Annual Report of the Emergency Centre for Transboundary Animal Diseases Tanzania Programme, 2017-2018

The FAO Emergency Centre for Transboundary Animal Diseases (ECTAD) is Food and Agricultural Organization’s (FAO) corporate Centre for the planning and delivery of animal health and production assistance to FAO member countries in responding to threats of transboundary animal diseases and crises. The Centre is also the advisory arm of FAO to the government on animal health matters. The primary objective of the unit is to strengthen government’s veterinary capacity for prevention, early detection and rapid response to emerging infectious diseases (including priority endemic zoonotic diseases (PEZDs) and transboundary animal diseases (TADs)). The ECTAD also contributes to the implementation of the Country Programme Framework (CPF) and the majority of the ECTAD’s activities are aligned with the Global Health Security Agenda (GHSA) and combating antimicrobial resistance. The FAO ECTAD Tanzania is a unit within FAO Tanzania Representation with technical backstopping based in the FAO ECTAD Regional office, Nairobi. The Centre’s Tanzania office was officially established in March 2016. Prior to its creation, ECTAD programmes for East Africa were coordinated at the Regional level from Nairobi. However, with the expanded funding from the United States Agency for International Development (USAID), country-specific programme was rolled out primarily under the FAO “Supporting Global Health Security Agenda (GHSA) to address Zoonotic Diseases and Animal Health in Africa (GHSA-ZDAH)”. This is in response to the scores and findings of the Joint External Evaluation of International Health Regulation core capacities of the United Republic of Tanzania1. The GHSA has recommended the establishment of separate in-country’s ECTAD teams to implement the robust but intense country specific activities in implementing countries. In addition, through a funding from the UK Department of Health, activities to combat antimicrobial resistance in Tanzania are ongoing. In Tanzania, the following programmes and many activities are being implemented: (i) United States Agency for International Development funded Supporting the GHSA to address Zoonotic Diseases and Animal Health in Africa, (ii) UK Department of Health Fleming Fund funded Engaging the food and agriculture sectors in sub-Saharan Africa and South and South-east Asia in the global efforts to combat antimicrobial resistance using a One Health approach (Tanzania component), (iii) Defense Threats Reduction Agency (DTRA)-funded Strengthening epidemio-surveillance capabilities and underlying regulatory frameworks in Eastern Africa (Tanzania component), and (iv) The Norwegian Government – United Nations funded UN Joint Programme for Kigoma with focus on food and economic security through Agriculture (animal production and health component). The FAO ECTAD year plans extend from October to September annually.The thematic areas of focus for FAO ECTAD in Tanzania in the 2017-2018 financial year included the following:

o Strengthening the national epidemio-surveillance capacity to rapidly prevent, detect early and rapidly respond to animal diseases, zoonoses, antimicrobial issues and other public health emergencies,

o Building /strengthening of the veterinary laboratory capacity, o Supporting outbreak investigations and response,o Epidemiological analysis of disease risks and economic impacts to inform decisions,

1 Joint External Evaluation of International Health Regulation core capacities of the United Republic of Tanzania (and Zanzibar). Available at: https://www.who.int/ihr/publications/WHO-WHE-CPI-2017.7/en/ & http://apps.who.int/iris/bitstream/handle/10665/258696/WHO-WHE-CPI-REP-2017.39-eng.pdf?sequence=1&isAllowed=y

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o Strengthening of the epidemiology and laboratory networks nationally and regionally,o Promotion of One Health initiative in the country,o Supporting the development of guidelines, regulatory frameworks and policies necessary for

animal health and production interventions.

Ongoing projects Currently, with funding as mentioned above, ECTAD is implementing the under listed activities:

1. Supporting the GHSA to address Zoonotic Diseases and Animal Health in Africa The Global Health Security Agenda (GHSA) is a growing partnership of over 50 nations, international organizations, and non-governmental stakeholders with the aim to build countries’ capacity to help create a world safe and secure from infectious disease threats and elevate global health security as a national and global priority. The specific objectives of the GHSA-ZDAH program includes: Improve adoption of measured behaviors, policies and/or practices that minimize the transmission of zoonotic diseases from animals into human populations; Strengthen existing surveillance systems for prioritized zoonoses of greatest national concern; Improve the national biosafety and biosecurity system, ensuring that especially dangerous pathogens are identified, held, secured and monitored in a minimal number of facilities according to best practices; Strengthen real-time bio-surveillance and laboratory-based diagnostics; and Contribute to increased availability of skilled and competent health personnel for sustainable and functional public health surveillance and response at all levels of the health system and the effective implementation of the IHR (2005).This GHSA-ZDAH project therefore engages professionals who use multi-disciplinary and multi-sectoral One Health (OH) approach to implement projects aimed at strengthening the country’s capacity. In Tanzania, FAO ECTAD has partnered with identified national and sub-national partners, and utilized the top prioritized zoonotic diseases (Rabies, Anthrax, Rift Valley Fever (RVF) and other Viral Haemorrhagic Fevers (Ebola and Marburg), Zoonotic Avian Influenza, Human African Trypanosomiasis (HAT) and Brucellosis) to deliver the following:

i. Strengthening passive surveillance system by introducing disease reporting system using mobile phone technology (Event Mobile Application (EMA-i)) in 70 districts. To date, 100 mobile phones and 11 desk top computers have been handed over to the Ministry to support data capturing, reporting and analysis through the use of EMA-i. This has enhanced disease reporting with over a 100% increase in numbers of reports received by the Directorate of Veterinary Services.

ii. Technical knowledge and skill of 25 animal health personnel improved in epidemiological analysis; So far more than 200 personnel have benefited from training programmed implemented under the GHSA project since its launch in 2016.

iii. Developed guidelines for surveillance of prioritized zoonotic diseases for human and animal. The national integrated surveillance guidelines provides for increased collaboration and information sharing for the Rabies, Anthrax, Rift Valley Fever (RVF) and other Viral Haemorrhagic Fevers (Ebola and Marburg), Zoonotic Avian Influenza, Human African Trypanosomiasis (HAT) and Brucellosis; Combined, these improvement in knowledge and skills are aimed at capacity enhancement to target PZDs in Tanzania.

iv. Developed national integrated prevention and control plans for anthrax, brucellosis and Human (and Animal) Trypanosomiasis aimed at reducing the burden of anthrax and

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brucellosis and trypanosomiasis in human and animal populations in Tanzania. The documents will be distributed electronically in the human and animal health system nationally;

v. Reviewed the National Pandemic Influenza Emergency Preparedness and Response Plan in Animals with a view to merge with the World Health Organization (WHO) Human Influenza Pandemic Preparedness document

vi. Supported operationalization of Tanzania Animal Surveillance Network (TANSnet) for regular exchange of information and best practices among surveillance and response stakeholders in the country. The second TANSNet meeting held in October 2018 and had in attendance a total of 61 animal health surveillance stakeholders from Ministry of Livestock and Fisheries (4), Ministry of Agriculture Natural Resources Livestock and Fisheries - Zanzibar (1), Tanzania Veterinary Laboratories Agency (10), Zonal Veterinary Centres (8), President’s Office Regional Administration and Local Government Sector Coordination (2), Regional Secretariat (12), District Veterinary/Livestock office (12) Prime Minister’s Office – One Health Coordination Desk (2), Tanzania National Parks (1), Tanzania Veterinary Paraprofessional Association (1) Tanzania Wildlife Research Institute (1), Livestock Training Agency (2) Private Vet Practitioners (3). The Secretariat together with the Directorate of Veterinary Services also publish the TANZANIA ANIMAL HEALTH NEWSLETTER on behalf of the Government of United Republic of Tanzania;

vii. Supported training of OH Rapid Response Teams where 73 health personnel participated. The training strengthened multi-sectoral coordination mechanism at sub-national levels, built capacity to advance OH and facilitated a coordinated approach for prevention, detection, and response of PZDs;

viii. Supported 2 outbreak investigations in the year using multi-sectoral approach. Major support was provided for rabies outbreak in Moshi where 29,885 animals were vaccinated out of an estimated 40,102 animals.

ix. Supported international sample shipment of diagnostic materials (biological samples for suspected rabies (n = 40 pooled saliva samples)) to Onderstepoort Veterinary Research, South Africa. The result will inform risk scoping and mitigation measure in high risk locations within Tanzania;

x. Provided assorted sample collection and outbreak investigation and response materials to the tune of 101,529 USD in order to improve emergency preparedness and response capacities for the country;

xi. Reinforced the Laboratory Information Management System (SILAB-LIMS) through installation or upgrade of SILAB-LIMS in 9 veterinary laboratories. Eighteen (18) laboratory personnel were also trained on its use and application. This has reduced turn round time of sample submission to delivery results from approximately a week (7 days) to between one and two (1-2) days. The system has been linked to Epi Unit to enhance report sharing. To ensure sustainability, two persons were trained in the aspects of troubleshooting of the system’s hardware and software;

xii. Supported the use of online procurement service for primers/probes (RVF and Rabies). The TVLA has benefitted from this services through prompt procurement to enhance rapid disease diagnosis. In addition, diagnostic kits for RVF (10 IgG & 10 IgM ELISA Kits), rabies (10

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ELISA antibody kits) and brucellosis (20 Rose Bengal Slide agglutination test & 15 indirect ELISA kits) were provided to the laboratories;

xiii. Conducted laboratory assessments for government, research, reference laboratories, wildlife private and university laboratories for capacities and biosafety statuses. In addition, an inventory of, all public and private veterinary laboratories handling dangerous pathogens and toxins has been conducted and are being tracked. The outcomes have been shared with relevant national stakeholders to inform policies and implement necessary actions;

xiv. Launched the In-Service Applied Veterinary Epidemiology Training (ISAVET) programme by sponsoring 3 government staff to participate in the pilot training in Uganda. . The trainees (n = 3) are currently undertaking fieldwork in Arusha, Dodoma and Mwanza on selected animal diseases. This activities is foreseen to continue in the year 2019 with the training of more staff and implementation of post-training field activities;

xv. Developed continuous professional development plan for the animal health workforce. The document has been approved by the national government for implementation;

2. Engaging the food and agriculture sectors in sub-Saharan Africa and South and South-east Asia in the global efforts to combat antimicrobial resistance using a One Health approach Antimicrobial resistance (AMR) is a worldwide health threat at the human–animal-environment interface. Overuse and misuse of antimicrobials (AM) in public health, animal health, crop agriculture and the environment sectors can result in the development of AMR. The consequence may include but not limited to ineffectiveness of previously used AM for the successful treatments of infections/diseases in humans and animals. Globally, the estimates of total annual global antibiotic consumption in agriculture vary considerably, however, due to poor surveillance and data collection in many countries, the exact quantity is not known. The experts have put the estimates between 63,000 tonnes and over 240,000 tonnes globally and approximately 50 and 70% of all antibiotics produced are used in animals2. In the United Republic of Tanzania, agriculture contributes approximately 30% of the national GDP and 67% of the total employment figures. Tanzania livestock population ranked the second highest in the African continent. The scenario and burden of antimicrobials usage in human and animal health in Tanzania, although unknown, is expected to be similar to what exist elsewhere in Sub-Saharan Africa. Antimicrobials are used extensively in the treatment of infectious diseases in chickens, cattle and to a lesser extent in pigs, sheep and goats. In addition, emerging commercial aquaculture with eminent antimicrobial usage may further exacerbate resistant microbes’ selection, and antimicrobial metabolites exist in organic fertilizers used for crops (horticulture and cashew production)3. With funding from Fleming fund ECTAD is implementing the Antimicrobial Resistance (AMR) project. This project aimed at supporting the engagement of the food and agriculture sector in the development and implementation of National action plan (NAP) on AMR, with a focus on regulatory platforms, legislation, capacity to collect data on antimicrobial use (AMU), AMR, and antimicrobial residues and improving practices to minimize the need for and use of antimicrobials and transmission of AMR along the food chain. In the period between 2017 and 2018, the following deliverables have been achieved:

2 O'Neill J. Antimicrobials in Agriculture and the environment: Reducing unnecessary use and waste. London: Review on Antimicrobial Resistance. 2015. Available from: https://amr-review.org/sites/default/files/Antimicrobials%20in%20agriculture%20and%20the%20environment%20-%20Reducing%20unnecessary%20use%20and%20waste.pdf. 3 Nonga et al., (2010), Zoonoses Public Health, 57: 339–344; Ngowi et al., (2007), Crop Prot. 26(11): 1617–1624. doi: 10.1016/j.cropro.2007.01.008 & Mdegela et al., (2013). HURIA: Journal of the Open University of Tanzania, 15: 18-33.

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i. Developed a National AMR & AMU surveillance framework in the food, agriculture and environment sectors; the framework provides technical guidance on how to conduct AMR surveillance and monitoring of AMU across the identified sectors.

ii. Raised awareness on AMR to value chain actors and key stakeholders using electronic and print media (radio spot messages, dialogue, newspapers articles, AMR brochure, posters, roll-up, tear drop and backdrop banners) and implemented and engaged in AMR awareness campaign during the World Antibiotic Awareness Week (held from 12-18 th November 2018). Organized and supported panel discussion on AMR during the World Antibiotic Awareness Week (WAAW) campaign using One Health approach at Muhimbili University of Health and Allied Science (MUHAS) in Dar es Salaam. This event attracted a number of local and international media like the BBC (Swahili Service). These activities have sensitized the communities on the burden of AMR in Tanzania and reiterated the Government commitment, its institutions and partners to double efforts in tackling AMR in the country.

iii. Trained and sensitized 42 journalists from 20 media houses and 18 communication officers from sectoral government institutions (Environment Division in the Vice President’s Office (ED-VPO), Ministry of Livestock and Fisheries (MoLF), Ministry of Industry, Trade and Investment (MoITI), Ministry of Health, Community Development, Gender Elderly and Children (MoHCDGEC), Tanzania Food and Drugs Authority (TFDA), Ministry of Agriculture, Natural Resources, Livestock and Fisheries (MoANLF) – Zanzibar and Zanzibar Food and Drugs Authority (ZFDA)) on AMR threats related to food security, safety and nutrition. This activity ensured that correct messaging on AMR communication reach the public for action;

iv. Supported National AMR situational analysis in the food and agriculture sectors. The findings contribute towards increased understanding of AMR threat in the country and development of interventions. Similarly, a review of the regulatory frameworks has been supported and is currently under review. The outcome should assist in identifying existing legal gaps and recommend mechanisms for enforcement to reduce unnecessary usage of antimicrobial and reduce the burden of AMR.

v. Supported the assessment of 2 each of animal and human health laboratory for capacities and functionalities using the FAO Assessment Tool for Laboratories and Antimicrobial resistance Surveillance Systems (FAO ATLASS). Specific capacities to conduct microbiological isolation, identification and antimicrobial susceptibility Testing (AST) and to collect AMR data in the country were assessed. The findings assisted in laboratory categorization and to plan for capacity building.

vi. Delivered training on antimicrobial resistance and susceptibility testing to selected laboratory personnel (n = 16) from 8 laboratories nationally. These laboratories have been supported with AST reagents to conduct surveillance for AMR.

vii. Conducted an anthropological survey on knowledge, attitude and practices of antimicrobial use and antimicrobial resistance along the livestock value chain in the pastoral production systems in Longido and Arumeru districts, northern Tanzania. In addition to this, 8 research assistants (enumerators) from Arusha and Moshi towns, Longido and Monduli districts were trained on qualitative and quantitative methods of data collection in preparations to undertake KAP study, and have collected data. The data is currently being analysed.

viii. Supported the development of Zanzibar National Action Plan on AMR using One Health approach. This activity is on - going.

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ix. Co-supported the formation of Multisectoral Coordinating Committee (MCC) and Technical Working Group (TWG) in Zanzibar on the issues of AMR in partnership with the World Health Organization (WHO). This body will oversee and coordinate all AMR and AMU related issues in Zanzibar.

x. Supported the procurement, availability and delivery of laboratory equipment /items to Zanzibar Central Veterinary facility to enable laboratory personnel to conduct basic microbiological analysis including antimicrobial susceptibility testing (AST) and AMR data collection in Zanzibar.

3. Strengthening epidemio-surveillance capabilities and underlying regulatory frameworks in Eastern Africa Eastern Africa including the greater Horn of Africa (HoA) holds some of the highest concentrations of domestic and wild animals globally. The region has been constrained by major disasters in the recent past that include drought and floods, diseases that affect livestock, insect vectors and other pests driven by climate change, land use changes, urbanization and increased wildlife-livestock- human contacts amongst other reasons. Most of the countries in the region are ill equipped and prepared to respond to disease emergencies. In the animal health sector, the regional situation is worsened by frequent occurrences of many transboundary animal diseases (TADs) endemic in the region. Priority TADs such as African Swine Fever (ASF), Peste des Petits Ruminants (PPR), Avian Influenza, Rift Valley fever (RVF), Contagious Caprine Pleuropneumonia (CCPP), Contagious Bovine Pleuropneumonia (CBPP), Foot and Mouth Disease (FMD), Brucellosis, Anthrax and Rabies are likely to increase in incidence in case preparedness and response is not effective and efficient. The situation is usually exacerbated by other emerging and re-emerging diseases that complicates the situation that is worsened by the poor governance of veterinary services. With funding from DTRA, the FAO ECTAD is implementing the project above. To strengthen the policy frameworks supporting disease surveillance and to enhance national epidemiological and field veterinary preparedness and surveillance capabilities in Ethiopia, Kenya, Tanzania, and Uganda particularly against the transboundary animal diseases not covered by the GHSA project above. The impact of these activities will be to further mitigate the threat posed by pathogens of security concern to East Africa and to improve the rapid and effective detection, diagnosis, and reporting of such pathogens. In Tanzania, FAO ECTAD has worked with the national partners to deliver the following:

i. Developed national Standard Operation Procedure for epidemiological surveillance of priority transboundary animal diseases

ii. Facilitated drafting of Animal Health Surveillance Strategy (validation workshop is set up towards the end of January 2019)

iii. Facilitated drafting of national control strategies for CCPP, Sheep and Goat Pox and ASF(validation workshop is set up for February 2019)The documents will enhance surveillance, disease reporting and control of transboundary animal diseases in the United Republic of Tanzania.

4. UN Joint Programme for Kigoma – Focus on Food and Economic Security through Agriculture

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Kigoma and Kagera regions with estimated human populations of 2,127,930 and 2,458,023 respectively, are some of the poorest regions in Tanzania based on the national household survey in 2012. The estimated poverty prevalence rates of 49% and 39% persist in the two Regions respectively. In addition, the axis faces additional challenges of being the largest receiver of increasing number of refugees, coming from both Burundi and DRC. Furthermore, Kigoma is prone to earthquake and this worsen the living conditions of inhabitants of the region. To improve food and nutritional security in selected vulnerable human populations while creating opportunities for community-level poverty reduction, the animal health/production component of the project is funded by the joint Norwegian Government and the UN to: improve poultry production in Kigoma through targeted distribution of poultry to the vulnerable populations, good husbandry practices and disease interventions; and to enhance food and nutritional security in humans, especially children and the poor, through promotion of consumption of poultry products at home-level and through local sale for income generation in the community. This component is complementary to the crop component that offers a value chain centric approach to address the various bottle necks in the maize, cassava, beans value chains, so as to increase the investment of smallholder farmers, while lowering the risk of the investments and increasing private sector engagement. The project started in December 2018 and the following deliverables have been achieved:

i. Procured Newcastle vaccine (372,000 doses) and associated cold chain facilities (3 fridges and 90 cool boxes to be distributed to Kibondo, Kasulu and Kakonko districts.

ii. Revised Training Manual on Newcastle Disease Vaccination for Field Staff, Newcastle Disease Vaccination Toolkit for community vaccinators and Fact Sheet for selected TADs to enhance disease recognition by extension officers

The expected outcomes include improved poultry production, enhanced income generation, and enhance food and nutritional security in humans in the selected districts.

How do we work?FAO ECTAD works in very close collaboration with the government and people of the United Republic of Tanzania to deliver on its mandate. Specifically, we liaise with the following national partners: Ministry of Livestock and Fisheries (MoLF) of the United Republic of Tanzania, the Ministry of Agriculture, Natural Resources, Livestock and Fisheries of the Revolutionary Government of Zanzibar (MANRLF), the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC), the Ministry of Natural Resources and Tourism of the United Republic of Tanzania (MoNRT), the One Health Coordination Desk at the Prime Minister’s Office (OHCD-PMO) and the President’s Office Regional Administration for Local Government (PO-RALG). Others include the Universities (SUA, CUHAS, MUHAS, NM-AIST), the research institutes and other educational institutions. Key non-governmental development partners including the WHO, CDC, OIE, DTRA, USAID, P&R, OHCEA (OHW) and PREDICT-2.

Main achievements/ milestones1. Emergency response to rabies in Moshi

No single incidence of rabies has been reported from May 2018 to date as compared with an average of 14 cases per month for the period January 2017 to April 2018. This is due to a multisectoral team (>70) and One Health students (50) implementing a mass dog vaccination and public awareness mission in Moshi district in Kilimanjaro region from 30 April–4 May 2018.

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To-date more than 29 000 animals have been vaccinated, a significant increase in vaccination coverage recorded compared to previous record of 4781 vaccinations per annum in Moshi.This achievement received wide media coverage including:- The Guardian: Rabies claims 1 500 Tanzanians every year (4 May 2018)https://www.ippmedia.com/en/news/rabies-claims-1500-tanzanians-every-year - The Citizen: Efforts to kick rabies out of Kilimanjaro underway (2 May 2018)http://www.thecitizen.co.tz/News/Efforts-to-kick-rabies-out-of-Kimanjaro-underway/1840340-4540286-fkf7r0z/index.html - Daily News: Dar gears up to produce own livestock vaccine next year (1 May 2018)https://www.dailynews.co.tz/index.php/home-news/57591-dar-gears-up-to-produce-own-livestock-vaccines-next-year

2. Multi sectoral zoonotic guidelines for surveillance for PZDs for human and animal health

The strategy was approved by the Prime minister’s office and Ministry of Health Community Development Gender Elderly and Children to enhance timely detection and reporting of outbreaks.

3. Laboratory information management improved The use of SILAB laboratory information management system in TVLA laboratories has significantly contributed to reducing turn-around time of sample submission to result delivery from seven to one-two days. It also improved the accuracy and reliability of sample data capture, management, traceability of each test sample, quality of test reports and transmission of the test results to the customer in a timely and efficient manner. FAO installed SILAB in nine veterinary laboratories including training of 18 laboratory personnel. SILAB has enabled the linkage of zonal laboratories to the national system. Eight zonal laboratories, the TVLA central laboratory and Zanzibar veterinary laboratory have been connected.

4. Epidemiological information shared in real time across 70 districtsThe use of EMA-i created interconnectedness of epidemiological information sharing among contiguous districts, regions and national government. EMA-i also allowed rapid evaluation of epidemiological information that aid prompt districts interventions. Beside data collection and transmission, EMA-i includes the “near-me” and “reporting analysis” functionality, which allowed users to be aware of events occurring in the neighbourhood and to create useful epidemiological reports which can be shared in real-time for prompt decision making. This has enhanced disease reporting with over a 100% increase in numbers of reports received by the Directorate of Veterinary Services.

5. National AMR & AMU surveillance framework in the food, agriculture and environment sectorsThrough FAO financial and technical support, National AMR & AMU surveillance framework in the food, agriculture and environment sectors was developed and endorsed by government respective ministries. The Framework provides technical guidance on how to conduct AMR surveillance and monitoring of AMU across the identified sectors.

Opportunities for partnerships and collaborations

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ECTAD Tanzania proposed to or have had engagement with the Tanzania International Organization for Migration (IOM), the Heifers International Tanzania, the DFID and a number of new programs supported by USAID.

Resource mobilizationWithin the period in review, the Unit has applied for the following funds and feedbacks are expected:

(1) The OPEC Fund for International Development under the project title: Healthy Animal, Healthy People and Empowerment of Youth/Women (HAPpY). A total of US$ 349,810.00 was applied for and the application was submitted in December 2018.(2) Mott McDonald Funding for Antimicrobial Resistance under the project title: McDonald Funding for Antimicrobial Resistance Tanzania Country Grant. A total of £1,639,720.20 was applied for and the submission was made in August 2018.

In the year 2018-2019, the Unit propose to seek additional funds through Partnerships for Enhanced Engagement in Research (PEER) 2018/2019 Solicitation under USAID.

Photographs

Figure 1: A farmer showing drug containers and explaining to research team on how he uses antimicrobials at his boma during the KAP study conducted in Dec, 2018 in Longido district, Arusha.

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Figure 2: Facilitator guiding a participant on donning and doffing of Personal Protective Equipment (PPE) during One Health Rapid Response Teams in Mwanza, September 2018.

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Figure 3: One of the participant practicing donning and doffing of Personal Protective Equipment (PPE) during One Health Rapid Response Teams in Mwanza, September 2018.

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Figure 4: Panelists and organizers posing for a group photo after participating in AMR panel discussion held on 14th Nov, 2018 at Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam to commemorate the International AMR week. From left Dr Vera Mugittu (Research fellow - University of Edinburgh), Fasina Folorunso (ECTAD Team Lead-FAO), Professor Apolinary Kamuhaga (MUHAS), Dr Leonard Subi (Director of preventive services – MoH), Daudi Basheka (MoH), Rose Shija (WHO),Elizabeth Tayler (WHO), Dr Doreen Mloka(MUHAS) and Professor Mecky Mathee(MUHAS).

Figure 5: Panel discussion on AMR during the World Antibiotic Awareness Week campaign (WAAW) targeting medical students at MUHAS – 14th November, 2018 in Dar es Salaam.

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Figure 6: Dr Khadija Omar from Ministry of Agriculture Natural Resources and Fisheries, Zanzibar (third left) and Asma SaidouniOulebsir (second right) from FAO showing participants migration of surveillance data between EMA-I mobile application and Empress-I web based system during EMA-i Training held in Dodoma from 15th to 20th October 2018.

Figure 7: Director of Veterinary Services - Ministry of Livestock and Fisheries, Dr Martin Ruheta showing one of the mobile phone donated by FAO for animal diseases surveillance using EMA-I application during EMA- i Training in Dodoma alongside Mr. Fasina Folorunso (ECTAD Country Team Lead) and Asma SaidouniOulebsir (FAO EMA-i Technical Expert)

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Figure 8: A queue of dogs presented for vaccination during the 2018 Rabies Campaign in Moshi.

Figure 9: FAO and Muhimbili University of Health and Allied Sciences staff raising awareness on rabies to standard one pupils in one of the primary school in Moshi Rural District, May 2018.

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Figure 10: Representative from CDC Tanzania, One Health Coordination Desk – Prime Minister’s Office, Ministry of Livestock and Fisheries, Tanzania National Parks (TANAPA) and other institutions posing for a group photo after the GHSA partners meeting conducted at FAO Tanzania country office.

Figure 11:Cross-section of the multidisciplinary students from OHCEA who participated in the Rabies Campaign in Moshi

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