The COVID-19 pandemic has marked a challenging but breakthrough moment for science, research and society at large. A cornerstone of human and animal health systems, laboratories across the world have seen the continuity of their operations put to the test. Their significant engagement to enhance capacity, to conduct research and to put equipment and expertise at the disposal of the larger health system, often meant that only critical diagnostic laboratory functions were maintained and ramped up, while other types of activities had to take a back seat. Travel restrictions made access to laboratory facilities limited or nearly impossible for external stakeholders, and essential quality assurance activities, such as audits and technical training, became difficult to implement. Among these challenges was the implementation of in-country missions by the World Organisation for Animal Health (WOAH).

WOAH, however, was prompt to react and adapt its flagship capacity building programme, called the Performance of Veterinary Services (PVS) Pathway. With a voluntary, country-centric approach and targeted support lying at its heart, the programme has provided independent expertise to national Veterinary Services in more than 140 countries over the last decade. Carried out remotely in Liberia earlier this year, the latest PVS Sustainable Laboratories mission sets itself apart as an example of the Organisation’s adaptation to the COVID-19 disruption. The remote initiative has shed new light on the innovation of veterinary laboratories possible through new delivery modalities, while providing opportunities for more flexibility looking forward.

Making the digital leap: challenges and opportunities

To propose a 100% virtual mission to Liberia, WOAH undertook a risk analysis to identify the critical success factors for this new kind of activity. After the methodology and tools were adapted, the mission was ready to begin.

The initiative took off in Liberia’s Leon Quist Ledlum Central Veterinary Diagnostic Laboratory in January 2021. Being the only lab in the West African country, the facility has been playing a key role and it now aims to increase its capacity to conduct more animal health surveillance programmes at a national level.

A series of webinars were organised over a three-month period on three different aspects: data collection, resource modeling and the preparation of a mission report. Like for all similar missions, the team was made up of WOAH-trained internationally renowned experts. Despite the new format, the mission’s objectives remained unchanged: to identify physical, human and economic resources needed by the country’s veterinary laboratory system, evaluate its performance within the broader national landscape, and present insight to the national Veterinary Services to support their decision-making process with resource allocation and help them keep risks in check.

The lack of in-person engagement was overwhelmingly perceived as the highest risk attached to this delivery modality. Initial concerns, however, were mitigated by the positive outcomes seen at an early stage: a greater amount of time to collect data, faster analyses, high-quality data visualisations thanks to improved digital tools. For Dr Ana Maria Nicola, Leader of the Liberia Mission Expert Team and Director of SENASA Veterinary Laboratories in Argentina, the data collection phase with more focused assistance from the PVS Experts enhanced the impact of the mission, the understanding of its objectives and the overall quantity and quality of data to support expertise and analysis.

But while technology acted as a key enabler, it also proved a constraint. Internet penetration in the African country currently stands at 19%. The laboratory landscape mirrors the country’s digital divide, which was further exacerbated by the pandemic: the lack of access to internet and hardware by most participants limited interactions with staff, making it hard for all participants to fully benefit from the online process. Despite frequent attempts to encourage active participation, ensuring a genuinely inclusive environment was not always an easy feat.

Another stumbling block was understanding the laboratory’s current context. The shift to the virtual modality required a change of mindset: operating at a distance lacks direct observations and valuable hands-on exposure to facilities along with the opportunity to appreciate its underlying features and capacities. In most cases, the operating environment had to be imagined based on staff declarations. Dr David Korcal, Team Member and Quality Assurance Manager at the Diagnostic Laboratory for Population and Animal Health in Michigan (United States of America), argues: “The idea of laboratory operations was formed through pictures and descriptions which were gathered over time. We had to be careful not to be too quick to form opinions without all the facts.” All declarations made by the beneficiaries needed to be followed up, documented and confirmed, which added a layer of complexity to the mission. Dr Ana Maria Nicola echoes the statement, adding that declarations may paint a partial picture of the activities, but they cannot cover the whole context and workflow of laboratories – two components that are critical for putting them under the microscope.

A future-proof approach

The lessons learnt from this first-ever virtual PVS Pathway mission are plentiful: more effective preparation and better methodology, higher flexibility and continuity of the project activities under severe conditions, just to name a few. By applying WOAH’s guiding principles of scientific expertise and commitment to stepping up global health management, capacity building efforts under the PVS Pathway framework have proved successful in delivering value to beneficiaries. “The personnel were very enthusiastic about the mission engagement,” claims Laboratory Director Dr Watta Anthony. “I must admit that the mission has made a significant impact on our thinking and management skills.”

Importantly, the virtual mission points to a way forward with digital tools and collaboration playing an important role. This technology-driven vision also fits into the broader objectives of WOAH’s 7th Strategic Plan, and specifically the commitment to tap into the potential of data. “The digitalised PVS Pathway offered to Liberia by WOAH Mission was well received,” comments Dr Joseph Anderson, WOAH Liberia Delegate and Director of Livestock in the Veterinary Services Department of Animal Health Services Ministry of Agriculture in the country. “I personally learnt a lot of useful details from the mission and colleagues about the process that will make our laboratory very functional and sustainable.”

However, although the positive outlook bodes well for the future, a 100% remote format may only partially suit roll out on a large scale. Assessing both the challenges and impacts of practices implemented as a result of COVID-19 has been key to finding an equitable formula where WOAH can improve results for Members, experts, and resource partners alike. Because they combine web-based activities and face-to-face interactions, blended missions seem to be well-positioned to fulfill this need with their dual nature: they hold the most potential to increase efficiency, ensure accountability and cut cost, while also engaging countries’ participation earlier and more effectively.

Restrictions on cross-border movements are likely to remain in place over the coming months. This means that a fully virtual delivery will be embraced for upcoming WOAH PVS Sustainable laboratories missions. The experience with Liberia, however, is certainly one to remember as a new milestone in the history of WOAH: by informing the development of other PVS Pathway missions, it will fuel wins for the future and inspire hybrid ways for the Organisation to respond to rising challenges and see its activities thrive in a growingly interconnected world.

The global eradication of Rinderpest gives reason to be optimistic when it comes to fighting infectious animal diseases. While the recent COVID-19 pandemic has shown the devastating impact emerging infectious diseases can have, it is also a reminder of the critical role vaccines can play in protecting us all.

This text was originally published on the iD4D website under Creative Commons BY NC ND 4.0 International License.

For centuries, Rinderpest outbreaks caused the death of millions of cattle, buffalo, yak and wild animals across Africa, Asia and Europe. These outbreaks meant consecutive food shortages resulting in starvation, economic and social unrest, as well as disrupted cattle-powered ploughs used in rural areas to cultivate land. Decades of concerted efforts from governments and local organizations supported by the World Organisation for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO), along with other partners, resulted in the eradication of Rinderpest through mass vaccination campaigns of cattle. Global victory over this devastating disease was declared in 2011, ten years after the last case had been reported to the OIE.

Towards improved animal health governance

Beyond the remarkable achievement of global Rinderpest eradication itself, what was learnt will benefit generations to come. The history of the fight against the disease was a main driver for the accelerated establishment of national Veterinary Services in numerous countries as well as for the foundation of many veterinary schools. A prime example is the inauguration of the world’s first veterinary school in Lyon, France in 1761, spurring the opening of other schools across Europe. Similarly, in Africa, the first veterinary school was founded in Egypt in 1827 to control Rinderpest. National and regional networks of veterinary laboratories that perform diagnostics and control the quality of vaccines followed suit to tackle Rinderpest. In Asia, the Indian Veterinary Research Institute was established in 1913 to develop a Rinderpest vaccine, while in Africa, the Pan African Veterinary Vaccine Centre of the African Union (AU–PANVAC) began operating in 1986. On a global scale, the devastation caused by the disease was the impetus for the creation of the Office International des Épizooties (OIE) in 1924 – which later became the World Organisation for Animal Health. These structures, institutions and organizations laid the important foundations for today’s animal health governance systems.

To this date, Rinderpest eradication remains an unprecedented milestone in the history of animal health. The only comparable feat in the domain of public health is the eradication of Smallpox, a human disease, which was achieved in the 1980s. Both diseases have viral origin and share features that made them targets for eradication since reliable diagnostic tools and safe and efficacious vaccines were made available, along with political and financial support. Following the way paved by Rinderpest and Smallpox, other infectious diseases are now targeted for eradication, such as dog-mediated human rabies and poliomyelitis in humans, and peste des petits ruminants (PPR) in animals.

Vaccines are paving the way for disease eradication by 2030

The international community is now aiming to eradicate peste des petits ruminants (PPR) by 2030. The disease affects sheep and goats in about 70 countries, mostly in Africa, Asia and the Middle East, where 80% of the small ruminant population lives. These animals are mainly owned by family farmers, who rely on them for food and other products, such as wool and skin, as well as for income generation. Small ruminants also act as insurance for crop failure and drought. They contribute to food security, nutrition, livelihoods, national economic development and the overall well-being of about 330 million people. Among them, many are women, whose revenue is critical for their children’s nutrition and education as well as their overall empowerment. The eradication of PPR would therefore be a key contribution to protecting smallholders, farmers and their livelihoods.

The PPR virus belongs to the same family as the one responsible for Rinderpest. Hence, numerous lessons learnt from Rinderpest eradication can be applied to the PPR elimination efforts. As PPR vaccines are readily available and can induce life-long protective immunity, vaccination is one of the key tools identified within the Global Control and Eradication Strategy.

Vaccination: a cornerstone of infectious disease control and eradication

Although the learnings from Rinderpest and Smallpox eradication have been echoed on multiple occasions and fora, the infectious diseases presently targeted for eradication face a set of challenges, including unstable political situations, lack of funding at national level and vaccine hesitancy. As the current Covid-19 pandemic has put our resilience to the test, it has been a strong reminder of the efficacy of vaccination in global public health when applied with an equity lens, saving millions of lives every year and dramatically reducing deaths from preventable diseases. In the animal health field, vaccination has allowed for increased production yields, healthier animals and better return on investment for business owners. In the case of Rinderpest, the battle against the disease accelerated the development of a safe and inexpensive vaccine. With the vaccine on hand, it was then possible to roll out large-scale vaccination campaigns in affected regions.

While it starts resembling a distant memory, Rinderpest remains a potential threat due to the risk of escape, or deliberate release, of the virus from institutes keeping hazardous materials. The OIE and partners have been putting emphasis on prevention of a potential re-emergence and preparedness to mitigate the consequences, should it occur. Rinderpest vaccine reserves for global use provide a safety net and are a central element of the Global Rinderpest Action Plan. As a result of the Rinderpest eradication experience, the distribution of reliable vaccines for PPR and their inclusion in vaccine banks are priority actions.

Rinderpest eradication is a testament to the role played by vaccination and multi-lateral collaboration in protecting society against the effects of infectious diseases. New health threats will emerge, while old ones might reappear. We need to remain vigilant. Let’s embrace key lessons from the past to secure a healthy future for all.

Link: Creative Commons — Attribution-NonCommercial-NoDerivatives 4.0 International — CC BY-NC-ND 4.0