Challenges to the Veterinary

Profession

S. Abdul RahmanExecutive Director and Past President,Commonwealth Veterinary Association

Council Member, World Veterinary Association

Director, Alliance for Rabies Control UK.

Past President, Association for Prevention and Control of Rabies in India (APCRI)

Former, Chairman,OIE Working Group on Animal Welfare

Former Dean, Bangalore Veterinary College, Bangalore

1

Role of Veterinarians

Veterinarians are extremely well placed

to positively influence the future health

and welfare of all animals, including

humans.

Expansion of this role for the

profession is becoming increasingly

urgent as

⚫ the human population expands and

⚫ the earth’s ecology appears to be

veering towards a dangerous

imbalance.

The Context: Globalisation

◆ Unprecedented movements of

commodities and people, used by

pathogens to colonise all the planet

◆ Climate changes and human

behaviour allow colonisation of new

territories by vectors and pathogens

«The 5 Ts »

❖ Trade

❖ Travel

❖ Transport

❖ Tourism

❖ Terrorism

Current Global Scenario

⚫ The world population of 2050 will be roughly nine billion,

but they will eat like twelve billion people would eat

today.

⚫ The human population has more than doubled since

1960.

⚫ Some domestic animal populations however, grew more

rapidly than people did .

⚫ The World chicken population quintupled since 1960,

Current Global Scenario

Consumption Pattern has Changed

⚫ Rural and Urban poor suffer from under nutrition and

malnutrition due to inadequate purchasing power.

⚫ Food habits of the more affluent sections of the

population are fast changing with greater emphasis on

fruits, meat(Chicken in India), vegetables and animal

products.

⚫ Paradox of abundant grain reserves co-existing with

millions of people suffering from hunger.

Growth of Livestock Sector

⚫ Demand drives the growth of the livestock sector.

⚫ The consumption of animal products will be driven by

changes in population size, available family income,

relative food prices, taste and preferences.

⚫ Recent trends in the consumption patterns have shown a

steep upward trend, especially for eggs, meat and milk.

⚫ Animal production is really in the high -growth segment

of the world food system compared to the staple food

sector.

⚫ The desired meat consumption - given today’s

consumption behaviour - will require at least a doubling

of per capita meat supply by 2050

Increase in Global Demand For

Food

•+1 billion people by 2050, with

a shift to middle-class

•Demand for animal protein,

notably milk and eggs will

increase by more than 50%

•Focus on developing /

transition countries

•Production will need to follow

•Impact of diseases on animal

production: at least 20% losses

globally

Global

Asia

0

10

20

30

40

50

60

70

Beef Poultry

Mill

ion

to

nn

es

Projected increase in consumption, 2000-2030

Global

Asia

2000: 580 million tons

2050: 1043 million tons

Estimated growth in global

demand for dairy

Kilos of meat consumed per person per year 40 years ago and today (FAOstat)

Meat and Climate Change

Estimated growth in global

demand for meat

2000: 229 million tons

2050: 465 million tons

Food Waste

▪ Over 100 mill. tonnes of food are wasted annually; estimation for 2020

,food waste is expected to rise to about 126 million tonnes by 2020.

▪ About a third of all food produced globally for human

consumption is lost or wasted - around 1.3 billion tonnes per year

(FAO)

▪ Food loss and waste in industrialized countries are as high as in

developing countries, but their distribution is different:

▪ Developing countries: over 40% of food losses happen after harvest

and during processing,

▪ Industrialized countries: over 40% occurs at retail and consumer level.

⚫ In spite of our agricultural

progress and food safety

programmes we have

nearly as many children,

women and men suffering

from poverty as the entire

population of India in 1947.

⚫ Our agriculture today is

usually reflected to as a

“gamble in the monsoon”.

Present Scenario of India

SUSTAINABLE DEVELOPMENT

GOALS (SDGS)

World Leaders have committed to 17 Goals for people

and planet called the Sustainable Development

Goals (SDGs) or Global Goals.

They did this, setting out to achieve 3 key things:

• End extreme poverty.

• Fight inequality and

• Fight injustice

Sustainable Development

Goals (SDGs)

Challenges to the Veterinary

Profession

Control Animal Diseses -

Zoonosis

Education

Help fight poverty and

hunger

ClimateChange &

Antimicrobial Resistance

IncreaseAnimal

Production

Th

e V

ete

rin

ary

L

ink

ag

es

• Food Safety and Security

• Emerging Zoonotic Diseases

• Antimicrobial Resistance

• Climate Change

• Animal Welfare

New Challenges to the Veterinary Profession

Veterinarians and Food

Safety and Security

⚫ Today consumers are more and

more concerned about issues of

animal welfare and food product

quality.

⚫ Veterinarians have a great

collaborative approach to

address these public health

issues

⚫ Veterinarians play an important

role in ensuring the safety of milk

(especially from antibiotic

resistant Salmonella typhimurium

DT104),

Fauci, NIAID/NIH 2005

Dengue

Dengue

H5N1AI

H5N1 AI

Chikungunya

Dengue

Compounding Factors for

Emerging Zoonotic Disease

⚫ Poaching and bush meat consumption – increasedpotential for ZD “spill over” from natural wildlifereservoirs

⚫ Increased urbanisation = decreased land availability

⚫ “Slash and burn” deforestation is implicated in theemergence of diseases from wildlife populations

⚫ “Pathogens as hitchhikers” (Gibbs, 2005) as a result ofglobalisation and tourism e.g. SARS outbreak 2004

⚫ Animal trading implicated as introducing disease on anumber of occasions

Emerging Zoonotic Diseases

⚫ The risk factors precipitating the occurrence of EZD are

many and are in a state of continuous evolution and agents

relevant to South-East Asia.

⚫ These include Avian Influenza, Rabies, Japanese

Encephalitis, Leptospirosis, Hanta virus, SARS, Nipah

virus, Cysticercosis, Echinococcosis and Schistosomosis.

⚫ In addition, plague and anthrax are also considered

important in India

22

Avian Influenza Overview

⚫Avian influenza (AI) - identified in

the early 1900s

⚫High pathogenic avian influenza

(HPAI) – causes contagious

illness, death in birds significant

increase since 2013

⚫No.of Serotypes:H5N1,H5N2,H5N3,

⚫H5N6,H5N8,H7N2,H7N3,H7N7,H5N9

⚫H5N8 by migratory birds

⚫ Low pathogenic (LPAI) causes

mild to no illness

⚫Vast majority of AI viruses found

in birds do not represent a public

health concern

Bird flu: the Risk to Humans

⚫ It could cross to humans as Spanish flu

did

⚫ Humans have no immunity to this strain

Vaccines cannot be made in advance

⚫ World capacity for vaccine production

low

⚫ Low income countries are most at risk

⚫ Rural community risks contact with

poultry

⚫ Veterinary, medical and essential

services will be overwhelmed

Henipaviruses

⚫ Hendra and Nipah virus are

two henipaviruses known to cause severe disease

in humans with a high case-fatality rate.

⚫ From these bats, virus can be transmitted to an

amplifying host, horses and pigs, and from these

hosts to humans, or

⚫ the virus can be transmitted directly to humans.

Henipavirus distribution

- 0riginally thought to be restricted by Pteropus bat range (shaded area)

Bats serologically positive for henipavirus

Confirmed human henipavirus infection

Hendra Virus

⚫ Emerged in 1994 as a fatal disease of horses and humans in Australia

⚫ 14 spill-over events;

⚫ Deaths of 30 horses and four people since 1994.

⚫ 57% case fatality rate in people

⚫ 40% case fatality rate in horses

⚫ Pteropid fruit bat reservoir hosts.

Nipah virus

• 265 patients with viral encephalitis

• 105 fatalities (c. 40% case fatality

rate)

• > 1 million pigs were culled.

• 800 pig-farms were demolished.

• 36,000 jobs lost

• Over US$450 million economic loss

to Malaysia.

• Pteropid fruit bat reservoir hosts.

NiV Emergence in South

Asia

⚫ Annual outbreaks recognised

in Bangladesh since 2001.

⚫ Two outbreaks also

recognised in India.

⚫ 475 people reported to be

affected, 273 deaths.

⚫ Case fatality rate ranged from

10-100%, mean 57%.

⚫ All outbreaks appear to be due

to direct pteropid bat-to-human

transmission.

⚫ Evidence of direct human-

human transmission.

Collecting date palm sap

Ebola virus epidemics in Gorillas and

Man

Walsh et al. (2003) Nature 422, 611-614

Bermejo et al. (2006) Science 314, 1564

Ebola impact in NW

Congo over past 10

yrs:

gorilla ↓ 95%

chimp ↓ 83%

Rabies

⚫ 3.1 billion people live in 15 countries in Asia that are

endemic for dog rabies

⚫ Rabies kills 55 000 people every year and also has the

highest case-fatality ratio of infectious diseases.

⚫ Approximately 31000 (90% ) occur in Asia

⚫ 99% of deaths occur in Asia where Rabies is endemic in

dog population

Rabies

⚫ The increase in dog population has resulted in

an increased incidence of dog bite cases.

⚫ Dogs continue to be the main source of rabies

infection to man.

⚫ It has been estimated that nearly 96% of

people seeking anti-rabies treatment are

exposed to dogs.

⚫ A rabies survey in India has shown that 50% of

rabies cases were due to pet dogs bites.

Annual Human Mortality Due

To Rabies

⚫ Global Deaths 55000

⚫ Deaths in Asia 31000

⚫ Deaths in SEA 25000

⚫ Deaths in India 20000

Global Outputs – Deaths

URBAN

⚫ India = 1,058

⚫ China = 1,324

⚫ Other Asia = 0,853

⚫ Africa = 5,886

RURAL

⚫ India = 18,201

⚫ China = 01,257

⚫ Other Asia = 08,135

⚫ Africa = 17,937

Urban: 9000:

16%

Rural:

46000: 84%

Rabies

⚫ Rabies is a vaccine preventable disease. The most cost

effective strategy for preventing rabies in people is by

eliminating rabies in dogs through vaccination~ World Health Organization (WHO)

⚫ The control and elimination of rabies in dogs through

vaccination remains the only cost effective way to

sustainably protect humans from contracting the disease.~ World Organisation for Animal Health (OIE)

⚫ Vaccinating dogs against rabies is the key to stopping this

terrifying disease. It protects the dogs from rabies and

creates a barrier between the disease and the people~ Global Alliance for Rabies Control (GARC)

Epidemiological Situation

Of Rabies In India

⚫ No systematic studies on the incidence of

Rabies in Animals in India

⚫ Incidence of Rabies in India is generated from

Annual reports of State Departments of

Veterinary Services to the Dept.of Animal

Husbandry Govt.of India.

⚫ Postmortem records of Depts of Pathology of

Veterinary Colleges.

Epidemiological Situation

Of Rabies In India

• Pet/Owned/Household dog population : 28 million.

• Stray dog population : 25 million

• Annual animal bite incidence rate (per 1000

population) : 17.4.

• Unreported cases much higher out of which only 3

million receive post exposure vaccine

Leaving survival of 14 million victims to luck

• Frequency of bite : 1 bite per 2 seconds.

INCIDENCE OF RABIES IN INDIA (2014)

Disease Name Species Number of

outbreak

Number of

Attack

Number of

Death

Rabies Bovine 90 2153 2153

Canine 70 2588 2588

Ovine/Caprine 60 3226 3226

Buffalo 23 119 119

Total 243 8086 8086

Source: Basic Animal Husbandry & Fisheries Statistics (2015), GOI

….Not a true representative, since rural India (75 %) is invariably

not covered

Mechanism for diagnosis and surveillance of rabies in animals in

India is a need (Courtesy: Dr.Isloor)

44

Why Do People Still Die of

Rabies?

⚫ Lack of awareness on all levels about ⚫ Responsible pet ownership – vaccinating pets

⚫ Need for post-exposure prophylaxis (PEP)

⚫ Primary wound care

⚫ Rabies immunoglobulin (RIG) not available

⚫ Rabies vaccines not available⚫ Greater cost of travel

⚫ Increased risk of rabies onset

⚫ Rabies vaccines are too expensive⚫ Likelihood of giving up

⚫ Delays because of need to raise money

⚫ Control of Dog Reservoir

Slide courtesy of Dr Katie Hampson, University of Glasgow

Stray Dog Issues

⚫ In countries like India a lot

of open eateries are there

around which dog- gathering

is a common problem .

⚫ The lack of community awarenessabout rabies prevention is a major

issue that thwarts efforts

to prevent human death due

to rabies.

Dog Control through Solid

Waste Management

The Need for a One-Health

Approach

⚫ In the fight against rabies, the priority is to safeguard

human welfare but it should not be at the unnecessary

expense of dogs

⚫ One health approach will provide good animal welfare

which will have direct benefit to human health

⚫ To ensure sustainability, dog vaccination programmes

will need political support and will need to integrate

public health, veterinary, livestock and animal welfare

agencies

Animal Welfare

Food Housing

Behaviour Health

1. Food

2. Water3. Comfort

4. To lie and move

5. Microclimate

6. No injuries

7. No painful procedures

8. Hygiene and care

11. Human-animal relationship

10. Species specific behaviours

9. Social contacts

Nutrition Zootechnics

Veterinary care

Farm management

Animal Welfare: Animals, the close relation between their health and welfare

Disaster Management

Disasters and animals

⚫ Floods in UP and Orissa

⚫ Hurricane Nargis inMaynmar and Katrina inUSA

⚫ Earthquake in Nepal,Pakistan

⚫ Drought in Kenya

⚫ Bush fires in Australia

Climate Change

What is likely to happen in the next 100 years➢ Global temperatures will rise by between 1.8 – 4 degrees

C by 2100

➢ Global Sea-level will rise by between 18 – 59 centimetres(some put it at 1.4 metres)

➢ Many low-lying islands esp. atoll islands can disappearwithin two – three generations

➢ Deglaciation of Greenland & west Antarctic ice sheetswill result in sea-level rise of 7 metres and 5 metresrespectively

➢ – Many island countries globally would disappear

*4th Assessment report of the Inter-governmental Panel on Climate Change (IPCC)

Impact on Production

Decrease in milk production

• either transitory or long term

• depending on length and severity of heat stress

Decrease in reproductive performance

• Decreased length and intensity of estrous period

• Decreased conception rate

• Increased risk of early embryonic losses

• Decreased fetal growth and calf size

Technological interventions to

meet the climate change

challenge

1. Genetic Selection of less sensitive breeds

2. Improved Pasture Management

3. Housing management

4. Nutritional Interventions(Methane mitigation ?)

5. Improved Health Services

Antimicrobial Resistance

⚫ Development of antimicrobial resistance is directly

related to antimicrobial usage, especially

inappropriate usage

⚫ Understanding antimicrobial pharmocokinetics/

dynamics and resistance mechanisms can help guide

appropriate usage

⚫ Knowledge of local susceptibility patterns is essential

⚫ Paucity of new antimicrobial agents in pipeline

Antimicrobial Resistance:

A Complex Problem In

Veterinary Medicine

⚫ Companion animals

⚫ Farm animals, including food animals

⚫ Individual patients, herd health, human health

⚫ Antimicrobial agent use without direct veterinary supervision

⚫ Over the counter sales

⚫ Client education

⚫ Pet owners

⚫ Food animal producers

One child every five

minutes dies in S E Asia as

a result of an antibiotic

resistant infection

25000 people die every year in

Europe from antibiotic

resistant infections

Estimated that 23000

people die in the USA

every year from antibiotic

resistant infections

Governmental agencies &

regulatory authorities Research and

academic institutions

International

organizations

AMR laboratories

The private sector

A multidisciplinary

approach involving

A wide range of

partners is needed to

manage AMR

in ASIAN countries.

Conclusion

What Needs to Be Done?

⚫ With the demand for animal protein to feed the nearly 9

billion people out of which 2 million in India, by 2050

there is an urgent need to strengthen the Animal

resources development by implementing various

programmes .

These include:

⚫ Strengthening the veterinary profession by increasing

the number of veterinary institutions

What Needs to Be Done?

The science of animal production must continue to push

at frontiers in:

⚫Animal genetics:

⚫ Design of breeding programs,

⚫ Genotype-environment interaction,

⚫Genomic selection,

⚫Disease resistance and

⚫Support animal welfare - productivity related trade-offs.

What Needs to Be Done?

⚫ Innovative and new technologies are required in

animal production, and communicating the

advantages of innovations to farmers and

consumers must be an integral part of this.

⚫ More cooperation among scientists, media, and

policy makers is needed to make science

communication more effective

⚫ A strategy for the Indian livestock economy serving

food security requires new technology and changing

consumption behaviour.

⚫ A big push to enhance livestock productivity for thecountry’s food and nutrition security is needed now.

⚫ Is the Veterinary Curriculum in Vet Colleges adequate

to educate the new generation of Vets?

⚫ Are the Vet Colleges properly equipped to efficiently

train the Vets?

⚫ Are the Governments providing adequate funding to

meet the above requirements?

⚫ Are the Vets being supervised and tested in their

existing knowledge to meet challenges?

Can the Veterinary Profession

Meet these Challenges

What is needed?

⚫ There is an urgent need to :

⚫ Strengthen the capacities of countries globally

⚫ Create or maintain National Animal Health and

Veterinary Public Health Systems that:

⚫ Can provide for surveillance, Early detection

and Rapid response to outbreaks of aquatic

and terrestrial animal diseases, including

zoonoses,

Conclusion

India with its huge population and problems of poverty,illiteracy, unemployment and social and economicunrest, diversities of culture, religion and language andwith 70 percent of its population living in rural areas,has survived the last six decades post-independencewith sheer grit and determination and has emerged asan Asian superpower with many firsts to its credit.

Conclusion

⚫ If in the industrial sector, it has become a leader in Information technology and software development,

⚫ in the agriculture and livestock sector, it has achieved self-sufficiency, and even surplus, in agricultural grain and crop production and reached the coveted number one position in milk production and 5th highest producer of egg production in the world today.

⚫ It is left to one’s imagination and intelligence that if India could achieve all this distinction burdened with the problems mentioned above, what could happen if poverty and hunger were eliminated and unemployment solved.

⚫ No country in the world would then be able to match its power!!

Conclusion

⚫ Livestock sector is the most important alternative to agriculture and has provided tremendous avenues for income generation and employment.

⚫ To meet the challenges posed by Poverty and Hunger, Emerging Zoonotic Diseases, Climate Change and Antimicrobial Resistance to provide food to India in particular and the Whole Planet in General the entire World is solely dependent upon

VETERINARIANS

Thank You For Your Attention