Final Report Summary - ADVANZ (ADVANZ - Advocacy for the fight against Neglected Zoonotic Diseases)
Executive Summary:
The aim of ADVANZ (Advocacy for Neglected Zoonotic Diseases) is to persuade decision makers and empower stakeholders at local, regional, and international levels towards a coordinated fight against neglected zoonotic diseases (NZD). The action is focussed first and foremost towards Africa, where the burden from NZDs is heaviest. The project recognizes that a major part of the initiative for control of NZDs must come through a behaviour change in the population at risk. A major challenge is that NZD to a large extent are ‘silent’ for the humans living in communities in endemic areas. Therefore locally adapted information is required to generate awareness and alter bad practices.
At the same time, the change must be approached via an informed support mechanism, veterinarian, public health and agricultural extension workers being aware of the variety of NZD and the different approaches to combat them.
A website was created late 2012 to publish news on NZDs and advertise for the work of ADVANZ. There were links to the other two NZD projects funded by FP7, OH-NEXTGEN and ICONZ.
In WP1, a new Pan-African OH NZD platform has been created, which harnesses strengths from existing disease specific networks and providing a platform for intersectoral collaboration. We have held one pilot meeting in the platform in March 2013, and several follow-up meetings between the coordinator and the WP1 lead, University of KwaZulu Natal. One of the major outcomes of the first meeting was to not name the entity a ‘network’, network of networks, or over-arching network, which was intended in the initial application. It was the common sentiment of the meeting participants, each being members of individual single string NZD disease networks, that these terms indicated superiority and competition, that ADVANZ would over-rule the work in current networks. Therefore the term Pan-African platform was agreed upon. Furthermore a draft of a constitution for the platform has been created in the latter half of 2013. All participants at the first meeting has approved of the constitution draft. The Pan-African platform will be officially launched at the NZD4 (see below).
Through the work of WP3, ADVANZ was going to provide evidence-based knowledge of the cost-effectiveness of controlling these diseases in a manner that can be appreciated. The information is based on the One Health approach, which targets decision making bodies involved in disease control: relevant Ministries, district health- veterinary and vector control offices and the locally affected communities. The work is based on the contribution from WP2, which was active first period of the project, and where current knowledge on the 8 NZDs was compiled. This work was carried out by beneficiary number 1, 3, 5 and 6.
The second period of the project had three main goals
1. As part of WP1 to consolidate the Pan-African platform on NZDs and to continue dissemination and advocacy activities for NZDs
2. In WP3 to create a publishable set of advocacy materials, based on the documents compiled by WP2.
3. To complete the final arrangements and execute the fourth international meeting on neglected zoonotic diseases, the NZD4 (WP4)
In WP1, the Pan-African OH NZD platform has been created. The official launch of the platform took place at the NZD4 meeting. The ADVANZ.org website will be the home of the platform, where the information material created by WP3 is also hosted. Furthermore ADVANZ has supported the development of a digital T. solium cysticercosis advocacy tool was published, which can be accessed through ADVANZ.org or theviciousworm.org.
Working on the data compiled by WP2 during the first period of the project, WP3 of ADVANZ now have set up a website which provides evidence-based knowledge of the diagnosis, prevention and control of NZDs. All data is based on the One Health approach, and targets decision making bodies involved in disease control: relevant Ministries, district health- veterinary and vector control offices and also the locally affected communities. A part of the tasks of WP3 consisted in sub-contracting an artist who would be responsible for the artwork in the information material. After creating the ToR for the task, a Kenyan artist, Joseph Kariuki, was hired for the job.
The set of information materials can be reached through this website: http://advocacy.advanz.org .The work has mainly been carried out by project beneficiary number 3, AVIA-GIS. A report on creating the materials, D3.1 has been uploaded to ECAS.
The fourth international meeting on neglected zoonoses, NZD4, was successfully held at the WHO headquarters in Geneva in November 2014. Arranging the meeting was done primarily by WP4, with assistance from the WHO, partner 3, and partner 1, who employed a WHO volunteer for two months to assist in the arrangements in Geneva. About 110 participants joined the meeting. The official report from the meeting is to be published in May 2015. A report on the planning and meeting execution is provided in D4.1 and has been uploaded to ECAS.
The ADVANZ advisory board has been active in supporting ADVANZ throughout the project, primarily in regards to arranging NZD4, but also to concerning sustaining the ADVANZ output in the future. The board members were coming from Zambian Ministry of Health, FAO, OIE and WHO, and also had two major experts in One Health and zoonotic disease control from University of Florida and University of Liverpool.
Project Context and Objectives:
3.2 Core of the report for the period: Project objectives, work progress and achievements, project management
3.2.1 Project objectives for the period
The project objectives for the period were:
1. In WP1 to sustaining the ADVANZ.org website with news and updates on NZDs as well as continuously nurture the Pan-African platform.
2. In WP3 to contract a suitable artist to cover the graphical work and create an information package based on the collated information by WP2
3. In WP4 to arrange and execute the NZD4 meeting
4. In WP5 to run a smooth management procedure of the project
3.2.2 Work progress and achievements during the period
Deliverables
D1.1 Month 30, Internet based NZD advocacy platform finalized and ready for hand-over to WHO.
D1.1 was finalised by Month 30. A report has been uploaded to ECAS.
According to the Document of Work of ADVANZ, the main objective of WP1 was to establish and maintain a Pan-African One Health network on Neglected Zoonotic Diseases (OH NZD), and to maintain the dissemination channel of ADVANZ and this was to be achieved through;
1. Conducting an inventory of existing South-South networks relevant to advocacy, research, control and prevention of NZDs
2. Establishing a Pan-African network for NZD-OH equipped with the necessary resources to promote advocacy and provide effective information materials resources targeted for various stakeholders involved in the control and prevention of NZD
3. Use of the platform to introduce and promote a “One Health” approach in the control and prevention of NZD through promotional materials based on success stories from WP2
4. To design and maintain the ADVANZ website, http://advanz.org in order to host the South-South advocacy network which will act as a platform for dissemination of advocacy and information material on NZD with a One Health approach to intervention research, control and prevention.
During the first period of the project 1 and 2 were achieved:
An inventory of existing South-South networks relevant to advocacy, research, control and prevention of NZDs was done in late 2012 and a data base was created with information of various networks and contact details. This information was later used to invite participants to the first meeting in the African Neglected Zoonotic Diseases support platform which was hosted by UKZN and held at the Indaba Hotel and Conference Centre, Gauteng, South Africa, from the 08 - 09th March 2013.
During the meeting the framework for the Pan-African platform for NZD-OH was formulated and an agreement was made to develop the framework and a constitution was formulated.. Through all stakeholders consultation a platform has been created with an approved constitution assuring good governance. The Platform is going to be accessible through the ADVANZ website (http://advanz.org).
One of the major outcomes of the first meeting was to NOT name the entity a ‘network’, ‘network of networks’, or ‘over-arching network’, which was intended in the initial ADVANZ project application. It was the common sentiment of the meeting participants, each being members of individual single string NZD disease networks, that these terms indicated superiority and competition; that ADVANZ would over-rule the work in current networks. Therefore the term Pan-African platform was agreed upon. Furthermore a draft of a constitution for the platform has been created in the latter half of 2013. All participants at the first meeting has approved of the constitution draft. The Pan-African platform will be officially launched at the NZD4 in November 2014 (see below).
The Platform is now ready to receive resources to promote advocacy and provide effective information materials resources targeted for various stakeholders involved in the control and prevention of NZD from WP 3.
During the course of 2013 and 2014 both Prof. Samson Mukaratirwa, Dr. Christopher Saarnak and Prof. Maria Vang Johansen have participated in several meetings and conferences to promote the platform. Among others:
1. The second One Health congress in Bangkok, Thailand, January 2013, where ADVANZ joined forces with ICONZ and OH-NEXTGEN and promoted the NZD and One Health
2. The second African One Health conference in Arusha, Thailand, April 2013
3. MedVetNet Association International Scientific Conference 2013 - One health, one medicine: sharing challenges for combating zoonoses, Lyngby, Denmark, June 2013
4. The 8th European Congress on Tropical Medicine and International Health, September 2013, Copenhagen, Denmark
The second project period WP1 focussed on dissemination activities and maintaining the website.
Through the website the platform is ready to distribute the resources created by WP3, providing effective information materials and similar resources targeted for various stakeholders involved in the control and prevention of NZD.
Since the start of the second project period the Platform received resources to promote advocacy and provide effective information materials resources targeted for various stakeholders involved in the control and prevention of NZD from WP3. Various stakeholders have been identified and materials are being disseminated.
Also during the course of 2014 and 2015 the WP1 coordinator, Prof. Samson Mukaratirwa, has participated in several meetings and conferences to promote the platform including the launching of the NZ4 of which the Platform was officially launched. The Platform website is functional and being maintained and a virtual meeting with Platform members is anticipated to take place in June 2015.
A further work of NZD advocacy and knowledge dissemination has been the development of a digital T. solium cysticercosis advocacy tool. This work was done in collaboration with the FP7 project ICONZ. The program was finished in November 2014, and was promoted during the NZD4 meeting in Geneva. It can be accessed through the advanz.org website as well as its’ own site theviciousworm.org
The advocacy tool targets policymakers, professionals and laypeople and comprises educational material such as illustrated short stories, videos and scientific text designed for different target groups. A mixed methods evaluation of the tool was conducted in Mbeya, Tanzania, with veterinarians, meat inspectors, agricultural extension workers and students, medical officers, health officers and assistant medical officers and students. This showed substantial increases in knowledge and a general acceptability of the medium.
Figure 1. A postcard flyer that was done to promote The Vicious Worm
Also finalized in the second period has been a promotional leaflet describing the ADVANZ material and the Pan/African platform. The leaflet has been added in Appendix 10.
During the course of the second period Prof. Samson Mukaratirwa, Dr. Christopher Saarnak and Prof. Maria Vang Johansen have participated in several meetings and conferences to promote the platform. Among others:
5. The ECOHESA symposium in South Africa in March 2014 presenting Control of neglected zoonotic diseases using one health and ecohealth approaches / introducing the ADVANZ Pan-African platform
6. The NZD4 in Geneva, Switzerland
7. The third One Health congress in Amsterdam, the Netherlands, March 2015
As part of WP1, a paper in the Odenstepoort Journal of Veterinary Research has been published:
SAARNAK, C., JOHANSEN, M., MUKARATIRWA, S.
ADVANZ: Establishing a Pan-African platform for neglected zoonotic disease control through a One Health approach. Onderstepoort J Vet Res, North America, 81, apr. 2014.
Available at: http://www.ojvr.org/index.php/ojvr/article/view/740/1075
WP2. Meta-analysis, database and identification of gaps in existing advocacy
Deliverables
D2.1 Month 12, Comprehensive database of existing information and advocacy materials and gap analysis and recommendations for further development documented in report.
WP2 was finalised during the first project period and the deliverable uploaded to ECAS.
According to the Document of Work of ADVANZ, work package 2 was to be implemented in year 1. The general objective of WP2 was to conduct a meta-analysis and compile a database of existing advocacy and information materials related to neglected zoonoses. Particular attention would be paid to evidence of successful and profitable intersectoral collaboration between the medical and the veterinary professions to control neglected zoonoses in low resource societies. Specific objectives included the mapping of information gaps, the identification of intersectoral collaboration examples, their description and a critical analysis of the reasons for success. Examples of zoonoses affecting humans, livestock and wildlife were to be used, in different epidemiological, ecological or animal husbandry contexts. Ecological, technical, economic, political and socio-anthropological determinants were to be considered to formulate messages for improved control of neglected zoonoses in low-resource societies.
A concept note and a work plan for the implementation of WP2 were presented at the ADVANZ kick-off meeting on 30 October 2012 in Copenhagen. They were further refined in a workshop in London in April 2013 with the project coordinators and representatives of other work packages. The themes were distributed to the different partners involved in WP2 as follows: dog associated zoonoses (rabies, leishmaniosis and echinococcosis) for ITM, ruminant associated zoonoses (bovine tuberculosis, brucellosis and anthrax) for Swiss TPH, trypanosomosis for UEDIN and cysticercosis for UCPH.
Ruminant associated zoonoses
ITM produced synoptic reviews of the epidemiology and impact of each of the dog associated neglected zoonoses in low resource societies and identified the key extension messages for each of them and for improved dog management. Each source was briefly commented about its quality, its target (communities, professionals and/or decision makers) and its relevance for the purpose of ADVANZ. The table below summarizes the number of websites and documents reviewed for each disease and for dog management.
Rabies Leishmaniosis Echinococcosis Dog Management
Factual information (Wikipedia, OIE, WHO, OIE…) 13 websites 6 websites 6 websites
Education and advocacy material (videos, articles in newspapers…) 29 websites 31 websites 23 websites 2 websites
Others (posters, leaflets, booklets…) 15 documents 4 documents 4 documents
While there is a lot of informational material available on rabies, the number and the quality of material on leishmaniosis and echinococcosis are relatively low. Most of the material is available in English. Part of it is in French or Spanish (mostly for leishmaniosis) and, sometimes, in vernacular languages.
Bacterial zoonoses
With regard to the bovine associated zoonoses, the FAO manual on meat inspection for developing countries provides useful illustrated information on anthrax, bovine tuberculosis and brucellosis. However, the online manual is rather old without high quality photos. Access to internet resources for anthrax is Africa is complicated due to the domination of sites on anthrax as biological warfare and potential use in bioterrorism. The few useful sites are hardly found without prior knowledge on possible sites and organisations providing appropriate information. We only found one booklet that presents educational material for anthrax showing for example the important vaccination of cattle. An MSc thesis done in the framework of FP7 ICONZ programme shows on a map the under-reporting of anthrax outbreaks in Mali and this map is made available for the ADVANZ programme. There are more internet resources for brucellosis and bovine tuberculosis, although educational material is mainly for UK farmers. Partners make available messages and pictograms developed within research programs in Africa. Sites for bovine tuberculosis are in English, because there are more bovine tuberculosis projects in East than in West Africa. For brucellosis there is also information in French and Arabic as well as a video on brucellosis from Egypt. The open source literature and information sites on bovine tuberculosis in Africa reveals that that the proportion of human tuberculosis due to M. bovis is lower than was generally thought two decades ago, but causes considerable losses especially to peri-urban dairy production. As to brucellosis in Africa and particularly West Africa, the human health and livestock production impact of brucellosis are only now being better evaluated in multidisciplinary research programmes that also aim at understanding viable control options in Africa. The main knowledge gap is if and how brucellosis vaccine can be administered at the same time with other vaccines, for example anthrax. International organizations have requested such studies a long time ago – but have not yet been done which reflects the neglected nature of this zoonosis.
WP3. Information material to raise awareness of and promote control of Neglected Zoonoses in a One-Health context
Deliverables
D3.1 Month 30, New advocacy and information material created for selected examples of neglected zoonoses themes as part of the One-Health concept including texts, audio material and videos, and aimed at decision makers, the media, veterinary and public health workers, domestic animal keepers and the communities where they live.
D3.1 was ready for the NZD4 meeting in Geneva. A description of the output has been uploaded to ECAS.
Objective 3.1 To create advocacy and information material for NZD including texts, audio material and videos, and aimed at decision makers, the media, veterinary and public health workers, domestic animal keepers and the communities where they live.
Avia-GIS was in charge of WP3: Information material to raise awareness of and promote control of Neglected Zoonoses in a One-Health context.
The overall objective of this work package was to provide clear and easily accessible advocacy and information materials to promote the control of neglected zoonoses. Although these roles clearly overlap, we define advocacy as aiming to change attitudes and information as aiming to change practices.
During this first part of the project Avia-GIS was actively involved in the process of defining how ADVANZ will achieve its objectives in practice and how WP1 and WP2 will develop and provide material for WP3.
In parallel discussions have been conducted with the Avia-GIS IT staff about the design of the ADVANZ advocacy web-page and app which includes a clickable village and an ADVANZ available existing advocacy material database. This included browsing the Internet to find available advocacy materials.
Four permanent staff members of Avia-GIS contributed to this work:
• Guy Hendrickx: senior spatial epidemiologist and information system specialist, in charge of overall project coordination and follow-up.
• Alexandra Shaw: senior livestock economist and one-health specialist, in charge of project implementation.
• Els Ducheyne: senior spatial analyst, in charge of designing the ADVANZ clickable village and information system.
• Bart de Groot: senior IT specialist, in charge of developing the ADVANZ clickable village and information system.
Artist input
Joseph Kariuki, a Kenyan artist was recruited to make the drawings needed for the website and the mobile application.
• Pastoralist homestead scene. In this setting most of people’s income comes from livestock. The main animal species kept are cattle, sheep and goats, with some dogs also present. The scene refers to an East African pastoralist setting, but is NOT very clearly and exclusively Maasai, but a bit more generally applicable.
• Morocco, Tunisia, Mali, Niger, northern Burkina Faso, Northern Nigeria: ‘Maghreb and Sahel’ scene, where people are predominantly Muslim and keep cattle, sheep and dogs, but no pigs.
• Mixed farming village scene. In this type of village most of people’s income comes from crops. The scene refers to a humid, central African type setting. But they also keep some cattle and draft oxen in addition to sheep, goats, pigs and chickens.
The information can be accessed through the ADVANZ website at advocacy.advanz.org. In appendix XXX a promotional leaflet demonstrating the contents of the ADVANZ material is shown.
WP 4. Neglected Zoonoses 4th International Meeting
Objective 4.1 Undertake overall responsibility for the organisation, programme and promotion of NZD4 meeting scheduled for early 2014
The NZD4 meeting took place on 19th and 20th Nov 2014 at WHO Headquarters and was attended by over 100 participants including representatives from national governments, international organisations, academia, foundations, the private sector and NGOs.
Purpose
From Advocacy to Action aimed to present successful methods for the control of neglected zoonotic diseases (NZDs). Its goal was to mobilize increased advocacy and action by building confidence in policy makers that the approaches outlined for going forwards are the right pathways to take. Invited participants, with the knowledge and insights provided at the meeting, should be able to act as high-level advocates in their home countries, to persuade others into action. Attending policy makers, funders and other stakeholders were expected to engage and benefit from this opportunity for networking in the context of NZD control.
Objectives
• Showcase the success of implemented programmes and track progress since the previous international NZD meetings
• Identify ways in which to achieve the NZD control milestones as specified in the WHO roadmap
• Explore ways in which current control interventions can be extended to include other NZDs
• Increase awareness of NZDs through promotion of health education and communication
• Launch the Pan-African platform for the prevention and control of NZDs
• Influence leaders, in particular key policy makers and donors, to increase their commitment to actions to control NZDs
Outcome
The anticipated outcome of the meeting was that, through the evidence and case studies presented, key policy makers and donors would be motivated to increase their commitment to actions to control these diseases.
A copy of the Concept Note and Background Information can be found on the WHO website at: http://www.who.int/neglected_diseases/zoonoses/fourth_meeting/en/
It is attached as an appendix (Appendix II)
A copy of the programme and attendee list can be found on the ADVANZ website at: http://www.advanz.org/downloads/nzd4-meeting-materials/
Objective 4.2 – Compile a report to guide international organisations, policymakers and One Health advocacy platforms on the issue of neglected zoonoses and the importance of One Health approach in addressing these.
A team of rapporteurs lead by Anna Walker (Okello) of University of Edinburgh, took meticulous notes during both the presentations and discussions at the NZD4 meeting, which were used both for the final discussion session and for writing the report.
An executive summary was produced shortly (a few weeks) after the meeting. This summary can be found on the WHO website at:
http://www.who.int/neglected_diseases/zoonoses/fourth_international_nzd_meeting/en/
The main NZD4 document is a larger report document that will be produced in both PDF and printed formats. The final draft of the report has been written and approved by the organising team and WHO editors. The final report design has been approved by the NZD4 organising committee.
Printed and PDF copies of the report will be ready for distribution at the end of May 2015. This report will be uploaded to the ADVANZ website and printed copies sent to all of the meeting participants. The PDF copies will be widely distributed to international organisations, policy makers and One Health advocacy platforms amongst others.
3.2.3 Project management during the period
WP5. Project management
Deliverables
D5.1 Month 3. Minutes from kick-off meeting
D5.2 Month 15. Minutes from mid-term meeting
D5.3 Month 26. Minutes from 3rd ADVANZ meeting
D5.4 Month 30. Minutes from final meeting
On 29th October 2012 the kick-off meeting for ADVANZ was held in Copenhagen. Participants from all partner institutions were present. The minutes have been uploaded in ‘ECAS’.
A mid-term meeting was held in September 2013. Participants from all partner institutions were present. The minutes have been uploaded in ‘ECAS’.
On 19th November 2014 the 3rd ADVANZ meeting was held in Geneva, Switzerland. Participants from all partner institutions and 3 members of the ADVANZ advisory board, including the head, were present. The minutes have been uploaded in ‘ECAS’.
A final meeting was held in March 2015. Participants from all partner institutions and 2 members of the ADVANZ advisory board, including the head, were present. The minutes have been uploaded in ‘ECAS’.
A separate Work Package (WP5) is dedicated to overall project management. The overall aim of this work package is to design and maintain a management structure and corresponding procedures that support the goals of the project. This work package is led by Project Coordinator Dr. Christopher Saarnak, Department of Parasitology and Aquatic Diseases, University of Copenhagen in collaboration with the Assistant Coordinator Prof. Maria Vang Johansen who works in the same department as Dr. Saarnak. The Coordinator and the EU Office at the University of Copenhagen (namely EU Liaison Officer Karin Norris) have collaborated closely on the implementation of all administrative, legal and financial matters.
In addition to the administrative and financial management, the management of the content of the project (the so-called Coordination Management) is done at three different levels: the Project Committee, The Project Coordinator and the Work Package Leaders. The Project Committee consists of all partners of the ADVANZ project and is the highest governing body of the project.
The project works with an advisory group of external experts. Head of this group is Prof. Paul Gibbs, University of Florida. Also member of the groups are representatives from the so-called Tripartite: WHO, FAO and OIE. The members are: Bernadette Abela-Ridder (WHO), Katinka deBalogh (FAO) and Alex Thiermann (OIE). Both WHO and FAO were present at the mid-term meeting. We have had intermediate formal meetings with Prof. Paul Gibbs in June 2013, September 2013 and February 2014. Furthermore, Paul Gibbs also joined (via skype) a WP2/WP3 planning meeting held in April 2013.
Bernadette-Abela Ridder (WHO) has been active in the planning phase of WP4, the NZD4 meeting. Some 10 Skype meetings were held in 2014, some also with the participation of the other three members of the advisory board.
Project Results:
ADVANZ is expected to have a major impact on the general awareness of the existence, importance and added value of controlling NZD in disease endemic areas. This is expected to enhance interest for NZD both nationally and internationally across all relevant sectors. As a part of the impact chain, the increased awareness is expected to contribute to chances in national policies, and change practices among livestock owners which at the moment favour persistence or even emerging of NZD. ADVANZ’s strategy will be to influence policies directly but also develop the capacity of others for NZD advocacy. By establishing a Pan African OH-NZD network uniting existing single-string NZD promoters, the group of committed advocates will increase substantially and will deliver more holistic and culturally and environmentally acceptable solutions.
Targeting all stakeholders from livestock owners to decision makers, the impact is expected to be reduced prevalence of NZD, increased and improved animal production and welfare which ultimately should improve the livelihood of affected populations. This will meet the objectives of the FP7 work programme by contributing to the reduction of poverty and the Millennium Development Goals.
By using African media groups to produce the advocacy material it is expected that the material will be more culturally appropriate and emphasizing values considered crucial for message uptake. The material will also be developed to target children and young people and be gender sensitive. ADVANZ is primarily targeted Africa but as it seeks to develop a generic model for NZD advocacy it is expected that the model can be extended to Asia and S. America at a later stage.
A successful outcome to ADVANZ will be increased awareness of the burdens and significance of the NZD, but also the possibilities of applying a One Health approach which leads to cost-effective and practical strategies for their prevention and control. In detail, ADVANZ will provide a model for prevention and control of NZD that builds on disease specific knowledge which has been synthesized regarding the added value of One Health paying special attention to cultural and environmental issues. It is anticipated that extension messages developed using modern animation and illustration technologies would allow an efficient transfer of knowledge from the scientific community to the stakeholders.
Complemented by the other NZD projects in the FP7 framework, ADVANZ will pay a major contribution to the delivery of the objectives of the FP7 work programme. The outcome will be the delivery and implementation of clear, culturally acceptable, and cost effective sustainable strategies to optimise the control of NZD. ADVANZ will work in partnership with all stakeholders to ensure that the information is made available in a format which can be utilized by national governments and international decision makers to develop their policies to control the diseases and to securing commitment at the national and international level.
ADVANZ will have a major impact by ensuring full participation of all stakeholders including Government (directors of both livestock and health services), district officials, traditional and religious authorities and representatives of the general population. It will be essential to provide an opportunity for the community to express themselves and for effective dialogue to take place. Consulting stakeholders throughout the project is an interactive process and will result in the achievement of greater understanding of the impact of the NZD.
Engaging with local media will be an essential alley to capture lay people’s attention, as the local media are at any given time mirroring the language, the interest, and the fashion of the local recipients. Examples from sub-Saharan Africa have thus shown that e.g. using local musicians to promote the danger of smoking has a much greater impact than any scientific communication. Knowledge about target groups’ key interest will be drawn from the local SME partners and from the advisory board to be able to target the messages more precisely. Special attention will be paid to the role of women in the society involved as they are very often key players in disease control implementation at a local level. Input from women’s groups will assist in developing the most appropriate information material.
Steps that need to be taken to bring about the impacts mentioned
Control of neglected zoonoses in developing countries has often failed because the proposed strategies were merely transposed from industrialised countries to low-resource societies. Yet, epidemiological, economic and cultural conditions have been rarely taken into account. The epidemiology of neglected zoonoses is indeed very dependent of the farming systems and the conditions in which animals are maintained. Whereas animals in industrialised countries are usually confined and have little contact with the environment, in low resource countries, animals are often roaming and share grazing areas with other animals, including wildlife, exposing them to a much higher risk of disease transmission. On the other hand, in industrialised countries, live animals or animal commodities travel huge distances to meet their market, in low resources countries, animal products are usually consumed in the vicinity of the areas where animals were raised, putting biosecurity concerns in very different perspectives.
In addition, control strategies applied in industrialised countries prove to be very expensive and not always efficient. For instance, bovine tuberculosis continues causing problems in UK, in badgers, despite the massive amount of money invested for its eradication. While Taenia solium was virtually eradicated by the industrialisation of pork production, T. saginata is still prevalent in European cattle, in spite of the generalised use of toilets and very high hygienic standards in the affected countries. If it is evident that low-resource countries will never be able to invest as much as industrialised countries in the control of NZD, it is also clear that controlling these diseases in low-resource societies would even be more complicated and hence more expensive.
Decision makers, stakeholders and the communities do not have the capacity to evaluate the relevance of control strategies and have often been frustrated when failing to control diseases, resulting in a generalised fatigue. ADVANZ proposes to review control strategies and formulate messages that are more likely to have an impact in affected areas.
The impact zoonotic diseases have on human health should be a key parameter to be considered before disease control strategies are developed. Animals in developing countries appear to be much more resistant to pathogens than upgraded breeds and, for instance, bovine tuberculosis, in the absence of control in most of the African continent, does not seem to have an impact as severe as it had in Europe in the 20th century. Yet, in some very specific conditions, bovine tuberculosis may have a very serious impact on human health and justify an intervention. Encouraging the veterinary services to slaughter TB infected animals and promoting milk pasteurisation should only be done in these very specific conditions.
Even if neglected zoonoses have an impact on human health, the communities might not be prepared to change their habits either because they do not perceive the risk (lack of awareness) or because they fail to change their habits. Boiling milk, housing or enclosing animals, using toilets… often appear much more complicated to implement than one thought. ADVANZ will use social scientists to identify ways of changing the communities’ behaviours to an extent that is acceptable to them and that is sufficient to significantly reduce the zoonotic burden.
ADVANZ will not do the dissemination of the informational material and does not have the ambition to translate it in vernacular languages. ADVANZ will rely on the countries’ veterinary, health and extensions services to take ownership of the material and adapt it to their needs for use in local television and radio programmes, newspapers, leaflets, posters, etc. The informational material will be made easy to translate and adapt accordingly. A more objective understanding of zoonotic diseases is expected to induce, among the stakeholders and the communities, the development of creative strategies to improve the control of neglected zoonoses in their respective societies.
How account is taken of other national and international NZD and One Health activities
This project will efficiently and timely complement other FP7 funded activities. The preliminary stages for NZD burden and control, prevalence mapping, risk analysis, providing acceptable, validated and stakeholder endorsed methodologies for gap analysis and control tools are provided by projects like ICONZ and DISCONTOOLS. OH-NEXTGEN will be training the next scientific generation to deal with neglected zoonoses, and ADVANZ will fill the gap by providing advocacy to decision makers, stakeholders and the communities. As such, the whole society spectrum will be covered. The international collaboration in ADVANZ will ultimately lead to significantly more general awareness of NZD and ways to control them throughout the world. To ensure up to date information to be provided, ADVNAZ will work closely with other groups and organisations involved with NZD both in Europe and in the developing ICPCs.
Potential Impact:
advanz.org
theviciousworm.org
ku.dk
List of Websites:
Two reports & brochures produced to promote the ADVANZ output.
Both are in the final report pdf.
Furtermore the project was instrumental in conducting the 4th WHO meeting on NZDs. A final report will be published in June 2015.
The aim of ADVANZ (Advocacy for Neglected Zoonotic Diseases) is to persuade decision makers and empower stakeholders at local, regional, and international levels towards a coordinated fight against neglected zoonotic diseases (NZD). The action is focussed first and foremost towards Africa, where the burden from NZDs is heaviest. The project recognizes that a major part of the initiative for control of NZDs must come through a behaviour change in the population at risk. A major challenge is that NZD to a large extent are ‘silent’ for the humans living in communities in endemic areas. Therefore locally adapted information is required to generate awareness and alter bad practices.
At the same time, the change must be approached via an informed support mechanism, veterinarian, public health and agricultural extension workers being aware of the variety of NZD and the different approaches to combat them.
A website was created late 2012 to publish news on NZDs and advertise for the work of ADVANZ. There were links to the other two NZD projects funded by FP7, OH-NEXTGEN and ICONZ.
In WP1, a new Pan-African OH NZD platform has been created, which harnesses strengths from existing disease specific networks and providing a platform for intersectoral collaboration. We have held one pilot meeting in the platform in March 2013, and several follow-up meetings between the coordinator and the WP1 lead, University of KwaZulu Natal. One of the major outcomes of the first meeting was to not name the entity a ‘network’, network of networks, or over-arching network, which was intended in the initial application. It was the common sentiment of the meeting participants, each being members of individual single string NZD disease networks, that these terms indicated superiority and competition, that ADVANZ would over-rule the work in current networks. Therefore the term Pan-African platform was agreed upon. Furthermore a draft of a constitution for the platform has been created in the latter half of 2013. All participants at the first meeting has approved of the constitution draft. The Pan-African platform will be officially launched at the NZD4 (see below).
Through the work of WP3, ADVANZ was going to provide evidence-based knowledge of the cost-effectiveness of controlling these diseases in a manner that can be appreciated. The information is based on the One Health approach, which targets decision making bodies involved in disease control: relevant Ministries, district health- veterinary and vector control offices and the locally affected communities. The work is based on the contribution from WP2, which was active first period of the project, and where current knowledge on the 8 NZDs was compiled. This work was carried out by beneficiary number 1, 3, 5 and 6.
The second period of the project had three main goals
1. As part of WP1 to consolidate the Pan-African platform on NZDs and to continue dissemination and advocacy activities for NZDs
2. In WP3 to create a publishable set of advocacy materials, based on the documents compiled by WP2.
3. To complete the final arrangements and execute the fourth international meeting on neglected zoonotic diseases, the NZD4 (WP4)
In WP1, the Pan-African OH NZD platform has been created. The official launch of the platform took place at the NZD4 meeting. The ADVANZ.org website will be the home of the platform, where the information material created by WP3 is also hosted. Furthermore ADVANZ has supported the development of a digital T. solium cysticercosis advocacy tool was published, which can be accessed through ADVANZ.org or theviciousworm.org.
Working on the data compiled by WP2 during the first period of the project, WP3 of ADVANZ now have set up a website which provides evidence-based knowledge of the diagnosis, prevention and control of NZDs. All data is based on the One Health approach, and targets decision making bodies involved in disease control: relevant Ministries, district health- veterinary and vector control offices and also the locally affected communities. A part of the tasks of WP3 consisted in sub-contracting an artist who would be responsible for the artwork in the information material. After creating the ToR for the task, a Kenyan artist, Joseph Kariuki, was hired for the job.
The set of information materials can be reached through this website: http://advocacy.advanz.org .The work has mainly been carried out by project beneficiary number 3, AVIA-GIS. A report on creating the materials, D3.1 has been uploaded to ECAS.
The fourth international meeting on neglected zoonoses, NZD4, was successfully held at the WHO headquarters in Geneva in November 2014. Arranging the meeting was done primarily by WP4, with assistance from the WHO, partner 3, and partner 1, who employed a WHO volunteer for two months to assist in the arrangements in Geneva. About 110 participants joined the meeting. The official report from the meeting is to be published in May 2015. A report on the planning and meeting execution is provided in D4.1 and has been uploaded to ECAS.
The ADVANZ advisory board has been active in supporting ADVANZ throughout the project, primarily in regards to arranging NZD4, but also to concerning sustaining the ADVANZ output in the future. The board members were coming from Zambian Ministry of Health, FAO, OIE and WHO, and also had two major experts in One Health and zoonotic disease control from University of Florida and University of Liverpool.
Project Context and Objectives:
3.2 Core of the report for the period: Project objectives, work progress and achievements, project management
3.2.1 Project objectives for the period
The project objectives for the period were:
1. In WP1 to sustaining the ADVANZ.org website with news and updates on NZDs as well as continuously nurture the Pan-African platform.
2. In WP3 to contract a suitable artist to cover the graphical work and create an information package based on the collated information by WP2
3. In WP4 to arrange and execute the NZD4 meeting
4. In WP5 to run a smooth management procedure of the project
3.2.2 Work progress and achievements during the period
Deliverables
D1.1 Month 30, Internet based NZD advocacy platform finalized and ready for hand-over to WHO.
D1.1 was finalised by Month 30. A report has been uploaded to ECAS.
According to the Document of Work of ADVANZ, the main objective of WP1 was to establish and maintain a Pan-African One Health network on Neglected Zoonotic Diseases (OH NZD), and to maintain the dissemination channel of ADVANZ and this was to be achieved through;
1. Conducting an inventory of existing South-South networks relevant to advocacy, research, control and prevention of NZDs
2. Establishing a Pan-African network for NZD-OH equipped with the necessary resources to promote advocacy and provide effective information materials resources targeted for various stakeholders involved in the control and prevention of NZD
3. Use of the platform to introduce and promote a “One Health” approach in the control and prevention of NZD through promotional materials based on success stories from WP2
4. To design and maintain the ADVANZ website, http://advanz.org in order to host the South-South advocacy network which will act as a platform for dissemination of advocacy and information material on NZD with a One Health approach to intervention research, control and prevention.
During the first period of the project 1 and 2 were achieved:
An inventory of existing South-South networks relevant to advocacy, research, control and prevention of NZDs was done in late 2012 and a data base was created with information of various networks and contact details. This information was later used to invite participants to the first meeting in the African Neglected Zoonotic Diseases support platform which was hosted by UKZN and held at the Indaba Hotel and Conference Centre, Gauteng, South Africa, from the 08 - 09th March 2013.
During the meeting the framework for the Pan-African platform for NZD-OH was formulated and an agreement was made to develop the framework and a constitution was formulated.. Through all stakeholders consultation a platform has been created with an approved constitution assuring good governance. The Platform is going to be accessible through the ADVANZ website (http://advanz.org).
One of the major outcomes of the first meeting was to NOT name the entity a ‘network’, ‘network of networks’, or ‘over-arching network’, which was intended in the initial ADVANZ project application. It was the common sentiment of the meeting participants, each being members of individual single string NZD disease networks, that these terms indicated superiority and competition; that ADVANZ would over-rule the work in current networks. Therefore the term Pan-African platform was agreed upon. Furthermore a draft of a constitution for the platform has been created in the latter half of 2013. All participants at the first meeting has approved of the constitution draft. The Pan-African platform will be officially launched at the NZD4 in November 2014 (see below).
The Platform is now ready to receive resources to promote advocacy and provide effective information materials resources targeted for various stakeholders involved in the control and prevention of NZD from WP 3.
During the course of 2013 and 2014 both Prof. Samson Mukaratirwa, Dr. Christopher Saarnak and Prof. Maria Vang Johansen have participated in several meetings and conferences to promote the platform. Among others:
1. The second One Health congress in Bangkok, Thailand, January 2013, where ADVANZ joined forces with ICONZ and OH-NEXTGEN and promoted the NZD and One Health
2. The second African One Health conference in Arusha, Thailand, April 2013
3. MedVetNet Association International Scientific Conference 2013 - One health, one medicine: sharing challenges for combating zoonoses, Lyngby, Denmark, June 2013
4. The 8th European Congress on Tropical Medicine and International Health, September 2013, Copenhagen, Denmark
The second project period WP1 focussed on dissemination activities and maintaining the website.
Through the website the platform is ready to distribute the resources created by WP3, providing effective information materials and similar resources targeted for various stakeholders involved in the control and prevention of NZD.
Since the start of the second project period the Platform received resources to promote advocacy and provide effective information materials resources targeted for various stakeholders involved in the control and prevention of NZD from WP3. Various stakeholders have been identified and materials are being disseminated.
Also during the course of 2014 and 2015 the WP1 coordinator, Prof. Samson Mukaratirwa, has participated in several meetings and conferences to promote the platform including the launching of the NZ4 of which the Platform was officially launched. The Platform website is functional and being maintained and a virtual meeting with Platform members is anticipated to take place in June 2015.
A further work of NZD advocacy and knowledge dissemination has been the development of a digital T. solium cysticercosis advocacy tool. This work was done in collaboration with the FP7 project ICONZ. The program was finished in November 2014, and was promoted during the NZD4 meeting in Geneva. It can be accessed through the advanz.org website as well as its’ own site theviciousworm.org
The advocacy tool targets policymakers, professionals and laypeople and comprises educational material such as illustrated short stories, videos and scientific text designed for different target groups. A mixed methods evaluation of the tool was conducted in Mbeya, Tanzania, with veterinarians, meat inspectors, agricultural extension workers and students, medical officers, health officers and assistant medical officers and students. This showed substantial increases in knowledge and a general acceptability of the medium.
Figure 1. A postcard flyer that was done to promote The Vicious Worm
Also finalized in the second period has been a promotional leaflet describing the ADVANZ material and the Pan/African platform. The leaflet has been added in Appendix 10.
During the course of the second period Prof. Samson Mukaratirwa, Dr. Christopher Saarnak and Prof. Maria Vang Johansen have participated in several meetings and conferences to promote the platform. Among others:
5. The ECOHESA symposium in South Africa in March 2014 presenting Control of neglected zoonotic diseases using one health and ecohealth approaches / introducing the ADVANZ Pan-African platform
6. The NZD4 in Geneva, Switzerland
7. The third One Health congress in Amsterdam, the Netherlands, March 2015
As part of WP1, a paper in the Odenstepoort Journal of Veterinary Research has been published:
SAARNAK, C., JOHANSEN, M., MUKARATIRWA, S.
ADVANZ: Establishing a Pan-African platform for neglected zoonotic disease control through a One Health approach. Onderstepoort J Vet Res, North America, 81, apr. 2014.
Available at: http://www.ojvr.org/index.php/ojvr/article/view/740/1075
WP2. Meta-analysis, database and identification of gaps in existing advocacy
Deliverables
D2.1 Month 12, Comprehensive database of existing information and advocacy materials and gap analysis and recommendations for further development documented in report.
WP2 was finalised during the first project period and the deliverable uploaded to ECAS.
According to the Document of Work of ADVANZ, work package 2 was to be implemented in year 1. The general objective of WP2 was to conduct a meta-analysis and compile a database of existing advocacy and information materials related to neglected zoonoses. Particular attention would be paid to evidence of successful and profitable intersectoral collaboration between the medical and the veterinary professions to control neglected zoonoses in low resource societies. Specific objectives included the mapping of information gaps, the identification of intersectoral collaboration examples, their description and a critical analysis of the reasons for success. Examples of zoonoses affecting humans, livestock and wildlife were to be used, in different epidemiological, ecological or animal husbandry contexts. Ecological, technical, economic, political and socio-anthropological determinants were to be considered to formulate messages for improved control of neglected zoonoses in low-resource societies.
A concept note and a work plan for the implementation of WP2 were presented at the ADVANZ kick-off meeting on 30 October 2012 in Copenhagen. They were further refined in a workshop in London in April 2013 with the project coordinators and representatives of other work packages. The themes were distributed to the different partners involved in WP2 as follows: dog associated zoonoses (rabies, leishmaniosis and echinococcosis) for ITM, ruminant associated zoonoses (bovine tuberculosis, brucellosis and anthrax) for Swiss TPH, trypanosomosis for UEDIN and cysticercosis for UCPH.
Ruminant associated zoonoses
ITM produced synoptic reviews of the epidemiology and impact of each of the dog associated neglected zoonoses in low resource societies and identified the key extension messages for each of them and for improved dog management. Each source was briefly commented about its quality, its target (communities, professionals and/or decision makers) and its relevance for the purpose of ADVANZ. The table below summarizes the number of websites and documents reviewed for each disease and for dog management.
Rabies Leishmaniosis Echinococcosis Dog Management
Factual information (Wikipedia, OIE, WHO, OIE…) 13 websites 6 websites 6 websites
Education and advocacy material (videos, articles in newspapers…) 29 websites 31 websites 23 websites 2 websites
Others (posters, leaflets, booklets…) 15 documents 4 documents 4 documents
While there is a lot of informational material available on rabies, the number and the quality of material on leishmaniosis and echinococcosis are relatively low. Most of the material is available in English. Part of it is in French or Spanish (mostly for leishmaniosis) and, sometimes, in vernacular languages.
Bacterial zoonoses
With regard to the bovine associated zoonoses, the FAO manual on meat inspection for developing countries provides useful illustrated information on anthrax, bovine tuberculosis and brucellosis. However, the online manual is rather old without high quality photos. Access to internet resources for anthrax is Africa is complicated due to the domination of sites on anthrax as biological warfare and potential use in bioterrorism. The few useful sites are hardly found without prior knowledge on possible sites and organisations providing appropriate information. We only found one booklet that presents educational material for anthrax showing for example the important vaccination of cattle. An MSc thesis done in the framework of FP7 ICONZ programme shows on a map the under-reporting of anthrax outbreaks in Mali and this map is made available for the ADVANZ programme. There are more internet resources for brucellosis and bovine tuberculosis, although educational material is mainly for UK farmers. Partners make available messages and pictograms developed within research programs in Africa. Sites for bovine tuberculosis are in English, because there are more bovine tuberculosis projects in East than in West Africa. For brucellosis there is also information in French and Arabic as well as a video on brucellosis from Egypt. The open source literature and information sites on bovine tuberculosis in Africa reveals that that the proportion of human tuberculosis due to M. bovis is lower than was generally thought two decades ago, but causes considerable losses especially to peri-urban dairy production. As to brucellosis in Africa and particularly West Africa, the human health and livestock production impact of brucellosis are only now being better evaluated in multidisciplinary research programmes that also aim at understanding viable control options in Africa. The main knowledge gap is if and how brucellosis vaccine can be administered at the same time with other vaccines, for example anthrax. International organizations have requested such studies a long time ago – but have not yet been done which reflects the neglected nature of this zoonosis.
WP3. Information material to raise awareness of and promote control of Neglected Zoonoses in a One-Health context
Deliverables
D3.1 Month 30, New advocacy and information material created for selected examples of neglected zoonoses themes as part of the One-Health concept including texts, audio material and videos, and aimed at decision makers, the media, veterinary and public health workers, domestic animal keepers and the communities where they live.
D3.1 was ready for the NZD4 meeting in Geneva. A description of the output has been uploaded to ECAS.
Objective 3.1 To create advocacy and information material for NZD including texts, audio material and videos, and aimed at decision makers, the media, veterinary and public health workers, domestic animal keepers and the communities where they live.
Avia-GIS was in charge of WP3: Information material to raise awareness of and promote control of Neglected Zoonoses in a One-Health context.
The overall objective of this work package was to provide clear and easily accessible advocacy and information materials to promote the control of neglected zoonoses. Although these roles clearly overlap, we define advocacy as aiming to change attitudes and information as aiming to change practices.
During this first part of the project Avia-GIS was actively involved in the process of defining how ADVANZ will achieve its objectives in practice and how WP1 and WP2 will develop and provide material for WP3.
In parallel discussions have been conducted with the Avia-GIS IT staff about the design of the ADVANZ advocacy web-page and app which includes a clickable village and an ADVANZ available existing advocacy material database. This included browsing the Internet to find available advocacy materials.
Four permanent staff members of Avia-GIS contributed to this work:
• Guy Hendrickx: senior spatial epidemiologist and information system specialist, in charge of overall project coordination and follow-up.
• Alexandra Shaw: senior livestock economist and one-health specialist, in charge of project implementation.
• Els Ducheyne: senior spatial analyst, in charge of designing the ADVANZ clickable village and information system.
• Bart de Groot: senior IT specialist, in charge of developing the ADVANZ clickable village and information system.
Artist input
Joseph Kariuki, a Kenyan artist was recruited to make the drawings needed for the website and the mobile application.
• Pastoralist homestead scene. In this setting most of people’s income comes from livestock. The main animal species kept are cattle, sheep and goats, with some dogs also present. The scene refers to an East African pastoralist setting, but is NOT very clearly and exclusively Maasai, but a bit more generally applicable.
• Morocco, Tunisia, Mali, Niger, northern Burkina Faso, Northern Nigeria: ‘Maghreb and Sahel’ scene, where people are predominantly Muslim and keep cattle, sheep and dogs, but no pigs.
• Mixed farming village scene. In this type of village most of people’s income comes from crops. The scene refers to a humid, central African type setting. But they also keep some cattle and draft oxen in addition to sheep, goats, pigs and chickens.
The information can be accessed through the ADVANZ website at advocacy.advanz.org. In appendix XXX a promotional leaflet demonstrating the contents of the ADVANZ material is shown.
WP 4. Neglected Zoonoses 4th International Meeting
Objective 4.1 Undertake overall responsibility for the organisation, programme and promotion of NZD4 meeting scheduled for early 2014
The NZD4 meeting took place on 19th and 20th Nov 2014 at WHO Headquarters and was attended by over 100 participants including representatives from national governments, international organisations, academia, foundations, the private sector and NGOs.
Purpose
From Advocacy to Action aimed to present successful methods for the control of neglected zoonotic diseases (NZDs). Its goal was to mobilize increased advocacy and action by building confidence in policy makers that the approaches outlined for going forwards are the right pathways to take. Invited participants, with the knowledge and insights provided at the meeting, should be able to act as high-level advocates in their home countries, to persuade others into action. Attending policy makers, funders and other stakeholders were expected to engage and benefit from this opportunity for networking in the context of NZD control.
Objectives
• Showcase the success of implemented programmes and track progress since the previous international NZD meetings
• Identify ways in which to achieve the NZD control milestones as specified in the WHO roadmap
• Explore ways in which current control interventions can be extended to include other NZDs
• Increase awareness of NZDs through promotion of health education and communication
• Launch the Pan-African platform for the prevention and control of NZDs
• Influence leaders, in particular key policy makers and donors, to increase their commitment to actions to control NZDs
Outcome
The anticipated outcome of the meeting was that, through the evidence and case studies presented, key policy makers and donors would be motivated to increase their commitment to actions to control these diseases.
A copy of the Concept Note and Background Information can be found on the WHO website at: http://www.who.int/neglected_diseases/zoonoses/fourth_meeting/en/
It is attached as an appendix (Appendix II)
A copy of the programme and attendee list can be found on the ADVANZ website at: http://www.advanz.org/downloads/nzd4-meeting-materials/
Objective 4.2 – Compile a report to guide international organisations, policymakers and One Health advocacy platforms on the issue of neglected zoonoses and the importance of One Health approach in addressing these.
A team of rapporteurs lead by Anna Walker (Okello) of University of Edinburgh, took meticulous notes during both the presentations and discussions at the NZD4 meeting, which were used both for the final discussion session and for writing the report.
An executive summary was produced shortly (a few weeks) after the meeting. This summary can be found on the WHO website at:
http://www.who.int/neglected_diseases/zoonoses/fourth_international_nzd_meeting/en/
The main NZD4 document is a larger report document that will be produced in both PDF and printed formats. The final draft of the report has been written and approved by the organising team and WHO editors. The final report design has been approved by the NZD4 organising committee.
Printed and PDF copies of the report will be ready for distribution at the end of May 2015. This report will be uploaded to the ADVANZ website and printed copies sent to all of the meeting participants. The PDF copies will be widely distributed to international organisations, policy makers and One Health advocacy platforms amongst others.
3.2.3 Project management during the period
WP5. Project management
Deliverables
D5.1 Month 3. Minutes from kick-off meeting
D5.2 Month 15. Minutes from mid-term meeting
D5.3 Month 26. Minutes from 3rd ADVANZ meeting
D5.4 Month 30. Minutes from final meeting
On 29th October 2012 the kick-off meeting for ADVANZ was held in Copenhagen. Participants from all partner institutions were present. The minutes have been uploaded in ‘ECAS’.
A mid-term meeting was held in September 2013. Participants from all partner institutions were present. The minutes have been uploaded in ‘ECAS’.
On 19th November 2014 the 3rd ADVANZ meeting was held in Geneva, Switzerland. Participants from all partner institutions and 3 members of the ADVANZ advisory board, including the head, were present. The minutes have been uploaded in ‘ECAS’.
A final meeting was held in March 2015. Participants from all partner institutions and 2 members of the ADVANZ advisory board, including the head, were present. The minutes have been uploaded in ‘ECAS’.
A separate Work Package (WP5) is dedicated to overall project management. The overall aim of this work package is to design and maintain a management structure and corresponding procedures that support the goals of the project. This work package is led by Project Coordinator Dr. Christopher Saarnak, Department of Parasitology and Aquatic Diseases, University of Copenhagen in collaboration with the Assistant Coordinator Prof. Maria Vang Johansen who works in the same department as Dr. Saarnak. The Coordinator and the EU Office at the University of Copenhagen (namely EU Liaison Officer Karin Norris) have collaborated closely on the implementation of all administrative, legal and financial matters.
In addition to the administrative and financial management, the management of the content of the project (the so-called Coordination Management) is done at three different levels: the Project Committee, The Project Coordinator and the Work Package Leaders. The Project Committee consists of all partners of the ADVANZ project and is the highest governing body of the project.
The project works with an advisory group of external experts. Head of this group is Prof. Paul Gibbs, University of Florida. Also member of the groups are representatives from the so-called Tripartite: WHO, FAO and OIE. The members are: Bernadette Abela-Ridder (WHO), Katinka deBalogh (FAO) and Alex Thiermann (OIE). Both WHO and FAO were present at the mid-term meeting. We have had intermediate formal meetings with Prof. Paul Gibbs in June 2013, September 2013 and February 2014. Furthermore, Paul Gibbs also joined (via skype) a WP2/WP3 planning meeting held in April 2013.
Bernadette-Abela Ridder (WHO) has been active in the planning phase of WP4, the NZD4 meeting. Some 10 Skype meetings were held in 2014, some also with the participation of the other three members of the advisory board.
Project Results:
ADVANZ is expected to have a major impact on the general awareness of the existence, importance and added value of controlling NZD in disease endemic areas. This is expected to enhance interest for NZD both nationally and internationally across all relevant sectors. As a part of the impact chain, the increased awareness is expected to contribute to chances in national policies, and change practices among livestock owners which at the moment favour persistence or even emerging of NZD. ADVANZ’s strategy will be to influence policies directly but also develop the capacity of others for NZD advocacy. By establishing a Pan African OH-NZD network uniting existing single-string NZD promoters, the group of committed advocates will increase substantially and will deliver more holistic and culturally and environmentally acceptable solutions.
Targeting all stakeholders from livestock owners to decision makers, the impact is expected to be reduced prevalence of NZD, increased and improved animal production and welfare which ultimately should improve the livelihood of affected populations. This will meet the objectives of the FP7 work programme by contributing to the reduction of poverty and the Millennium Development Goals.
By using African media groups to produce the advocacy material it is expected that the material will be more culturally appropriate and emphasizing values considered crucial for message uptake. The material will also be developed to target children and young people and be gender sensitive. ADVANZ is primarily targeted Africa but as it seeks to develop a generic model for NZD advocacy it is expected that the model can be extended to Asia and S. America at a later stage.
A successful outcome to ADVANZ will be increased awareness of the burdens and significance of the NZD, but also the possibilities of applying a One Health approach which leads to cost-effective and practical strategies for their prevention and control. In detail, ADVANZ will provide a model for prevention and control of NZD that builds on disease specific knowledge which has been synthesized regarding the added value of One Health paying special attention to cultural and environmental issues. It is anticipated that extension messages developed using modern animation and illustration technologies would allow an efficient transfer of knowledge from the scientific community to the stakeholders.
Complemented by the other NZD projects in the FP7 framework, ADVANZ will pay a major contribution to the delivery of the objectives of the FP7 work programme. The outcome will be the delivery and implementation of clear, culturally acceptable, and cost effective sustainable strategies to optimise the control of NZD. ADVANZ will work in partnership with all stakeholders to ensure that the information is made available in a format which can be utilized by national governments and international decision makers to develop their policies to control the diseases and to securing commitment at the national and international level.
ADVANZ will have a major impact by ensuring full participation of all stakeholders including Government (directors of both livestock and health services), district officials, traditional and religious authorities and representatives of the general population. It will be essential to provide an opportunity for the community to express themselves and for effective dialogue to take place. Consulting stakeholders throughout the project is an interactive process and will result in the achievement of greater understanding of the impact of the NZD.
Engaging with local media will be an essential alley to capture lay people’s attention, as the local media are at any given time mirroring the language, the interest, and the fashion of the local recipients. Examples from sub-Saharan Africa have thus shown that e.g. using local musicians to promote the danger of smoking has a much greater impact than any scientific communication. Knowledge about target groups’ key interest will be drawn from the local SME partners and from the advisory board to be able to target the messages more precisely. Special attention will be paid to the role of women in the society involved as they are very often key players in disease control implementation at a local level. Input from women’s groups will assist in developing the most appropriate information material.
Steps that need to be taken to bring about the impacts mentioned
Control of neglected zoonoses in developing countries has often failed because the proposed strategies were merely transposed from industrialised countries to low-resource societies. Yet, epidemiological, economic and cultural conditions have been rarely taken into account. The epidemiology of neglected zoonoses is indeed very dependent of the farming systems and the conditions in which animals are maintained. Whereas animals in industrialised countries are usually confined and have little contact with the environment, in low resource countries, animals are often roaming and share grazing areas with other animals, including wildlife, exposing them to a much higher risk of disease transmission. On the other hand, in industrialised countries, live animals or animal commodities travel huge distances to meet their market, in low resources countries, animal products are usually consumed in the vicinity of the areas where animals were raised, putting biosecurity concerns in very different perspectives.
In addition, control strategies applied in industrialised countries prove to be very expensive and not always efficient. For instance, bovine tuberculosis continues causing problems in UK, in badgers, despite the massive amount of money invested for its eradication. While Taenia solium was virtually eradicated by the industrialisation of pork production, T. saginata is still prevalent in European cattle, in spite of the generalised use of toilets and very high hygienic standards in the affected countries. If it is evident that low-resource countries will never be able to invest as much as industrialised countries in the control of NZD, it is also clear that controlling these diseases in low-resource societies would even be more complicated and hence more expensive.
Decision makers, stakeholders and the communities do not have the capacity to evaluate the relevance of control strategies and have often been frustrated when failing to control diseases, resulting in a generalised fatigue. ADVANZ proposes to review control strategies and formulate messages that are more likely to have an impact in affected areas.
The impact zoonotic diseases have on human health should be a key parameter to be considered before disease control strategies are developed. Animals in developing countries appear to be much more resistant to pathogens than upgraded breeds and, for instance, bovine tuberculosis, in the absence of control in most of the African continent, does not seem to have an impact as severe as it had in Europe in the 20th century. Yet, in some very specific conditions, bovine tuberculosis may have a very serious impact on human health and justify an intervention. Encouraging the veterinary services to slaughter TB infected animals and promoting milk pasteurisation should only be done in these very specific conditions.
Even if neglected zoonoses have an impact on human health, the communities might not be prepared to change their habits either because they do not perceive the risk (lack of awareness) or because they fail to change their habits. Boiling milk, housing or enclosing animals, using toilets… often appear much more complicated to implement than one thought. ADVANZ will use social scientists to identify ways of changing the communities’ behaviours to an extent that is acceptable to them and that is sufficient to significantly reduce the zoonotic burden.
ADVANZ will not do the dissemination of the informational material and does not have the ambition to translate it in vernacular languages. ADVANZ will rely on the countries’ veterinary, health and extensions services to take ownership of the material and adapt it to their needs for use in local television and radio programmes, newspapers, leaflets, posters, etc. The informational material will be made easy to translate and adapt accordingly. A more objective understanding of zoonotic diseases is expected to induce, among the stakeholders and the communities, the development of creative strategies to improve the control of neglected zoonoses in their respective societies.
How account is taken of other national and international NZD and One Health activities
This project will efficiently and timely complement other FP7 funded activities. The preliminary stages for NZD burden and control, prevalence mapping, risk analysis, providing acceptable, validated and stakeholder endorsed methodologies for gap analysis and control tools are provided by projects like ICONZ and DISCONTOOLS. OH-NEXTGEN will be training the next scientific generation to deal with neglected zoonoses, and ADVANZ will fill the gap by providing advocacy to decision makers, stakeholders and the communities. As such, the whole society spectrum will be covered. The international collaboration in ADVANZ will ultimately lead to significantly more general awareness of NZD and ways to control them throughout the world. To ensure up to date information to be provided, ADVNAZ will work closely with other groups and organisations involved with NZD both in Europe and in the developing ICPCs.
Potential Impact:
advanz.org
theviciousworm.org
ku.dk
List of Websites:
Two reports & brochures produced to promote the ADVANZ output.
Both are in the final report pdf.
Furtermore the project was instrumental in conducting the 4th WHO meeting on NZDs. A final report will be published in June 2015.
