cost ratio of less than one. The study indicates that FMD has a high economic impact in Ethiopia. Its control is predicted to be economically profitable even without a full consideration of gains from export. The targeted vaccination strategy is shown to provide the largest economic return with a relatively low risk of loss. More studies to generate data, especially on production impact of the disease and effectiveness of control measures are needed to improve the rigor of future analysis.

Farmers' Intentions to Implement Foot and Mouth Disease Control Measures in Ethiopia.

The objectives of this study were to explore farmers' intentions to implement foot and mouth disease (FMD) control in Ethiopia, and to identify perceptions about the disease and its control measures that influence these intentions using the Health Belief Model (HBM) framework. Data were collected using questionnaires from 293 farmers in three different production systems. The influence of perceptions on the intentions to implement control measures were analyzed using binary logistic regression. The effect of socio-demographic and husbandry variables on perceptions that were found to significantly influence the intentions were analyzed using ordinal logistic regression. Almost all farmers (99%) intended to implement FMD vaccination free of charge. The majority of farmers in the pastoral (94%) and market oriented (92%) systems also had the intention to implement vaccination with charge but only 42% of the crop-livestock mixed farmers had the intention to do so. Only 2% of pastoral and 18% of crop-livestock mixed farmers had the intention to implement herd isolation and animal movement restriction continuously. These proportions increased to 11% for pastoral and 50% for crop-livestock mixed farmers when the measure is applied only during an outbreak. The majority of farmers in the market oriented system (>80%) had the intention to implement herd isolation and animal movement restriction measure, both continuously and during an outbreak. Among the HBM perception constructs, perceived barrier was found to be the only significant predictor of the intention to implement vaccination. Perceived susceptibility, perceived benefit and perceived barrier were the significant predictors of the intention for herd isolation and animal movement restriction measure. In turn, the predicting perceived barrier on vaccination control varied significantly with the production system and the age of farmers. The significant HBM perception predictors on herd isolation and animal movement restriction control were significantly influenced only by the type of production system. The results of this study indicate that farmers' intentions to apply FMD control measures are variable among production systems, an insight which is relevant in the development of future control programs. Promotion programs aimed at increasing farmers' motivation to participate in FMD control by charged vaccination or animal movement restriction should give attention to the perceived barriers influencing the intentions to apply these measures.