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An Alternative Way Forward is to Control, Not Eradicate TB



 Added by  Sally
 2 Apr 2010, 7:56 PM


In the report by Paul R and David J Torgerson (Ref. 1) the authors argue that, apart from milk pasteurisation, the existing control measures do not make economic sense and are therefore a a clear example of misallocation of public resources. Their report is a vital read for policy makers. They conclude that the UK's current bTB elimination programme is extremely inefficient in terms of public health protection. They suggest too that an economic evaluation of the costs in animal health to the livestock industry, that strips out the costs of the test and cull policy, is required. If there is negative benefit the UK government should seek degregation from EU laws that compel member states to draw up plans for the elimination of bTB. This would enable the UK to abandon attempts to eliminate the disease from the UK cattle herd and to develop alternative measures for animal health protection, eg vaccination.
 
In the Torgerson report they consider the implications of abandoning the existing bTB control programme. The disease would increase in the national herd (which, they point out, is actually happening anyway, despite the costly control attempts of the last few decades). A self funded control programme could continue to exist for some cattle, eg animals used for milk production, or those which will be exported. Disease security on individual farms could be implemented. The test and cull policy would cease as a compulsory test for all cattle and the BCG vaccine could be introduced as an interim measure whilst better vaccines are being developed. Whilst BCG does not offer complete protection, with the correct doses, evidence suggests it can reduce transmission, particularly if given before calves have been exposed to bTB (Ref. 2).
 
Paul and David Torgerson conclude that in the light of the evidence presented in their report, they propose that the continuing bTB programme in the UK is economically unacceptable as a public health intervention. They are concerned regarding the lack of data with regard to the positive economic effects to animal health, given that the main costs are implementation expenditure. Thus, they believe, the most effective way of reducing the economic impact of bTB is to stop the bTB control programme in its present form. They believe that a shift away from prevention in cattle, whilst continuing with the regulation of milk and meat, should provide adequate public health protection at relatively modest costs.
 
Ref. 1 'Public health and bovine tuberculosis: what's all the fuss about?', Nov 2009
Ref. 2 'A Review of M. bovis BCG protection against TB in cattle and other animal species." FM Susan et al, 2003
 
 

BrianF (Guest)
Ref TB in humans I had a year in a sanatorium to cure my bovine TB back in the 1930's. This was from from drinking raw milk from the farm and delivering it too no doubt! I actually had a lot of fun in the sanatorium and I got over the disease with no subsequent problems. I am now a healthy 70 year old. We have become obsessed with disease to the point that we are no longer allowing natural immunity to develop. I was one of very few to develop bTB even though at that time milk was usually drank raw and most milk contained the bacteria that causes bovine TB. Presumably the majority that did not catch TB developed natural immunity to the disease.
 
I also lived (not visited!) in Central Africa for ten years. We had to boil milk all the time to keep safe! Everyone with any sense followed such advice. That was back in the 50's when health was better controlled than now. Some tribes still drink milk and even blood direct from their cattle. Health education is poor. In fact I wonder why South Africa has not even been recognising HIV until very recently. This disease is associated with all forms of TB because of the implications regarding the immune system.
 
Keith (Guest)
How can we realistically expect to do anything other than control bTB? The governments are wasting millions of pounds trying to eradicate this disease. Cattle movements and increased globalisation makes any disease control very difficult. There are thousands of cattle being moved each year, including many being imported from abroad.This is demonstrated in an article in the April 2010 issue of Gwlad (issue 94)(the regular newsletter for farmers sent out by the Welsh Assembly Government - WAG). It was actually about the disease, Bluetongue, which is relatively new to GB and is the latest problem to cause havoc in the farming sector. Of particular significance, however, was the statement by Christianne Glossop, WAG's chief vet; 'During 2009 over 11,000 susceptible [for Bluetongue] animals were brought into Great Britain from continental Europe, mainly from Germany and the Netherlands, some of which came to Wales. It is certainly worth asking whether this movement is really necessary.' So here we have a huge number of animals being moved and a senior public official questioning whether this movement is necessary! But will anything be done about it?
 
Interestingly there is a vaccination for Bluetongue but it is for the BTV8 strain only and an annual boosters is required - so more expense for farmers. No-one knows if or when them other strains will reach the UK but the article says that work is continuing with vaccine manufacturers to produce one to cover the BTV1 strain too - 'in anticipation of the disease situation changing'! Animals that test positive for Bluetongue in Wales may be slaughtered and no compensation is paid to farmers for the loss
 
Sally (Guest)
'Public health and bovine tuberculosis: what's all the fuss about?', Nov 2009, the profiles for the two authors are given below.
 
Professor Paul R Torgerson currently holds the Chair of Veterinary Epidemiology at the University of Zurich, Switzerland. Previously he was a Professor at Ross University, a research associate professor at Zurich University, a lecturer at University College Dublin and a research fellow at Cambridge University. He holds a degree in veterinary medicine and a PhD, both awarded by the University of Cambridge. He is also a diplomat of the European College of Veterinary Public Health and a member of the World Health Organisationís Foodborne Disease Burden Epidemiology Reference Group (FERG - http//www.who.int/foodsafety/foodborne_disease/ferg/en/index3.html). His interest in burden of disease analysis originates from work on zoonoses, which result in significant morbidity on both animal and human populations. He has a specific research interested in developing improved techniques for disease burden analysis in particular the use of stochastic techniques to model uncertain data. He has published over 100 peer reviewed papers and book chapters and many of these are primarily on burden analysis of zoonotic diseases, including methodological papers. He also has a research focus on the transmission of zoonoses including modelling cost effectiveness of disease control intervention. He has been actively involved in zoonotic disease research in many countries. He reviews for many leading scientific journals and is a member of a number of learned societies.
 
Professor David Torgerson is currently Professor and Director of the York Trials Unit, Department of Health Sciences, University of York. He has an MSc in Health Services Research (Hull), a Diploma in Health Economics (Tromso) and a PhD in Public Health Medicine (Aberdeen). ∑Research interests include design and conduct of randomised trials; health economics; osteoporosis; menopause. Methodological interests include: cluster randomised trials; patient preference trials; pragmatic randomised trials.
 
Tim (Guest)
I understand that it is the EU that is insisting member countries implement a bovine TB eradication policy. There are only a few EU countries where there are still problems. In the UK there has always been bTB in certain 'hot spots' and maybe the climate in these areas is ideal for the bacteria to thrive. It does seem odd that the EU is forcing the UK to spend millions of pounds on a dubious eradication programme which is so clearly based on hypothetical risks, when the National Health Service is in dire need of additional funding to provide a better service for those who have genuine need for treatment now.
 
The legislation that governs bovine TB in Europe is set out in the EU Directive 64/432/EEC, COUNCIL DIRECTIVE of 26 June 1964 on animal health problems affecting intra-Community trade in bovine animals and swine which can be seen at
http://eur-lex.europa.eu/smartapi/cgi/sga_doc?smartapi!celexapi!prod!CELEXnumdoc&lg=EN&numdoc=31964L0432&model=guichett
 
and also www.defra.gov.uk/foodfarm/farmanimal/diseases/atoz/tb/abouttb/legis.htm

 

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