The Profiles Database & Decision Support Tool for Prioritisation of Animal Health and Welfare Issues for Government Intervention SZER Project Team Jane.

The Profiles Database & Decision Support Tool for Prioritisation of Animal Health and Welfare Issues

for Government Intervention

SZER Project TeamJane Gibbens, Andrew Frost, Simon Lawton,

Francesca Day

UK VETERINARY SURVEILLANCE STRATEGY

HISTORY & PROGRESS2003: Veterinary Surveillance Strategy published

– 10 year implementation plan• enhance veterinary surveillance• ensure early detection of important changes in animal health (BSE, FMD

inquiries)– Key goal: ensure best allocation of finite resources for surveillance – Confirmed use of an objective, peer-reviewed evidence base ‘profiles’

2004: Animal Health and Welfare Strategy published– Use sound science and evidence for decision making– Structured and transparent framework for prioritisation– ‘Profiles’ to be part of this framework

2005 – present: Wide consultation and exploration of options

• Explored and defined evidence to be used in ‘Profiles’

• Explored potential structure & built a prototype in Excel

• Validation of prototype (Defra Deputy Directors)

• Launched Profiles Database (Nov 2007)

Profiles Database and Prioritisation Project

Profiles DatabaseA collection of profiles on specific animal diseases or welfare issues.

Each profile is:•drafted by experts •peer reviewed •available to all on the web (once published)and will be used to automatically provide summary reports and Q&A’s as well once cleared for publication.

Profiles Database and Prioritisation Project

Prioritisation Project

A tool to use Profiles Database information to rank different diseases or issues for the 4 reasons for Government intervention listed in the AHW Strategy:– Protecting public health, – Promoting animal welfare,– Ensuring opportunities for international

trade, and– Protecting the interests of the wider society

and the economy

Prioritisation DST

• ‘Risk & Epidemiology’ score - Equivalent to EU ‘Epidemiology’ and ‘Control Measures’ chapters

– Likelihood of an unaffected holding becoming affected– Overall risk in epidemiological & societal terms

• (Potential) rate of spread• Extent to which the keeper or government can

control

•Able to be populated and run rapidly

•Visual summary – ranking of issues– By risk & impact (policy areas)– Level playing field

Profiles Database and Prioritisation Project

Benefit: can prioritise finite resources in the context of government policy and the AHW strategy

Example Prioritisation Score

• Overview of why each disease is important• Context of AHWS reasons for intervention• Avoids assumptions

– No difference in relative importance between RFI’s as each RFI (and R&E) score out of 100

Summary presentation of normalised scores for impact on each RFI plus R&E score (R&E derived from likelihood of occurrence, transmissibility and practicality of control)

42

68

71

34

4

15

17

30

45

53

24

65

0

34

48

11

39

52

0

0

0

8

0

38

9

35

11

2

38

33

38

14

14

9

26

21

26

18

38

69

69

23

16

30

17

37

80

36

43

#N/A

93

94

75

41

18

0 50 100 150 200 250 300

Toxoplasmosis - Sheep

Campylobacter - Chickens

BVD - Cattle

Bovine tuberculosis - Cattle

Bovine Spongiform Encephalopathy - Cattle

West Nile Fever/Virus - Horses

Trichinella - Pigs

Rabies - Dogs

Foot and Mouth Disease - Sheep

Foot and Mouth Disease - Cattle

Blue tongue - Sheep

Normalised score

Risk and Epidemiology Public Health Impact Welfare Impact Wider Society Impact International Trade Impact

How the DST works• Up to 10 criteria defined for each RFI• Each has a score• Each has a relative weight• Overall score = sum of contribution from each criterionExample: Wider Society criterion with weight 10

(Detailed guidance defines each category)

The greater the weighting, the more likely that a change in that criterion will change the disease’s relative ranking

08 Total potential unplanned cost to exchequer (6.1)

Value Contribution to WS score

Negligible 0 0 Low 3 30 Medium 8 80 High 18 180 Very High 25 250

Public Health ImpactAHWS: “To protect the health of the public”

• Summary score describes – How bad human disease is/might be 44% – Human attributable risk or exposure + extent GB based 38% – Uncertainty 13%– Costs of human disease 5%

1 Annual number of human cases of the disease in GB 5

2 Modal Severity of Human Disease 5

3 Likelihood for serious human morbidity 5

4 Transmissibility between humans in GB society 2

5 Average cost per case 1

6 Indirect economic costs of human illness 1

7 Proportion of human cases in GB attributable to exposure to animals or animal products from GB 5

8 Uncertainty: Assessment of the current state of knowledge of the public health significance of this infection or issue 5

9 Level of Human-Animal (or products) Interaction/ exposure 10

Animal Welfare• AHWS: “Protect & promote the welfare of animals

• Summary score describes

– Number of individual animals affected 30%

– Welfare impact: Five Freedoms + Duration 53%

– Welfare impact of control measures 11%

– Extent of excess suffering (disease/controls) 6%

01 Number of cases, at the modal severity, per year (or likely number if introduced) in GB

20

03 Modal duration of welfare impact experienced by animals of this species in GB.

20

07 Impact on freedom from hunger and thirst in this species 3

08 Impact on freedom from discomfort in this species 3

09 Impact on freedom from pain or injury or disease 3 10 Impact on freedom to express normal behaviour 3

11 Impact on freedom from fear and distress in this species 3

12 Welfare impact of likely or statutory control measures 7 13 Proportion of infected and/or affected animals suffering more severely than the mode

4

Wider SocietyAHWS: Protect interests of wider economy,

environment & society

• Summary score describes– Risk of unexpected government costs 29%– Wider community social & economic impact 29%– Environmental impact 29%– Producer economic impact 14%

08 Total potential unplanned cost to exchequer 10

21 Impact on the global environment 5

22 Impact on the local environment 5

23 Impact on the sector that produces this species 5

24 Impact on the wider rural community 10

International Trade

• AHWS: Ensure sustainable opportunities for (commercial) trade

• Summary score describes– Government effort 43%– Legal risk 30%– (Potential) extent of impact on sector 26%

01 Potential for restricting impact by regionalisation/ zoning or compartmentalisation 8

03 Relative importance of export trade to the industry sector 2

04 Resource and time required to re-establish intra-community trading status 20

06 Statutory obligation to control 20

07 Impact of disease on breadth of trade in animals and animal products 808 Annual level of export consignments containing animals/commodities of this species sent into intracommunity trade 309 Annual level of export consignments containing animals/commodities of this species sent into third country trade 3

12 Is there substantial commercial trade in species affected by this disease? 1

Risk & Epidemiology • Overall risk in epidemiological & societal terms

– Likelihood of an unaffected holding becoming affected– (Potential) rate of spread– Extent to which the keeper or government can control

01 Current holding level prevalence / Risk of introduction into animals in GB 5

03 Efficacy and practicality of control applied at the holding level 5 11 Uptake of control measures applied at the holding level by keepers of this species

5

12 Level of national preparedness or level of implementation for endemics/welfare issues

5

02 Rate of spread on and between affected premises 1

04 Efficacy of control measures to prevent dissemination in or between animals that are implemented above holding level

1

06 Potential for risk change in animals in GB 1

08 Potential for silent spread 1

10 Is there a reservoir in GB for this disease/agent in another species or vector 1

Demonstration

Demo screenshots

Future Developments

• ‘What if?’ scenarios– Introduce effective vaccine?– Stop all intervention?– Improve surveillance?

• Cross-cutting issues– Resource allocation for population databases– Animal identification– Scanning surveillance

• Use similar approach for non-infectious issues– Intoxications– Lameness in dairy cows