Emergency livestock and human health response to control the outbreak of Rift Valley fever in Madagascar

Project research:Emergency livestock and human health response to control the outbreak of Rift Valley fever in Madagascar

1. What was the project (title)?

• Emergency livestock and human health response to control the outbreak of Rift Valley fever in Madagascar

1. Which County, country, sub-region, region

• Madagascar
• Is it In-country, cross border, regional or continental?
• In-country

1. What is a single donor-funded project or multi-donor?

• Single donor

1. Who was/were the funding agency(ies)

• The United Nations Central Emergency Response Fund (CERF).

1. Project Duration in terms of duration of the project and the time frames when the project was implemented

• 25 June 2008 to 24 October 2008.
• Was it an Emergency or long term projects?
• Emergency
• What Emergency was it addressing?
• Zoonosis diseases; Refit valley fever

1. What were the shocks arising from the situation in order of priority?

• Severe disease and deaths both in human and animals.
• Huge economic losses to farmers due to death and abortion of RVF-infected livestock, including oxen.

1. What were the needs which arose from the shocks in order of priority?

• Measures to control the diseases

1. Short Overview, including rationale

• Rift Valley fever is a viral zoonosis (an animal disease affecting humans). Rift Valley fever poses a serious threat to the health and socio-economic well-being of Madagascar’s population, particularly on poor rural farmers who depend on animal traction as part of their livelihoods.This disease also has synergistic effects on people who are already suffering from malaria and other diseases as it leads to overburdening of Madagascar’s health system. Therefore, its outbreak and spread called for immediate intervention. With the support of the UN agencies in the country (FAO, WHO) and advice from experts on a mission to the country, the government of Madagascar developed an Emergency Response Plan to tackle RVf. The global objective of the UN support to Madagascar was to reduce the infection of human and to save lives as well as to reduce the livestock infection/mortality and consequent economic losses due to RVF.
• Project objective(s)
• Coordinate the activities between frontline institutions in charge of animal and humanhealth through the coordination committee and the recently established subcommittee.
• Identify and determine the magnitude of RVF outbreaks through active and passivesurveillance activities, rumor investigations in both livestock and humans andevaluate the risk for the coming months.
• Limit the transmission of the disease by supporting the detection and control ofinfected livestock.
• Protect livestock keepers and the general public through public awareness campaignsand adapted preventive measures.
• Protect individuals facing an occupational risk (butchers, veterinarians, and auxiliary staff) through sound management practices and in-depth awareness-raising initiatives.
• Did the objective address the shocks presented?
• Yes, they did.
• To what extent did the objective address the shock?
• Satisfactory; as they aim to control the disease, resulting in a reduction in economic and social losses due to RVF.

1. Intervention Type (refer to the table provided)

• Pre-emergency: veterinary and animal health support.
• Given the emergency, was the intervention chosen the most appropriate?
• No
• Which other interventions could have been more appropriate when either replaced or bundled with what was implemented?
• Bundling with herd reconstruction and restocking.
• Major Activities or Activity Areas
• Activity 1: Evaluation of the scope of the disease and risk assessment: orientation and training will be given to medical and veterinary staff in affected and high-risk regions.
• Activity 2: Improvement of the capacity to contain RVF in domestic animals: vaccination of animals.
• Activity 3:Reduction of RVF human infections; provide appropriate Personal Protective Equipment (PPE) to personnel who are directly exposed to the RVF virus. For example, in health care centers, and during slaughtering activities.
• Activity 4:Human case management improved:improvement of hospitals and peripheral health facilities to accommodate RVF patients for close clinical observations and treatment.
• Activity 5:Public Awareness on RVF increased: Creation of public awareness through embracing multi-sectorial and multidisciplinary approaches that cover both human and animal health aspects of the RVF outbreak.
• Were the activities chosen addressing the needs?
• Yes, the activities were in line with the needs of the beneficiaries.

1. How was the input measure? And what were the figures?

• To what extent did the activities address the needs?
• Satisfactory, when viewed from the project design.
• Can the activities be continued in the future without the project support?
• Yes, there is enough capacity building proposed by the project activities.
• What were the Expected outcomes and Impacts?
• Outcome 1: Analytical assessment of the extent of the disease and risk it poses.
• Outcome 2: Increase in a diagnostic capacity.
• Outcome 3: Reduction of the infection in livestock.
• Outcome 4: Reduction of human infection.
• Outcome 5: Increased public awareness.
• What were the measurements of the expected outcomes?

Outcome 1:

• Map of the prevalence of the disease in livestock and humans.

Outcome 2:

• Genetic characterization of the RVF virus.
• Identification of competent vectors.

Outcome 3:

• Decrease in the number of mortalities and abortions in livestock.

Outcome 4:

• PPE disseminated and used according to standard infection control precautions.

Outcome 5:

• Correct media messages that give a clear understanding of the risks related to a dressing of carcasses, meat, and milk consumption.
• What were the targets for each outcome(quantify)?
• Slaughterhouse personnel: 353 slaughterhouses in Madagascar with 14120 employees.
• Veterinary staff: 6 882 people work in the animal health sector.
• Livestock owners: 8 731 402 people own ruminants.
• Who were the Partners involved?
• The FAO.
• The WHO.
• The Ministry of Agriculture, Fisheries and Livestock.
• The Ministry of Health and Family Planning.
• Direction of Veterinary Services (DSV).
• What roles did they play in each activity?
• WHO:assisted in the implementation of the activities devoted to the Ministry of Health.
• FAO: assisted in the implementation of the activities devoted to the Ministry of Agriculture and the Veterinary Services.
• DSV and ministries: identified and trainedthe veterinarians who implemented the serological survey in the field, as well as performingmonitoring activities.Inaddition, the DSV provided support for training the meat inspectors and slaughterhousepersonnel.
• To what extent was the roles played integral to the activities success?
• Very important.This collaboration between FAO, WHOand relevant human health helped to ensureappropriate implementation of the animal and human health components.
• What Project Cost (In cash and in-kind)
• US$ 1,086,720
• Can the costs be broken down to activities? this would be a good measure of input
• The final report does not give the final break down of the cost per activity.
• Note: the project budget is attached as appendix 1.
• What were the Actual Project Results (at Outcome and Impact Levels) – quantitative/qualitative

Outcome 1:

• Suspected andconfirmed cases of the disease were reported mostly around Antananarivo, where veterinaryservices have a significant outreach. Only a limited number of cases were reported in remoteareas.
• CERF project provided necessary materials for collecting blood samples.

Outcome 2:

• Twenty-nine veterinarians took blood samples on animals; the team obtained 989 sera from small ruminants and 3 450 from cattle.
• CERF funds enabled the procurement of 500 PPE kits (plastic washable gloves, boots and aprons) and distributed them to 32 districts.The equipment was delivered to slaughterhouses for collectiveuse by beneficiaries.Beneficiary included: 4 000 workers (an average of 40 workers perslaughterhouse from 100 houses) and 40 meat inspectors.

Outcome 3:

• The project supported the training of slaughterhouse personnel and veterinarians.
• 48 meat inspectors in the six regions targeted by the project were trained in meat inspection and protective measures for slaughterhouseactivities; who later trained more than 4 000 slaughterhouse workers in their respective districts.The aim of this training was to improve passive RVF surveillance along with response effortsin the event of potential RVF outbreaks.

Outcome 4:

The following were produced and disseminated to increase awareness amongRVf risk-prone populations:

• 500 guidelines for RVF surveillance and 500 for RVF emergency response plans insupport of veterinarians.

Outcome 5:

• 57267, 3000, and 57 267 leaflets were produced for mayors, local leaders and for butchers and slaughterhouses personnel, respectively.
• Three posters were produced.
• Three short films; and
• One radio message (in six dialects).
• Ministry of Education included RVf in the school programme.

Impact

The delivery of awareness campaigns, the distribution of leaflets to local authorities and training of veterinarians have enabled an appropriate response in the event of a potential RVfoutbreak.

• To what extent do they differ with the targeted outcome and impact levels (qualitatively and quantitatively)?
• On activity 1; the project didn’t achieve its target of analyzing the sera given the protracted timeframe of traininglaboratory technicians and procuring the diagnostic kits. Therefore, it was not possible to quantify the level of immunity in livestock. The final project report does not give feedback on the number of vectors involved in the transmission of RVf.
• What were the Major Challenges (highlight the gaps) to achieving the project outcome and impact in terms of funding, partners, community, natural calamities among other.
• How were they a challenge in terms of quantity, quality,and time of the outcome?
• Success Factors (if applicable, indicate why the project was successful or NOT successful) funding, partners, community
• Collaboration of WHO and FAO ensurethe appropriate implementation of the animal and human health components.
• Relevance (extent to which it served priority needs of target communities)
• The delivery of awareness campaigns, the distribution of leaflets to local authorities, and the training of veterinarians will enable an appropriate response in the event of a potential RVF outbreak.
• The distribution of PPE before the rainy season will safeguard the lives and livelihoods of
• Vulnerable populations in six regions. As the people at the highest risk of contracting RVF areslaughterhouse personnel, this action was essential.
• Effectiveness (comparison of what was to be delivered vs. what was delivered)
• The project is effective, although there is no clear reporting on the exert target and achieved outcome.
• Sustainability indicators (Proxy: Evidence of adoption and scaling-up and -out)
• Training of the local Laboratoire National de Diagnostic Vétérinaire (LNDV) on analysis of collected sera is a positive indicator for continuity of the practices even after the project comes to an end.
• Training of local experts on disease surveillance is a plus to the sustainability of the project practices.
• Efficiency (value for money) – to be quantified separately using above and additional info
• This information can be computed using the project budget and the outcomes, although the monetary valuations of the outcome are not clear.

1. Lessons learnt? In terms of project analysis, design and implementation in every emergency and interventions

• Prioritization of project activities is key strategies to adopt in case there is a reduction in the project budget.
• To increase project success rate, there is a need to adopting a multi-sectoral strategy in the implementation process, where relevant stakeholders and bodies are brought on board.
• Key references (ACTUAL sources of info used)

FAO. (2008)Emergency livestock and human health response to control the outbreak of Rift Valley fever in Madagascar.

Appendix 1 project Budget (CERF component only)