ILIAD (International Lookout for Infectious Animal Diseases) was established to transform a concept developed by the FAS animal disease surveillance project into an operational test program. This concept calls for pro-active, in situ surveillance, using appropriate forms of new technology for outbreak reporting, associated diagnostics and clinical activities in remote farming communities and wildlife preserves.
Since 1996, the staff of AHEAD has consulted with an international Advisory Board on ways to implement recommendations on animal disease surveillance made at a 1993 Geneva conference on emerging diseases. Specifically, the question was: "How do we get started in dealing with the possible emergence and re-emergence of animal and zoonotic diseases, and where do we start first?"
The overwhelming response from these distinguished and concerned health officials was that we start in sub-Saharan Africa with an initiative that would complement existing international and national programs, and yet be independent; a program that emphasizes diseases shared by farmed, captive/bred and wild animals, focusing on land and water use intersects; one that mobilizes capabilities that may already exist within the veterinary health, conservation and rural farming communities; and one, very importantly, that addresses actual needs of specific locations where the program would be implemented.
Sub-Saharan Africa is predicted to spawn more emerging and re-emerging animal diseases than most other areas of the world, because of poverty, climate, inadequate veterinary public health programs, land use changes, population growth, and the interplay between wildlife and livestock. This makes it the one region of the world most in need of a surveillance program linked to upgraded and expanded diagnostic and clinical centers if the threats posed by animal disease to food production, export potential, and eco-tourism are to be countered.
The population of the region is projected to reach Chinese proportions in just a few decades, thus increasing strains on food supply. Revenues from wildlife-associated tourism and from captive breeding exports provide almost half the GDP (gross domestic product) for many countries in the region. These revenues are threatened each time there is a major outbreak of infectious disease. Not only can the economies of these countries not absorb the impact of repeated uncontrolled disease outbreaks, or the advent of emerging diseases not recognized early, they cannot grow and take advantage of international trade opportunities.
During an 18-month exploration of the feasibility of such a program in the region - first through a survey of 28 countries, and then through collaboration with leading institutions and individual scientists and program administrators - some imperatives have emerged:
I. Transmission of infectious disease between farmed animals and wildlife, and between both and humans is rampant in developing countries, just as it was in America and Europe in the first half of this century, just as it will continue to be anywhere poverty and farming co-exist and public health infrastructure is absent or inadequate.
In sub-Saharan Africa there are reoccurring endemic diseases that systematically cull thousands, in particular women and children, from the populations - diseases like malaria, cholera and sleeping sickness. Likewise, diseases systematically cull herds and flocks of farmed and wild animals - diseases like anthrax, FMD, bluetongue, rinderpest, Newcastle disease, tuberculosis.. In much of sub-Saharan Africa - indeed, in most regions of the world where resources are limited - and notwithstanding a number of very good international programs, the response is often to pursue a "quick fix", or simply to cordon off the outbreak area and let the disease run its course.
In sub-Saharan Africa, these approaches are grounded in several historical and political realities that have, over time, colluded both to dismantle systems created in the colonial period and to prevent the development of new ones. Civil wars, military dictatorships, dependence upon foreign aid structured in the "donor" rather than the "investor" mode, collapse of markets at the end of the Cold War, lingering colonialism on the part of both native and expatriate populations - all have impacted negatively.
Thus, the first need is to replace old systems that accepted as inevitable the loss of people and animals to disease outbreaks in certain areas with a system of building sustainable, indigenously operated pro-active programs to prevent and control disease within the most needy populations.
II. In recent years, the recognized emergence of new diseases and re-emergence of others have recalled our attention to problems that, out of sight/out of mind in richer parts of the world, have continued to plague the poorer parts.
This recognition was largely the result of a report issued by the US Institute of Medicine (IOM) in 1992 - a clarion "call to arms" on the threat from emerging infectious diseases. Before then, few people outside research laboratories or those affected by the AIDS pandemic were much concerned about "new" and deadly microbes. For the most part, these new scourges were breaking out in places remote and distant from the industrialized world. Even fewer were concerned about the "old" diseases.
The IOM report and a subsequent tide of outbreaks in the "protected" populations of the world changed all that – Lyme disease, hantavirus pulmonary syndrome, cryptosporidiosis, E. coli O157, and the new human form of spongiform encephalopathy (nv-CJD). Indeed, the coincidence of these events and new outbreaks of Ebola and dengue hemorrhagic fever generated within five or fewer years a diversified global industry - a kind of quasi-medical bandwagon creating an unusual fellowship of movie makers, novelists, reporters, politicians, environmentalists, defense analysts, medical researchers, public health administrators and even antimicrobial soap manufacturers.
The animal disease community has also reacted to the popularization of emerging disease threats. The Office International des Epizooties (OIE - the world animal disease organization) and the United Nations Food and Agricultural Organization (FAO) have restyled their traditional disease response mechanisms to include "emerging disease surveillance".
The FAO has created the EMPRES program to focus on transboundary diseases, highly contagious diseases - rinderpest, foot and mouth disease (FMD), peste des petits ruminants (PPR), Rift Valley fever (RVF), lumpy skin disease and contagious bovine pleuropneumonia (CBPP) - that easily move across national boundaries. While these are not new diseases, they are showing up in areas where they have not been seen for many years, and thus come under the IOM definition of "emerging".
With respect to wildlife diseases, the OIE established a committee in 1993. These efforts supplement the OIE's longstanding requirement that member countries report certain diseases in fauna. Much of the information the OIE committee considers comes from researchers attached to environmental and species conservation organizations and the international programs of schools of veterinary medicine. These researchers have contributed significantly to wildlife health but, for the most part with respect to disease surveillance, have pursued short-term field research projects not structured to build capacity in the countries where conducted.
The second need, then, is to establish continuity of interest and operations. It is important that animal disease surveillance programs in the sub-Saharan region be structured from the bottom up with potential for permanency, particularly in remote rural areas that often become the "gaps" in international programs.
III. In general, and except for the international programs, too few resources have been directed toward controlling diseases between wild and farmed animals. Wildlife parks and game reserves typically treat and attempt to control only those diseases that are capable of decimating specie populations, or causing fatalities in humans. On the other side, rural livestock development programs focus on diseases that reduce production and hamper trade. These approaches are not mutually exclusive, but are often implemented as if they were. And they do not typically recognize that there are three forces operating in tandem:
All these forces increase tensions between farmers and wildlife park operators, even as they increase the potential for transmittal of disease. On the park side of the equation, officials propose building new, or improving existing, veterinary units and laboratories to meet the threat of disease coming from farm operations. On the other side, officials propose new programs to protect the animal populations of small farmers. Rarely are these proposals coordinated to operate simultaneously on both sides of the divide. And timely exchange of information between wildlife and livestock veterinarians is the exception, rather than the rule.
The third need, then, is cooperation and coordination.