European Technology Platform for Global

Animal Health National Mirror Groups

UK UpdateBrussels – Sept 22 2009

Phil Sketchley: Chairman UK Mirror Group

Chief Executive : National Office of Animal Health

Structure of UK Mirror Group> Secretariat: VMD (Veterinary Medicines Directorate)

– Professor Steve Dean – Chief Executive– Dr Jack Kay – VMD-R&D and Science Policy Manager– Gemma Adams – secretary

> Chair: Phil Sketchley - NOAH – National Office of Animal Health – representing UK animal medicines industry.

Current stakeholders:– Professor Quintin McKellar - Dean RVC- Royal Vet College– Professor Julie FitzPatrick - Chief Executive, Moredun Research Institute.– Professor John Preston MRCVS – VMD Board.– Professor Martin Shirley, IAH– Catherine McLaughlin – Animal Health and Welfare, National Farmers Union,– Dr Alex Morrow – Defra Animal Health and Welfare and Eurogap.– Professor Jim Scudamore – Liverpool Vet School & ETPGAH consultant.– Prof Martin Shirley – Inst. Of Animal Health – Compton– Dr Otto Windl –Veterinary Laboratories Agency– Prof Andy Peters – ex industry R&D + GALVmed– Dr Peter Wells – ex industry R & D and Moredun

Progress of UK Mirror Group

> 6 meetings held so far –hosted by Defra

> July 2007 to Sept 2008

> Key Actions since first meeting:

Prioritising GAPS in Research

To further assist in developing a common priority list, it was agreed each member would submit details of

their perceived priorities:– most important exotic diseases– most important endemic diseases– most important zoonotic diseases– Now combined into one consolidated list of important areas

for further research

Review of how we assessed the disease

priorities for: 1) Exotic

2)Endemic3)Zoonotic

Prioritisation of Exotic, Endemic and Zoonotic Diseases

Generic Issues > Each Member Stare has existing research strengths many,

including expertise of scientific staff and relevant facilities to undertake work on these diseases.

> The UK National Mirror group set out to identify and harness these centres of excellence

> Some diseases may be specific to a single country or region are important not only, for example within the UK, but also the EU (and in many cases worldwide).

> Naturally the focus is locally/national but all MGs need to be cognisant of the needs of others both within Europe and Internationally – a joined up approach is essential.

> Technologies are available and evolving rapidly, allowing significant advances in understanding these diseases and developing solutions for therapy and prevention

> e.g. 3 years ago Blue tongue was not perceived as a real threat in the UK– it is now a real and present danger!!

> So no one can be complacent about new disease threats

Establishing gaps – Priorities for Future Research and Development

1) Infections are hugely important in animals by virtue of their prevalence, diversity and impact. It is not possible, even in advanced societies with buoyant economics to devote sufficient resource to tackling them all adequately.

2) In order to reap greatest benefit from the investment available for infectious disease research it is essential to prioritise and focus sufficient resource to make a difference.

3) Prioritisation is inherently difficult because of the extent of the problem, our incomplete knowledge of true impact and different views on the relative weighting of impact associated with for instance – human health risk, economic impact, animal welfare or threat to wildlife or the environment.

Establishing gaps – Priorities for Future Research and Development

4) Nevertheless some criteria can be considered and priorities constructed around known information and expert opinion. Diseases of companion animals, poultry, fish and pigs were not, at this stage, considered and recognition was given to diseases where major initiatives existed elsewhere internationally and it was considered that it would be inappropriate for the UK to replicate effort.

5) It was considered that focus would be achieved best by intially restricting the diseases for priority attention to four in each of three categories – Exotic disease, Endemic disease and Zoonotic disease.

Establishing gaps – Priorities for Future Research and Development

6) Diseases were then categorised on the basis of likelihood of occurring (if exotic) or prevalence (if endemic), potential impact on human health, potential or actual economic impact and animal welfare impact.

7) Significant consensus was reached when the above exercise was carried out by members of the Mirror Group blinded to each others results.

8) The outcomes were refined and agreed following general debate within the Mirror Group.

Increase the translation of technologies into applications, which are efficacious in the control of animal disease

Remove unnecessary legal and regulatory hurdles, which limit disease control options and decrease competitiveness of the industry

Streamline research, development and regulatory efforts in order to ensure consumer safety without compromising the efficiency of product development

Motivators for success?Speed of Access to Market

Identified Priorities from UK Mirror GroupAvian Flu

FMD

Blue Tongue Virus

Newcastle Disease

Mastitis (multi-agent)

Tuberculosis (and paratuberculosis/diagnostic tuberculins)

Parasitic gastroenteritis

Lameness

VTEC0157

Campylobacter

Salmonella

Antibiotic Resistance

How did we arrive at

this list of diseases?How did we arrive at

this list of diseases?

Narrative for Exotic DiseasesPrioritised on the basis that:-> All have caused epidemics in the UK in the last few years

(Newcastle Disease 2006; FMD 2007; Avian Flu 2008; Blue Tongue Disease 2007/08)

> All have significant detrimental economic effects on the UK in terms of trade restrictions

> All diseases are highly infectious and control procedures other than test and slaughter are limited for most diseases

> All diseases cause public concern

> All diseases are included in the OIE list of notifiable diseases

> Avian influenza, a zoonoses, has the potential to cause significant outbreaks of disease in the human population

> All diseases require further R&D investment in order to improve preventative measures

Narrative for Endemic Diseases

Prioritised on the basis that:-

> All diseases/conditions are prevalent in the UK (and the EU).> All diseases/conditions cause significant economic loss in

terms of poor production efficiency and including wasted carbon emissions through morbidity and mortality

> (or should this be separated into economic and environmental rather than combined the two)

> All diseases/conditions cause adverse effects on the welfare of livestock

> All diseases cause public concern> All diseases require further R&D investment in order to deliver

preventative measures to industry> Bovine tuberculosis, included under mycobacterial infections,

is spreading rapidly in certain areas in England and Wales, causing great concern in the industry and with the public.

Narrative for Zoonotic Diseases

Prioritised on the basis that:-

> All diseases/infections/issues are present current in the UK (and EU and beyond)

> All diseases/infections/issues cause public concern

> All diseases/infections could cause adverse effects on the UK economy through hospitalisation of many affected individuals

Methodology

> Each member of group submitted tables for their scores for the agreed list of diseases

– N.B The scoring model used was prior to the latest one from central DISCONTOOLS group.

> Group data then complied into a consolidated list for Minimum, Maximum and Average scoring

> More detailed statistical analysis now being completed by Liverpool University

Avi

an F

lu

FMD

Blu

e To

ngue

Vir

us

New

cast

le D

isea

se

Mas

titis

(mul

ti-ag

ent)

Tube

rcul

osis

(an

d

para

tube

rcul

osis

/dia

gnos

tic

tube

rcul

ins)

Par

asiti

c

gast

roen

teri

tis

Lam

enes

s

VTE

C01

57

Cam

pylo

bact

er

Sal

mon

ella

Ant

ibio

tic R

esis

tanc

e

IMPACT ON PUBLIC HEALTHImpact on Public Health and Food Safety 5 3 3 3 3 4 3 3 5 5 5 5Risk of occourrence 2 2 4 3 5 5 5 5 3 3 3 4Impact of occourrence 5 5 4 4 3 3 3 3 3 3 3 3

IMPACT ON INTERNATIONAL TRADEImpact on international trade and EU trade due toexisting regulation 5 5 3 4 1 2 1 1 1 1 1 1

CONTROL MEASURESEffective prevention and control practices 4 4 5 5 1 2 1 1 1 1 1 1Tools for surveillance 4 1 1 1 2 3 2 2 3 3 3 3Tools for prevention crisis 2 3 3 3 4 4 3 3 3 3 3 3Tools for control and implementation 3 3 2 2 4 4 3 3 4 4 4 4

Success of prevention and control in other countries 3 3 2 3 3 4 2 3 3 3 3 3

Example of Scoring for disease

threats and priorities. Each member

of UK group submitted scores

independently for each disease (1)

Example of Scoring for disease

threats and priorities. Each member

of UK group submitted scores

independently for each disease (1)

Example of Scoring for disease

threats and priorities (2)Example of Scoring for disease

threats and priorities (2)

Avi

an F

lu

FMD

Blu

e To

ngue

Viru

s

New

cast

le D

isea

se

Mas

titis

(mul

ti-ag

ent)

Tube

rcul

osis

(and

para

tube

rcul

osis

/dia

gnos

tic

tube

rcul

ins)

Para

sitic

gast

roen

terit

isLa

men

ess

VTEC

0157

Cam

pylo

bact

er

Salm

onel

la

Ant

ibio

tic R

esis

tanc

e

EPIDEMIOLOGY AND RISKSpeed of Risk 3 5 4 4 3 3 3 3 3 3 3 3Number of species involved 3 4 3 3 3 4 3 4 4 4 4 5Persistence of infectious agent 1 1 4 1 4 4 4 4 1 3 3 4Spreading potential to susceptible populations 3 5 4 4 4 4 4 3 3 3 3 4Wildlife diseases risk potential threat to animal health and public health 5 2 2 1 1 4 1 1 1 1 1 1Disease knowledge 2 1 1 1 2 4 2 2 2 1 1 2

Wildlife diseases that are a threat 1 1 1 1 5 1 1 1 1 1 1Dynamic (temporal, spatial, species variability) 5 3 3 1 1 1 1 1 1 1 1 1

Example of Scoring for disease

threats and priorities (3)Example of Scoring for disease

threats and priorities (3)

Avia

n Fl

u

FMD

Blue

Ton

gue

Viru

s

New

cast

le D

isea

se

Mas

titis

(mul

ti-ag

ent)

Tube

rcul

osis

(and

pa

ratu

berc

ulos

is/d

iagn

ostic

tu

berc

ulin

s)

Para

sitic

gast

roen

terit

isLa

men

ess

VTEC

0157

Cam

pylo

bact

er

Salm

onel

la

Antib

iotic

Res

ista

nce

IMPACT ON WIDER SOCIETYDiseases impact on production 3 5 4 4 4 3 4 3 3 3 3 3Economic diect impact (including cumulative cost eg enzootic vs epizootic 3 5 4 4 4 3 4 3 3 3 3 3Economic indirect impact (social, trade) 5 5 4 4 3 4 3 3 3 3 3 3Impact on specific production and supply channels 5 5 5 5 3 3 3 3 3 3 3 3Security of food supply/Benefit for developing world 5 5 5 4 1 2 1 1 1 1 1 3

All scores from different research

institutes then compiled for further

detailed statistical analysis (4)All scores from different research

institutes then compiled for further

detailed statistical analysis (4)

Avi

an F

lu

FM

D

Blu

e T

on

gu

e V

iru

s

New

cas

tle

Dis

eas

e

Mas

titi

s (m

ult

i-ag

ent)

Tu

ber

culo

sis

(an

d

par

atu

ber

culo

sis/

dia

gn

ost

ic

tub

ercu

lins)

Pa

rasi

tic

ga

stro

en

teri

tis

La

me

nes

s

VT

EC

0157

Cam

py

lob

act

er

Sa

lmo

nel

la

An

tib

ioti

c R

esis

tan

ce

Technology (Vaccine/Treatment) / Tool

Availability 3 4 2 2 4 4 3 3 3 3 3 3Commercial diagnostic tools

availability 2 5 5 5 2 5 2 2 5 5 5 5

Points achieved

Total achieved 81 85 78 72 66 84 62 61 63 64 64 71

Av

ian

Flu

A B C D E F G Min

Ma

x

Av

era

ge

Co

ns

en

su

s

IMPACT ON WIDER SOCIETY

Diseases impact on production 3 3 3 3 3 3 3 3 3 3.00

Economic diect impact (including cumulative cost eg enzootic vs epizootic

1 3 1 3 1 1 1 1 3 1.67

Economic indirect impact (social, trade)

3 3 3 5 2 3 3 2 5 3.22

Impact on specific production and supply channels

3 3 3 5 3 3 3 3 5 3.44

Security of food supply/Benefit for developing world

3 3 3 5 3 3 3 3 5 3.44

IMPACT ON PUBLIC HEALTH

Impact on Public Health and Food Safety

3 3 3 5 3 2 3 2 5 3.22

Risk of occourrence 2 2 2 2 1 2 2 1 2 1.78

Impact of occourrence3 3 3 5 3 2 3 2 5 3.22

IMPACT ON INTERNATIONAL TRADE

Impact on international trade and EU trade due toexisting regulation

3 3 3 5 3 3 3 3 5 3.44

Example of Scoring (Avian Flu) from members of UK workgroup- compiled for comparison of Min Max and

Average e.g. Avian Flu (1)

Example of Scoring (Avian Flu) from members of UK workgroup- compiled for comparison of Min Max and

Average e.g. Avian Flu (1)

Example of Scoring (Avian Flu) from members of UK workgroup (2)

Example of Scoring (Avian Flu) from members of UK workgroup (2)

Av

ian

Flu

A B C D E F G Min

Ma

x

Av

era

ge

Co

ns

en

su

s

CONTROL MEASURES

Effective prevention and control practices

3 3 3 4 1 2 3 1 4 2.67

Tools for surveillance 2 2 2 4 2 1 2 1 4 2.22

Tools for prevention crisis 3 2 3 2 2 2 3 2 3 2.44

Tools for control and implementation

2 2 2 3 2 2 2 2 3 2.22

Success of prevention and control in other countries

3 2 3 3 2 1 3 1 3 2.33

Technology (Vaccine/Treatment) / Tool Availability

2 1 2 3 2 2 2 1 3 2.00

Commercial diagnostic tools availability

2 1 2 2 2 2 2 1 2 1.78

Points achieved

Total achieved 58 57 56 81 53 54 56 53 81 61.00

Example of Scoring (Avian Flu) from members of UK workgroup (3)

Example of Scoring (Avian Flu) from members of UK workgroup (3)

Avia

n F

lu

A B C D E F G Min

Max

Avera

ge

Consensus

EPIDEMIOLOGY AND RISK

Speed of Risk 3 3 3 3 3 2 3 2 3 2.78

Number of species involved 3 3 3 3 3 3 3 3 3 3.00

Persistence of infectious agent 1 1 1 1 2 2 1 1 2 1.33

Spreading potential to susceptible populations

3 3 3 3 3 3 3 3 3 3.00

Wildlife diseases risk potential threat to animal health and public health

3 2 3 5 3 3 3 2 5 3.22

Disease knowledge 2 1 2 2 2 2 2 1 2 1.78

Wildlife diseases that are a threat

1 2 0 1 3 0 0 3 1.25

Dynamic (temporal, spatial, species variability)

1 3 0 5 1 2 0 0 5 1.89

AVERAGES OF ALL PRIORITISED DISEASES

AV

IAN

FL

U

FM

D

BT

V

NE

WC

AS

TL

E

MA

ST

ITIS

TB

PG

E

LA

ME

NE

SS

VT

EC

01

57

CA

MP

YL

OB

AC

TE

R

SA

LM

ON

EL

LA

EPIDEMIOLOGY AND RISK

Speed of Risk 2.78 3.44 2.78 2.88 1.89 2.22 2.00 1.67 1.89 2.00 2.33

Number of species involved 3.00 2.67 2.44 2.50 2.22 2.78 2.78 2.89 2.56 2.78 2.89

Persistence of infectious agent 1.33 2.22 2.78 2.13 3.00 3.22 2.67 2.44 1.89 2.00 2.11

Spreading potential to susceptible populations 3.00 3.44 2.78 3.00 2.89 2.89 2.67 2.00 2.56 2.67 2.56

Wildlife diseases risk potential threat to animal health and public health 3.22 1.78 1.44 2.13 1.00 3.22 1.00 1.00 1.33 1.22 2.00

Disease knowledge 1.78 1.67 1.67 1.38 2.00 2.44 1.56 1.78 1.78 1.56 1.56

Wildlife diseases that are a threat 1.25 1.44 1.44 1.50 0.78 3.00 1.22 1.00 1.22 1.22 1.78

Dynamic (temporal, spatial, species variability) 1.89 2.44 2.44 1.25 1.33 1.78 1.44 1.00 1.67 1.44 1.89

IMPACT ON WIDER SOCIETY

Diseases impact on production 3.00 3.44 2.78 3.25 2.78 2.56 2.78 2.44 1.78 1.78 2.33

Economic diect impact (including cumulative cost eg enzootic vs epizootic1.67 3.22 2.89 2.75 2.89 2.33 2.67 2.56 1.78 1.78 2.33

Economic indirect impact (social, trade) 3.22 3.44 3.00 2.88 1.78 2.33 1.67 1.78 2.11 1.89 2.11

Impact on specific production and supply channels 3.44 3.44 3.22 3.13 1.89 2.11 1.56 1.67 1.78 2.22 2.33

Security of food supply/Benefit for developing world 3.44 2.67 2.89 2.75 1.44 1.78 1.78 1.33 1.56 1.89 2.00

AVERAGES OF ALL PRIORITISED DISEASES

AV

IAN

FLU

FMD

BTV

NE

WC

AS

TLE

MA

STI

TIS

TB PG

E

LAM

EN

ES

S

VTE

C 0

157

CA

MP

YLO

BA

CTE

R

SA

LMO

NE

LLA

IMPACT ON PUBLIC HEALTH

Impact on Public Health and Food Safety 3.22 1.56 1.56 1.63 1.56 2.22 1.67 1.44 3.44 3.22 3.11

Risk of occourrence 1.78 1.44 2.11 1.63 2.56 2.44 2.22 2.11 2.00 2.44 2.22

Impact of occourrence 3.22 2.22 2.00 2.13 1.89 2.78 1.67 1.67 2.56 2.44 2.67

IMPACT ON INTERNATIONAL TRADE

Impact on international trade and EU trade due toexisting regulation 3.44 3.44 2.56 2.88 1.00 1.78 1.00 1.22 1.56 1.33 1.67

CONTROL MEASURES

Effective prevention and control practices 2.67 2.67 3.00 3.25 1.44 1.44 1.89 1.67 1.78 2.00 2.00

Tools for surveillance 2.22 1.67 1.56 1.25 1.67 2.33 1.67 1.78 1.89 2.22 2.00

Tools for prevention crisis 2.44 2.22 1.89 1.75 2.13 2.88 1.75 1.88 2.22 2.25 2.00

Tools for control and implementation 2.22 2.00 1.56 1.38 2.11 2.33 1.89 2.22 2.22 2.67 2.22

Success of prevention and control in other countries 2.33 2.00 1.67 2.13 1.89 2.33 1.44 1.56 1.56 1.78 1.89

Technology (Vaccine/Treatment) / Tool Availability 2.00 2.22 2.00 1.88 2.11 2.44 1.78 2.00 2.22 2.11 2.00

Commercial diagnostic tools availability 1.78 2.44 2.78 2.25 1.67 2.67 1.56 1.78 2.33 2.44 2.33

Points achieved

Total achieved 61.00 59.33 55.56 42.78 46.33 58.56 44.22 42.67 47.11 49.22 52.00

Communication at national level

> It is important that national mirror groups should have a wide cross section of stakeholders e.g.

– Research institutes and Universities.– Medicine / Vaccine research industry– Regulators – medicines and disease control bodies– Chief Veterinary Officers– Food Industry– Farming community and animal species specialists

> Knowledge transfer and awareness in essentiale.g. Presentations to 2009 conference for AVTRW - The Association for Veterinary Teaching and Research Work / VIF Meeting in Denmark etc…

Next Stage – 2010 Activities

> UK Mirror Group meet last week

> Reviewed and approved analysis of data just presented.

> Agreed to submit our data to central ETPGAH Mirror Group and DisConTools group

> Then decide if we need to repeat our priority template using latest Discontool scoring system

> Extend the UK group to a wider audience of interested stakeholders