New Zealand Joint Inter-agency Zoonotic Disease Research Programme

1. New Zealand Inter-agency Zoonotic Disease Research Programme 2000-2007 Development of a conceptual policy framework of a national significance Presentation at New Zealand School of Business and Government 28 June 2011 Wellington Dr.Alexander Kouzminov* *Initiator of Joint Inter-agency Zoonotic Disease Research Coordination Programme in New Zealand, Member and Secretary of Enteric Zoonotic Disease Research Coordination Steering Committee *Formerly Senior Advisor (Environmental Health), Ministry of Health

2. What do we know about zoonotic disease? The most significant microorganisms involved are Campylobacter, Salmonella, Giardia, Cryptosporidium, some strains of E. coli, Listeria monocytogenes, Salmonella enterica, Staphylococcus aureus and Taxoplasma gondii • Zoonotic disease may be caused by other infectious agents, including viruses - some emerging zoonotic viral diseases include SARS, Ebola, Marburg, West Nile, Ross River, avian influenza, Nipah, etc. • 2

3. Major difficulties with study, surveillance & control of zoonotic diseases ● They are both environmental and human health problem ● Disease organisms are transmitted between different environmental reservoirs and by a number of carriers food processing [food industry] food distribution [retail] X-con X-con food preparation [home/cater/service] food preparation consumption consumption Animal Population Human Population excreta excreta sewage treatment recreation aquatic environments untreated drinking water treated 3 drinking-water

4. Reported rates of zoonotic diseases in New Zealand, 1999-2002, per 100,000 per annum (ESR, 2001; WHO, 2004) Predominant disease 1999 2000 2001 2002 Campylobacteriosis 226 233 272 334 Salmonellosis 57 50 65 50 Giardiasis 50 47 43 41 Cryptosporidiosis 27 21 32 26 Leptospirosis 1.6 2.8 2.8 3.8 VTEC/STEC 1.8 1.9 2.9 2.0 Legionellosis 1.9 1.9 1.2 1.4 Potentially water-borne, % campylobacteriosis 60 63 63 71 All sources, % campylobacteriosis 45 42 50 58 All sources, % potentially water-borne 76 66 79 82 4

5. Campylobacteriosis in New Zealand is markedly greater than in comparable countries of similar socio-economic status Human registered campylobacteriosis, cases per 100,000 (WHO, 2004) Ration of notified vs unreported cases ~1:7.5, crude estimation based on UK study 400 ~ 25-fold increase in New Zealand since 1980 200 1980 1990 2000 NZ USA Australia excl NSW Iceland UK&Wales 5

6. SITUATION and TASK The background: Status at early 2000 Socio-economic impacts New Zealand has the highest level of the gastro-enteric (zoonotic) disease within OECD countries (WHO/FAO, 2002) Number of cases was increasing annually, and zoonotic disease was becoming a very important health and agricultural problem in New Zealand with an economic impact ~$0.5 billion per year Disease constitutes ~80% of the total notified illnesses in NZ (Scott W.G. et al., 2000) Research problems and gaps in strategic policy-development The major difficulty in dealing with zoonotic disease is that the disease is simultaneously an environmental, health, and agricultural problem The issue cuts across responsibilities of several government agencies. Control of zoonotic disease requires input from a wide range of organisations: central, regional and local government, agricultural and food industries, and research community 6

7. SITUATION and TASK, cont The background: Status at early 2000 The coordination problems Studies of disease had suffered from lack of traction, a facilitator, and a strategic focus There was no integrated multi-disciplinary research and policy-development portfolio responsibility The coordination of research and policy-development was made even more difficult by the trans-disciplinary nature of the work The cross-portfolio issues and problems There was no national coordination of planning of publicly funded research on zoonoses Different funders did not know what topics the others were funding leading to the potential for ‘double dipping’ There was a competitive rather than a productive environment between research groups Only by building collective understanding of the disease transmission process, we will be able to effectively and efficiency intervene the epidemic. 7

8. ACTIONS and RESULTS Actions in development of and sustaining a conceptual framework A consensus was achieved and future action proposed on the development of a strategic research portfolio – a programme to improve cross-sectoral study of zoonotic disease Dr Alexander Kouzminov organised and conducted a national meeting to try to foster better coordination of the funding efforts of the disease research in New Zealand, 2000 Selected participants - about 50 participants and potential partners attended: representatives from 5 central governments, 3 funding agencies, 20 Territorial Local Authorities (TLAs), primary industry, Crown Research Institutes (CRIs), and leading universities As a result of Dr Kouzminov’s initiative a Joint Inter-agency Enteric Zoonotic Disease Research Coordination Programme in New Zealand had been launched, May 2000 3 working groups were set up to facilitate a nationally coordinated approach to NZ’s research on disease: Steering Committee – to encourage and promote the funding and delivery of research Methodology and Risk Management Groups – operational / technical support 8

9. ACTIONS and RESULTS, cont Consultations and achieved consensus Initial research, memorandums, discussion documents, proposals for the development and coordination of zoonotic disease research in New Zealand ● Recommendations for the Ministry of Health senior executive team and other interested parties: Ministries – Health, Environment (MfE), Agriculture & Forestry (MAF), Conservation, Food Safety Authority (NZFSA), Local Government, TLAs Funders – Foundation for Research, Science & Technology (FRST), Ministry of Research, Science & Technology (MoRST), Health Research Council (HRC); Industry – Meat, Poultry Industry Assoc., Meat & Wool, Fonterra, Federated Farmers CRIs & Universities – ESR, NIWA, AgResearch, University of Auckland, Otago, Canterbury and Massey universities ● Documents outlined aim, strategy and objectives for the Programme ● Documents were extensively discussed by government agencies, industry, research ● Analysed feedbacks and proposed further actions, work and strategy ● Prepared project specification proposals for the Joint Programme ● 9

10. ACTIONS and RESULTS, cont Coordination, development research & policy frameworks, funding integration work Established effective communication with national & international partners ~50: National: 6 ministries, 4 funding agencies, local government, 21 TLAs, 5 primary industries, 5 CRIs, 3 universities, and 7 research groups International: 5 research groups and industries in USA, Canada, Iceland, Australia Attracted and secured funds for the Programme and specific projects (~$0.8mln) Funders: Ministry of Health, MAF, NZFSA, Fonterra, Well. Regional Council, Otago U. Explored a possibility of the joint collaborative investigations between groups in the northern (Iceland) and southern (NZ) hemispheres on enteric zoonoses Organised effective discussions with 3 funding agencies (FRST, MoRST, HRC): FRST included the Progarmme’s objectives, research and policy-development priorities in its New Zealand Strategic Environmental Health Research Portfolio (FRST funded) MoRST’s grant ($0.7mln), 2007-10) for a strategic inter-agency policy development programme for environmentally high-at-risk waters and land Progarmme’s Strategic Research Portfolio (a ranked list of research needs and priorities) over 5 years was developed FRST have used this Portfolio to fund a number of the science providers with endorsement of the Programme’s Steering Committee 10

11. ACTIONS and RESULTS, cont Coordination, development research & policy frameworks, funding integration work The issue has been brought to the attention of the Royal Society of New Zealand, Marsden Fund Committee, the Parliamentary Commissioner for the Environment, Local Government NZ, other government agencies (~10), and some NGOs (~10) 2-3 annual meetings of the Steering Committee Steering Committee had a dialogue with Department of labour (OS&H), Accident Compensation Corporation, Federated Farmers of NZ, Meat & Wool NZ, and worked closely with NZ Microbiological Society, NZ Water & Wastes Association, and other organisations 3 national meetings and 5 workshops were organised where the Programme’s progress reports and on-going achievements were presented Regularly distributed up-dated info of the Programme’s current work, reports and other documents to participants – mainly at CEOs, Ministers, and senior executives’ level Published the Programme’s objectives, priorities, on-going work and achievements in 15 research publications – both nationally and internationally, incl. e.g. UNESCO/WHO The Programme’s achievements were presented at 5 national / international conferences Organised sponsorship from the Progarmme’s budget and encouraged contributors and research providers to present their research results both nationally and internationally 11

12. OUTCOME Programme’s main objectives, targets and strategies have been incorporated into the current work, plans and/or funding portfolios of many partners Participants have started to apply knowledge gained from the Programme They have started to actively use the technical / managerial tools and mechanisms developed to reduce the disease A concerted effort over these years has seen disease care rates fall dramatically to less than half the rates reported in early 2000 (NZVet Space, Feb 2010). 12