Showing posts with label rapid diagnosis. Show all posts
Showing posts with label rapid diagnosis. Show all posts

Monday, 12 November 2007

It is about Democracy, dammit

When faced for the second time round with a dreary old "lessons to be learned" government review, can one summon the will to live, let alone pick up a pen?

Last time, a ProMed Moderator remarked tactfully
" the Lessons to be Learned Inquiry, had obviously to manoeuvre within a politically challenged landscape..."
You bet it did; a desert landscape with anxious vultures.
For how long can an Inquiry Chairman, sitting on his branch and appointed as a safe pair of hands, listen to howls of grief and anger about his political masters? Not very long. A quick swoop and the flesh of criticism is reduced to dry bones and dust and quietly forgotten. The sloughing off of reproach reached giddy heights during an interview on the Today Programme, December 18 2001 when the Chief Scientific Advisor to the UK government,David King, blandly announced:
"What I was happy to achieve in the FMD outbreak was showing that science in real time could provide a sound basis for policy advice."
Instead of falling dead on the spot he then went on to tell Jim Naughtie that the portable on-site RT-PCR diagnostic kit offered to the UK by ARS Tetracore in the US -(used successfully in Uruguay in the very same year)
"is based on a very well known technique...that technique has now been proven not to be capable of being validated..."
Not "validated"? For six years these simple to handle portable machines have been used by the US military to save lives and to track and destroy pathogens.

It is very evident that DEFRA's ignorance of virology, of vaccination, of farming and of animals is part of the reason for their institutionalised secrecy: they do not wish to be challenged. As for the Chief Scientific Advisor whose fell hand can be seen behind this year's policy, he may well have expertise in surface chemistry but - as the NFU's Anthony Gibson has said - he has no understanding of what was suffered by farmers who were forced to watch the destruction of entire pedigree herds in their farmyards.
"To him it appears to be a dry statistical exercise, whereas to those involved it was flesh, blood, tears, sweat and heartbreak."
In 2002 the official inquiries, anxious not to whisper criticisms too loudly at those great ones who had made such an unholy, bloody, fiasco of things listed some gentle recommendations. They were the lessons to be learned.

DEFRA did not learn them.

So, yet again, here are the Lessons to be Learned about coping with a foot and mouth outbreak.

1. Don't let virus escape.
It really didn't have to. Animal Disease Research should have been properly funded and the concerns of its experts listened to.
Pirbright's Professor Martin Shirley told the Science and Technology Select Committee earlier this year.
".....flat funding during the past three years for the Reference Laboratories (ie a significant cut in real terms) has meant that key areas of work, including some critical state-of-the art diagnostics, has to be undertaken by PhD students at the very beginning of their research training.....Year on year, we are able to do less science or we are able to employ less people, and this is an area of work that spans from foot and mouth through to bluetongue virus...to other exotic pathogens which pose a threat to the UK. We are forced to look at this whole area of activity to see where we can juggle the research, so there is a risk.... "


2.Vaccines against FMD are excellent. For pity's sake, let us use them.
Vaccination must be more than "considered" - it must be used as quickly as possible.
As for those regulations that cause exporting farmers (the powerful ones) to raise such a howl of agony if vaccination is suggested, is evident that there are many in the EU hierarchy itself who are not in agreement with the three month/six month rule.
The Member States should challenge these daft regulations - particularly now that Bluetongue vaccination is being embraced by one and all. Regulations are not set in stone. In the 2003 Directive, even the EU Directive - in its very first paragraph - says:
".....the Community is also a Community of values, and its policies to combat animal diseases must not be based purely on commercial interests but must also take genuine account of ethical principles."


3. The new technologies of rapid on-site RT-PCR diagnosis must be embraced and used.
They have been used to track and eliminate pathogens by the military in the West for nearly a decade. They are now being routinely used on farms in the former Soviet Bloc. What - apart from commercial jealousy - is stopping their use here?

4. A truly independent Advisory Group needs enough clout to oversee and if necessary intervene

There needs to be true accountability

Parliamentary Questions are all very well. They do, if asked with skill, eventually tease out of the reluctant Ministry some degree of truth about the way things were done - but an institutionalised secrecy pervades DEFRA and it seems that many have just given up trying to demand answers.

Yet such damning questions as the number of healthy animals killed - and why - should indeed be examined beyond the closed walls of Westminster. There was so little need for the suffering that went on.
If Pirbright had the sort of State of the Art equipment as that used in the private sector proper testing could have been done before animals were summarily killed. The Emersons, who lost all their free range animals were blackmailed with the emotive suggestion that their one possibly suspect pig (it was not in fact infected) could become a "virus factory". They reluctantly agreed to slaughter. In fact, they had no choice. Had they resisted, the Animal Health Act would have made their refusal a criminal act. How ironic it is that had they been living in former Soviet Bloc countries such as Uzbechistan, a diagnostic machine the size of a toaster could have discovered within 20 minutes if that pig was really infected or not. As it was, they lost their pets, their breeding cows who all had names, their pigs and sheep. All destroyed - and for no reason. It is criminal waste and cruelty.

5. Hindsight should have given us foresight

Eminent people spent a great deal of time and effort in preparing reports and making recommendations after the 2001 misery. In 2007 it was clear that we FAILED to follow the following:

1. Vaccination must form part of future control of a disease outbreak (Anderson)
2. Create a new national volunteer reserve to help in a disease outbreak(Anderson)
3. Devise new role for veterinary "paramedics" to assist vets in outbreaks(Anderson)
4. New training for farmers and vets in spotting rare diseases and bio-security(Anderson and Royal Society of London)
5. New guidance and instructions on slaughter of animals(Anderson)
6. A "senatorial" group to be set up to provide independent advice to the Prime Minister and Cabinet during a crisis.(Anderson)
7. Accountants and procurement experts to be recruited to work in emergency control centres during a crisis. (Anderson)
8. Emergency vaccination to be used as "a major tool of first resort" to prevent a foot and mouth outbreak becoming an epidemic (Royal Society)
9. The aim is to "vaccinate to live" and for animals to enter the food chain in the normal way. (Royal Society)
10. Tests to distinguish between an infected and vaccinated animals "a priority" ( i.e. for individual animals as well as the already validated herd based tests).
11. A new campaign to win over consumers to safe eating of foot and mouth vaccinated meat and milk. (Royal Society)
12. More research for a foot and mouth vaccine which could possibly be used routinely (ie not just for emergency vaccination) within 15 years - this would require international agreement. (Royal Society)
13. A new early warning system to alert the country to potential threat from new exotic diseases. One option is for a New National Centre for Animal Disease Research and Surveillance. (Royal Society)
14. A new national database of every owner of farm animals including pets, zoos, rare breed collections and animal sanctuaries. (Royal Society)
15. An extra £250 million funding for research and development, particularly to find a new diagnostic test to quickly identify diseased farms. (Royal Society)
16. Encourage new vets to join the state veterinary service(Royal Society)
17. The setting up of an independent standing committee to monitor the maintenance of effective planning (Royal Society of Scotland)



So if we do not pick up our pens and write to the Anderson Review, what then? Politics has been allowed to play hell with the lives of those it should protect. Knowing this, we are as much to blame if we do nothing.

It is inconvenient and a real pain - but Edmund Burke was right: All that is necessary for evil to triumph is for good men to do nothing. The email address for the Anderson Review is fmdreview@cabinet-office.x.gsi.gov.uk

Saturday, 20 October 2007

Counting for something

At the start of our two-day conference, (the combined ELA/EU FMD&CSF Coordination Action meetings held in Brussels on 17th and 18th of October 2007) farmers, vets, stakeholders and scientists, were welcomed to that semi-circle of seats, each with its own headset and microphone that is the Parliament chamber in Brussels.
United in a tentative optimism, we had come together from Holland, Britain, France, Germany, Norway, Switzerland and even the USA to listen and to question. In the UK, an unaccountable Ministry that gives the impression that animals count for nothing and that it is farming families who should bear the brunt both of animal diseases and the arbitrary controls to slap them down and stamp them out, is getting increasingly hard to stomach - but the fact that the MEPs had wanted us to come seemed a very promising start. Lily Jacobs of the Agriculture and Rural Development Committee, opened the afternoon's discussions with some statements that seemed promising too:
"animals must be seen as more than mere animal products"
and that
"vaccination should not affect value"
So optimism seemed at last to be justified. However, as some of us were able to say, emergency FMD vaccination (always so frustratingly "considered") is not going to be acceptable to those who resist it while the EU rules continue to penalise it. Insistence that trade is held up for a further three months, together with the complex meat treatments demanded, is simply not underpinned by the science. There were murmurs of support from behind and around when this was said but, to general dismay, grim shakings of the head by several of those facing us could be seen. The extra three month ban was defended in terms that made no sense at all to the scientists among us.

There are, it seems, persistent carriers of the dogma that FMD infection, stamped out at any cost in blood and unhappiness, is better than FMD elimination by the safe, potent, modern vaccines that can so successfully distinguish diseased from vaccinated animals.

It was a blow - the more so since it doesn't seem credible that this can be anything more than a thin disguise for protectionism. But the harm it causes to farm animals, farming families and to farming itself is incalculable and, as one of the gentle farmers at the conference later told us with such passion, the effects of 2001, let alone this latest misery, are still taking their economic and emotional toll. He said that in 2001, DEFRA had said that lambs had to be starving to qualify for the payments of the welfare cull
"We chose to feed them and ended up almost starving ourselves."

We were cheered by the robust assertion that expecting the farming families to foot the bill when they have no say in policy nor guarantees of efficiency is mere "taxation without representation" and unacceptable. But gloom returned at the news that the "Community Animal Health Policy" document, in its draft form, had actually had many references to "welfare" crossed through by the CVOs themselves. It made some of us very thoughtful.

This is not the place for a detailed report of the rest of the two day meeting. A great deal of ground was covered; there were experts with a refreshing manner and a grasp of their subjects that made listening a pleasure. Topics ranged from the practicalities of vaccine production to the importance of the genetic pool in rare breeds, from the skills on the ground needed in a crisis to the little known habits but boundlessly successful spread of the culicoides midge - and much in between. New friendships were forged, assumptions challenged without rancour, questions raised and answered - and a forum for change in the evolving European Livestock Alliance began to look increasingly possible. The speakers joined together at the front for a final question and answer session, the sun beamed in and everyone expressed warm appreciation towards ELA and the Coordination Action organisers for the hard work that had paid off so handsomely.

Even the disasters were not as bad as they might have been. Two of the most eminent of the party had been stuck in a traffic jam for six hours while the rest of us were in the EU parliament but had safely arrived and were smiling wryly at us on our return to the hotel. British Airways had managed to mislay both Roger Breeze's suitcase and the rapid diagnostic machine that was to have been demonstrated to all. It finally arrived at the Hotel reception area, safe and sound, the day after most delegates had left and very early on the morning of Dr Breeze's own departure. Roused at an ungodly hour to see it in operation after all, I was grateful to the French train strike that meant I too was still at the hotel. I can personally attest that getting a sample into the machine (it looked like a large toaster) is easy and safe. Once inside, the sample is locked irreversibly into its small cassette and can later be disposed of with no danger of cross contamination or leakage. My training took less than five minutes but I could operate such a machine in the field, see the results transmitted by the internet and then dispose of the sealed sample with as much confidence as any enthusiastic young operator in Kazakhstan or Uzbekistan.

Why there? Because, although not yet in sophisticated Europe, a paradigm shift in disease control is taking place. Irony of ironies it is happening in the former Soviet bloc countries. Driven by the need to protect the world from the biological warfare threats of former times, countless dollars and expertise are being poured into Eastern Europe. The Cold War development of pathogens and biological warfare is being sent into reverse there with the result that we are going to see diseases eliminated actually within our own lifetimes - many of those very diseases that are at present merely being swatted at by Europe with its regulations, arbitrary controls, agribusiness interests and absurdly centralised control freakery.


This progress from the East is unstoppable. The overall system that uses such machines will soon be in operation everywhere to pinpoint disease and target it efficiently. It isn't going to be stopped by DEFRA disapproval. It isn't going to be stopped by anything. Like the amazing success of Wikipedia, Google and the Internet itself - the opportunity to claim information without its having been channelled or diverted first will give back to ordinary people a large measure of control over their lives. Will we have long to wait before we see such a transformation happening in our own countries? Rather than years I think we can start counting the months. The impertinence of bureaucratic interference can be consigned to its inevitable obscurity. When technology allows to everyone who needs it access to information, democracy is alive and well - and it seems certain that this particular access to information will soon help ensure that our animals remain so too.
Photos: Moira Linaker

Monday, 8 October 2007

A dry statistical exercise - or flesh, blood, tears, sweat and heartbreak

Oct 8 2007 ~ John Beddington and "the job from hell"
    In January, John Beddington, a professor of applied population biology at Imperial College, and present Chair of the SAC committee, takes over from David King - (now, as is the nature of these things when one has been considered a safe pair of hands by the government, Sir David King.)
    An article in the Guardian today by Tim Radford sounds a warning note:
      "For a hint of what is to come, simply contemplate the procession of horrors, heartaches and howlers that have mugged the world's scientific advisers during the last three decades.."
    ~ but Mr Radford's assumption that because Prof Beddington comes from Imperial College and has been a scientific adviser to DEFRA he must therefore "... already know a bit about foot and mouth, bluetongue virus.." etc does not, unfortunately, follow. We have the example of the be-knighted David King, alas, to prove that it aint necessarily so.


Oct 8 2007 ~ While Professor King may be an international expert in many, many things it is a tragedy for the UK that he has been directing policy on Foot and Mouth ..

    about which he has displayed such distressing ignorance. He has continued to defend both the contiguous cull and the failure to use vaccination in 2001. He even went so far as to say that the on-site rapid portable diagnostic kit turned down in 2001- (it performed extremely well in Uruguay in 2001, similar devices are now used in many countries, and a prototype of a "next generation" device intended for point of need PCR testing across all of animal and plant agriculture and the food industry will be demonstrated in Brussels next week) was "not capable of being validated" (Radio 4 transcript) This small selection of the many warmwell files on the subject of Prof King's bizarre pronouncements from the past 6 years includes a quotation from Jason Groves, London editor of the WMN from 24 January 2005

      "....Government's plans for tackling a future outbreak of foot and mouth disease have been thrown into disarray after the government's Chief Scientist suggested that vaccination was still not a practical option for controlling the disease.
      .... His comments will fuel fears that the Government has done little more than pay lip service to vaccination... appear to directly contradict the official policy of the Department of the Environment, Food and Rural Affairs (Defra), which suggests that it would give early consideration to using vaccination in any future outbreak.."
    The NFU's Anthony Gibson - little dreaming it was all to happen again within 30 months - said that Sir David appeared to have no understanding of farming or what was suffered by farmers who were forced to watch the destruction of entire pedigree herds in their farmyards
      "To him it appears to be a dry statistical exercise, whereas to those involved it was flesh, blood, tears, sweat and heartbreak."
    We can only hope that, in contrast, Professor Beddington can prove himself to be capable of what Tim Radford describes: a "smart scientist with profound knowledge of everything." It is a tall order.


Monday Oct 8 2007 ~"...powerless
to stop it, while pointlessly disrupting the habits and interests of livestock owners by bringing commercial transactions to a standstill"

    It has been said many times that the policy now imposed within the EU against Foot and Mouth turns an outbreak into a national catastrophe - but it is,as Abigail Woods so clearly explained, a manufactured catastrophe following a manufactured plague. Instead of taking full advantage of the miracles of modern veterinary expertise, the understanding of 21st century virology in the creation of excellent vaccines, and state of the art technical ability to give - actually on-site - an almost immediate diagnosis, the EU policy gives preference to the "stamping out"of life - a process that is eradicating decent small livestock farmers too.
    One man sums it up:
      "In rural
      areas where foot and mouth disease holds sway, nothing, at least up to the present day, has
      been able to halt its progress. Suffice it to say
      that, among the regulatory sanitary measures
      applicable to contagious diseases in general, none apart from the obligation to declare the presence of the disease to the authorities, could reasonably be applied to this disease: no matter how benign the measure, it would undoubtedly be excessive, or would be powerless to stop it, while pointlessly disrupting the habits and
      interests of livestock owners by bringing commercial transactions to a
      standstill” (Translated from the french Reynal J. Traite´ de police sanitaire des animaux domestiques. Paris: Asselin; 1873. p. 1012.)
    130 years on and the dinosaur mentality at the top of DEFRA ensures that nothing has changed.