HIGH FLYERS THINK TANK

Emerging diseases – Ready and waiting?

The Shine Dome, Canberra, 19 October 2004

Group B: Animal health

Rapporteur: Dr Tim Mahony

We were charged with the topic of discussing emerging diseases in the animal context. This is basically a summary of what we determined about our current capabilities in assessing emerging diseases in the animal area.

Discussion points
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We felt that we have strong capabilities in terms of response and recovery, but we are probably lacking in surveillance and prevention.

Surveillance
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In terms of surveillance, in the animal area we have quite a number of systems that are in place that allow us to manage these emerging diseases.

We have the NLIS, which my department, DPI Queensland, is currently strongly involved with. That comes back to actually being able to trace back individual livestock animals. This is important – a good example is in the recent BSE case in America, that they were able to trace it back and blame the Canadians. So that is quite useful.

We also have a number of systems in place that allow nationwide reporting and collating of data. That is important in terms of managing emerging diseases.

What we probably need is to more fully integrate all these in a nationwide capability, so that we can do things like satellite mapping: if WA has got a problem, we can map that and we can look at what it is doing. Is it coming over the top towards Queensland, or down the bottom and belongs to South Australia? We can use data mining and records to also do similar things.

What we need to do, probably most importantly, is not look at this in terms of Australia but what it is in a global perspective. So some of the stuff that Martyn [Jeggo] was talking about this morning in terms of FMD is that we might be able to manage the things we have here but we need to actually know what we are going to be faced with in five years' time or even shorter periods of time.

Surveillance
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Still on surveillance: the value of discovery. As we all know, it is quite difficult to get money just to go out and have a look and see what's there, but there is importance in that. We all know about the Hendra outbreak in Brisbane, but what a lot of people don't know is that the actual first case probably occurred a month before that, in Mackay. If we had known about that, what would have happened at Hendra? Who knows? It comes back down to the fact that we can deal with things much more easily if we know what is actually up there.

We all know that Australia has very good and very effective quarantine in terms of preventing the incursion of new diseases into the country. But what about intracontinental? Do we need to actually get better systems in place for dealing with stuff within Australia that we already have? There might be things that are here but we don't know about them. And again if we don't know about it we can't manage it.

Prevention
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So prevention: again it comes down to border controls, and we have AQIS in terms of our national body.

Vaccines potentially are useful, but again it has to be a pre-existing disease – either one that is re-emerging or one that has happened somewhere else – so that there is actually a vaccine available. It is probably not realistic to expect that if we have a disease outbreak on Wednesday we will have a vaccine on Friday.

And it comes back down to the overlap between prevention and surveillance, in terms of the value of actually looking overseas and seeing what is there, so we can stop it before it gets here and before it becomes a problem. But while that is a great concept for a scientist to talk about, it has a few practical problems.

There is the public perception of us spending our tax dollars overseas for what might be perceived as no real benefit.

Then there is the potential of the country we are looking in. We go and have a look in another country and find another virus there, or a bacterium, that we decide might be a problem for us. But it might actually have trade implications for them in their own markets. So we need to identify that potential and then manage that as we go along.

We need to educate the public on what is the true value of that. We need to point out that it is much better if we can stop FMD at the border, rather than when it gets in here and already has that economic impact, even though it is much easier to justify it then. So prevention is cheaper than incursion.

Prevention
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Again it comes back to some of the things that the Human guys were talking about: public education. I guess our perception of public education was a little bit different. What we were actually talking about was educating the public on the value of the systems or the projects that we might want to work on – the value of preventing a disease from coming in, rather than having to manage it when it gets here. It is similar to what AQIS currently does, educating the general public on what they can do to prevent incursions into Australia. We have all seen the AQIS ads on TV, where they tell you not to bring things in. We need to work more on that.

And as it always comes down to, ‘Well, how do we fund all this?' I guess we decided that it should be both government and industry. Obviously the Australian beef industry would have a significant investment if they were to fund FMD research in Australia, although the benefit to our producers isn't necessarily obvious to them.

Prevention
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In terms of prevention, we also discussed animal welfare, in terms of stocking density used in some animal systems which predisposes or highlights the chance of an emerging disease occurring, and the role that it plays.

We felt that there may be increased pressure towards actually reducing the possibility of this in the future through the global food industry. That is things like consumer demand – people saying, ‘Well, I don't want to buy my chicken meat if it has been grown in very high densities.' The more that impacts on us, there might be an impact on emerging diseases there.

Response & recovery
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As I said before, we felt that response and recovery is maybe not adequate but certainly there are a lot of systems in place, in livestock anyway. That is on the basis of a whole-of-government and industry approach.

Animal Health Australia has the AusVet plan. If you have a particular emerging disease come up, if there is a plan in place you can just look that up and you know what to do. So the systems are all in place there.

Probably most importantly there, it states in that plan that costs will be shared amongst the participants, so there is no bickering about who pays for what while in the meantime the disease gets worse. It also details the response and recovery from such cases.

I guess there is always the case with emerging diseases, ‘If you don't know about it, how can you have a plan in place?' but I guess we can use this sort of model to overlay that.

Take home messages
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The take home message from the Animal group was, firstly, for public education on the importance of emerging diseases in animals, in terms of the potential economic impact to them.

We require more money for both basic research and surveillance, so again that comes back down to knowing what we have to manage. We can't manage it if we don't know about it.

And one concept that someone mentioned and I thought was really quite good was for Australia to become a regionally focused centre in Asia for these types of issues – so, a sort of CDC (Centre for Disease Control) type model. Rather than just being focused on Australia we would do that in our region, again because in most cases we can afford it whereas some of those partner countries may not be able to.

The table
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So, the table: we decided our preparedness in surveillance was low to medium; our prevention was low; our response was medium-plus; and our recovery was quite high. But when you put a bunch of scientists in a room they are always going to tell you they need more money!

Discussion

Jim Peacock – That's ‘Response predictable'. I thought the idea of a CDC type model in Australia for the Asian region was terrific. It would be a multinational centre. Just one thing about ‘more money': you will be asked immediately, ‘Well, what are you giving up?' Have you got an answer for that?

Tim Mahony – No.

John Manners – Just in relation to the CDC concept, or centre concept for the region, I might be wrong in this but it is my understanding at the moment that, for example, AAHL does not work with a number of diseases because there is basically community and political opposition to their being brought into this country, even for research. So perhaps Australia isn't in fact the logical site for a CDC for the region. Maybe a logical site is one that Australia funds, or co-funds with ASEAN (Association of South East Asian Nations, headquarters currently in Jakarta) or something like that, in a South East Asian country.

Tim Mahony – Yes. Certainly we didn't go with any particular model. Again there is always that, ‘If we don't have any view on it, will we actually bring it in, or do we fund, say, an institute to manage that particular part of it, so that we know about it in other countries?'

Aileen Plant – The CDC comment is really interesting, especially when you consider that the Americans think it is sufficiently important in our part of the world – not their part of the world, but our part of the world – to have significantly funded, as far as I can understand, basically a CDC in Singapore, and when you realise that Hong Kong are having their CDC opened next week because they see that their role as an international hub is so important that they really need to know a lot more about what is going on.

I would think that some diseases we can't deal with in Australia and we certainly would need to be collaborating, but I think if we have seen anything in the last year or so it is that we really do need to be better at thinking about Australia's capacity as opposed to the State capacity, which I think is incredibly patchy. Certainly in human disease it is incredibly patchy; I am sure it is no different in animal disease. If we could do something useful for the region, we would be doing something useful for Australia as well.

Tim Mahony – I think that was certainly one of the key points that we touched on, the importance of our looking beyond our own borders. Rather than trying to manage things once they get here, if we can manage them in another country, then that's a much better outcome for us and, hopefully, for that country as well.

Jim Peacock – But I think that, within Australia, QDPI has a fit if you go over into New South Wales or something. Is that true? That is a common feature, I think, even for the human diseases: we need to think about what is the right sort of response agency or awareness agency. Is it State based, in humans should it be NHMRC or health departments or what? So that is a major problem in Australia, I think.

You made the comment about the public perception and, probably more acutely, the industry perception that you might be wasting their money if you were spending money in other countries, working with them. I think that is a very serious point that we need to think about carefully, and how we handle that.