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No room for compromise

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IT IS appropriate that Defra should have published a review of progress in implementing the UK's Veterinary Surveillance Strategy in the month that marks the 10th anniversary of the start of the 2001 foot-and-mouth disease outbreak. The FMD outbreak gave added impetus to efforts to develop the strategy, although work had begun before 2001, having been prompted by the emergence of BSE and incidents of food poisoning caused by E coli O157.

After a lengthy consultation process, the surveillance strategy was published in October 2003, with a 10-year implementation plan. It set out five main goals: strengthening collaborations; developing a risk- and impact-based prioritisation process; deriving better value from surveillance information and activities; sharing surveillance information more widely and effectively; and enhancing quality assurance of surveillance outputs.

Given the importance of veterinary surveillance to animal and human health, a progress review would always be relevant. In this instance it is even more so, as it comes at a time of significant cuts in public spending and when, with the development of proposals on responsibility and cost sharing, the basis on which animal health and welfare is paid for in Britain seems set to change.

The review gives a good explanation of why surveillance is so necessary and suggests that, since the strategy was published, good progress has been made. It notes, for example, that collaborative initiatives have ‘plugged gaps’ in previous coverage, resulting in improved surveillance of the equine population and a strategy for surveillance for wildlife. It says that development of the surveillance information management system RADAR (for ‘rapid analysis and detection of animal-related risks’) has resulted in a ‘step change’ in evidence-based policy and decision making. It also draws attention to the development of a disease profile tool that allows animal-related threats to be considered and ranked in the same context, based on a ‘level playing field’ of evidence. Such developments, it says, have led to notable improvements in the efficiency and effectiveness of surveillance, and at less cost than originally envisaged.

So far, so good – but what of the future? The review notes that there has been increasing pressure on government funding available for veterinary surveillance and that this pressure is likely to intensify. This, it says, will inevitably impact on the way surveillance is delivered and may also result in compromises having to be made. It argues that it is vital that data obtained through surveillance should continue to be representative of the animal population being watched, as compromise here could mean that a disease problem could become widespread before it is detected. However, it seems to suggest that it might be possible to compromise on the sensitivity and quality of surveillance; this, it suggests, would be ‘unlikely to have such a devastating outcome’ as compromising on representativeness, albeit that there will be a risk that new disease events are likely to take longer to detect.

The wisdom of doing this is questionable, and not just because it runs counter to one of the original goals of the strategy. Important decisions may have to be made on the basis of analysis of surveillance data, and the results of analyses, and the quality of the decisions that are made, will ultimately depend on the quality of the original data. Those making the decisions may not necessarily be familiar with some of the uncertainties associated with epidemiological analysis but, as discussed by Mark Woolhouse in an article on p 156 of this issue, it is important that they are. Experience suggests that compromising on surveillance is not a good idea.

Discussing priorities, the review notes that a vital purpose of veterinary surveillance will continue to be to detect new and emerging diseases. This relies on scanning surveillance, which to a large extent depends on the Veterinary Laboratories Agency's network of regional laboratories, with input from practitioners. In this respect, news of an ‘inevitable reduction’ in the number of VLA regional laboratories (VR, February 5, 2011, vol 168, p 117) is profoundly worrying, not least because, without appropriate local input, it is difficult to see how the representativeness of surveillance can be maintained.

It is always important to assess and refine existing arrangements because, as the review points out, priorities can change. However, there is nothing in the review to suggest that the Government should cut back on surveillance. If anything, it presents some pretty good reasons for doing more.

A review of the implementation of the Veterinary Surveillance Strategy (VSS). Defra, February 2011. Available at www.defra.gov.uk/foodfarm/farmanimal/diseases/vetsurveillance/index.htm

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