The livestock vaccine supply chain: Why it matters and how it can help eradicate peste des petits Ruminants, based on findings in Karamoja, Uganda

Recapitulation of Peste des Petits Ruminants (PPR) Prevalence in Small Ruminant Populations of Pakistan from 2004 to 2023: A Systematic Review and Meta-Analysis

Peste des petits ruminants (PPR) is an extremely transmissible viral disease caused by the PPR virus that impacts domestic small ruminants, namely sheep and goats. This study aimed to employ a methodical approach to evaluate the regional occurrence of PPR in small ruminants in Pakistan and the contributing factors that influence its prevalence. A thorough search was performed in various databases to identify published research articles between January 2004 and August 2023 on PPR in small ruminants in Pakistan. Articles were chosen based on specific inclusion and exclusion criteria. A total of 25 articles were selected from 1275 studies gathered from different databases. The overall pooled prevalence in Pakistan was calculated to be 51% (95% CI: 42-60), with heterogeneity I2 = 100%, τ2 = 0.0495, and p = 0. The data were summarized based on the division into five regions: Punjab, Baluchistan, KPK, Sindh, and GB and AJK. Among these, the pooled prevalence of PPR in Sindh was 61% (95% CI: 46-75), I2 = 100%, τ2 = 0.0485, and p = 0, while in KPK, it was 44% (95% CI: 26-63), I2 = 99%, τ2 = 0.0506, and p < 0.01. However, the prevalence of PPR in Baluchistan and Punjab was almost the same. Raising awareness, proper surveillance, and application of appropriate quarantine measures interprovincially and across borders must be maintained to contain the disease.

Access to vaccination services for priority ruminant livestock diseases in Ghana: Barriers and determinants of service utilization by farmers

INTRODUCTION

Livestock diseases are a major constraint to agricultural productivity, frequently causing significant livelihood losses for farmers, and negatively affecting public food safety and security. Vaccines provide an effective and profitable means for controlling most infectious livestock diseases, but remain underutilized. This study sought to assess the barriers and determinants of vaccination utilization for priority livestock diseases in Ghana.

METHODS

We conducted a mixed-method study involving a quantitative survey with ruminant livestock farmers (N = 350) and seven focus group discussions (FGD) involving 65 ruminant livestock farmers. The survey data were analyzed, and distribution of barriers to vaccination access described. We evaluated the determinants of vaccination utilization (any use of vaccination against contagious-bovine-pleuropneumonia (CBPP) and peste-des-petits-ruminants (PPR) in 2021) using logistic regression analyses at the 0.05 significance level. FGD transcripts were analyzed deductively. We used triangulation to achieve convergence across the different datasets and analyses.

RESULTS

The farmers kept an average (median) of 5 tropical livestock units (TLUs) of ruminant livestock (IQR=2.6-12.0) that were on average 8 kilometers (IQR=1.9-12.4) away from veterinary officers (VOs). Only 16% (56/350) of herds were vaccinated against the diseases. Most farmers (274/350) had limited knowledge on vaccines against CBPP and PPR infections, 63% (222/350) perceived low risk of these diseases to their herds. About half of farmers reported experiencing outbreaks of either disease in the study year (2021). Farmers scored on average 80.5 out of 98 (IQR=74-85) on the RS-14 resilience scale. After adjusting for farmers' livestock rearing experience, herd size, sex, wealth status, distance to VOs, previous disease outbreaks, and perceived risk of the diseases, vaccination utilization was negatively associated with limited knowledge (aOR=0.19, 95%CI=0.08-0.43), and positively associated with personal exposure to outbreaks in the study year (aOR=5.26, 95%CI=2.01-13.7) and increasing resilience (aOR=1.13, 95%CI=1.07-1.19). FGDs revealed farmer misconceptions about vaccines, costs of vaccines, and timely access to vaccines from VOs as additional barriers.

CONCLUSIONS

Acceptability, affordability, accessibility, and availability of vaccine services represent the main barriers to vaccines utilization by ruminant livestock farmers in Ghana. Given that limited knowledge regarding the value of vaccination and shortfalls in veterinary service supply are of central importance for both the demand and supply side, more collaboration between the different stakeholders in a transdisciplinary manner to effectively address the low vaccination utilization problem is needed.

The Use of Drones to Deliver Rift Valley Fever Vaccines in Rwanda: Perceptions and Recommendations

Given the recent emergence of Rift Valley Fever (RVF) in Rwanda and its profound impact on livelihoods and health, improving RVF prevention and control strategies is crucial. Vaccinating livestock is one of the most sustainable strategies to mitigate the impact of RVF on health and livelihoods. However, vaccine supply chain constraints severely limit the effectiveness of vaccination programs. In the human health sector, unmanned aerial vehicles, i.e., drones, are increasingly used to improve supply chains and last-mile vaccine delivery. We investigated perceptions of whether delivering RVF vaccines by drone in Rwanda might help to overcome logistical constraints in the vaccine supply chain. We conducted semi-structured interviews with stakeholders in the animal health sector and Zipline employees in Nyagatare District in the Eastern Province of Rwanda. We used content analysis to identify key themes. We found that stakeholders in the animal health sector and Zipline employees believe that drones could improve RVF vaccination in Nyagatare. The primary benefits study participants identified included decreased transportation time, improved cold chain maintenance, and cost savings.

Identifying Pathogen and Allele Type Simultaneously in a Single Well Using Droplet Digital PCR

In the transmission control of chronic and untreatable livestock diseases such as bovine leukemia virus (BLV) infection, the removal of viral superspreaders is a fundamental approach. On the other hand, selective breeding of cattle with BLV-resistant capacity is also critical for reducing the viral damage to productivity by keeping infected cattle. To provide a way of measuring BLV proviral load (PVL) and identifying susceptible/resistant cattle simply and rapidly, we developed a fourplex droplet digital PCR method targeting the BLV pol gene, BLV-susceptible bovine major histocompatibility complex (BoLA)-DRB3*016:01 allele, resistant DRB3*009:02 allele, and housekeeping RPP30 gene (IPATS-BLV). IPATS-BLV successfully measured the percentage of BLV-infected cells and determined allele types precisely. Furthermore, it discriminated homozygous from heterozygous carriers. Using this method to determine the impact of carrying these alleles on the BLV PVL, we found DRB3*009:02-carrying cattle could suppress the PVL to a low or undetectable level, even with the presence of a susceptible heterozygous allele. Although the population of DRB3*016:01-carrying cattle showed significantly higher PVLs compared with cattle carrying other alleles, their individual PVLs were highly variable. Because of the simplicity and speed of this single-well assay, our method has the potential of being a suitable platform for the combined diagnosis of pathogen level and host biomarkers in other infectious diseases satisfying the two following characteristics of disease outcomes: (i) pathogen level acts as a critical maker of disease progression; and (ii) impactful disease-related host genetic biomarkers are already identified. IMPORTANCE While pathogen-level quantification is an important diagnostic of disease severity and transmissibility, disease-related host biomarkers are also useful in predicting outcomes in infectious diseases. In this study, we demonstrate that combined proviral load (PVL) and host biomarker diagnostics can be used to detect bovine leukemia virus (BLV) infection, which has a negative economic impact on the cattle industry. We developed a fourplex droplet digital PCR assay for PVL of BLV and susceptible and resistant host genes named IPATS-BLV. IPATS-BLV has inherent merits in measuring PVL and identifying susceptible and resistant cattle with superior simplicity and speed because of a single-well assay. Our new laboratory technique contributes to strengthening risk-based herd management used to control within-herd BLV transmission. Furthermore, this assay design potentially improves the diagnostics of other infectious diseases by combining the pathogen level and disease-related host genetic biomarker to predict disease outcomes.

Breaking institutional barriers to enhance women's participation in and benefit from the Peste des Petits Ruminants and Newcastle Disease vaccine value chains for Sembabule district of Uganda

This paper describes the institutional context that shapes the visibility and positioning of women along the Peste des Petits Ruminants (PPR) and Newcastle Disease (ND) vaccine value chains for Sembabule district of Uganda. It examines the institutional barriers and opportunities that affect women's empowerment derived from inclusion of women in the decision-making processes along the livestock vaccine value chain (LVVC) and that can support viable women-centered and owned enterprises, at the vaccine development, delivery, distribution and use level. Qualitative data analysis tools such as focus group discussions, focus meals, jar voices and key informant interviews were used. Using outcome mapping, a stakeholder analysis of the critical partners in the PPR and ND value chain was done involving the regulators, vaccine manufacturers, importers, distributors, agrovets, public and private veterinary service deliverers, local leaders, women groups, and farmers. The study concluded that training related to gender equality and livestock vaccines, infrastructural and technical support to the poultry and goat women and men farmers and other chain actors are inadequate in themselves to increase vaccine adoption and improve livestock productivity in Sembabule district. Strategies that promote gender-transformative collaborative efforts among the LVVC actors and build viable gender-transformed women groups and networks are critical to increase women's participation in and benefit from the livestock vaccine value chain.

Gendered Barriers and Opportunities for Women Smallholder Farmers in the Contagious Caprine Pleuropneumonia Vaccine Value Chain in Kenya

Simple Summary

Small animals such as goats, sheep and chickens are an important source of income for rural livelihoods, especially for women farmers in Africa, because they are able to control the resources that come from the sale of these animals. However, one of the biggest problems they face is livestock diseases, even when vaccines are available. In Kenya, Contagious Caprine Pleuropneumonia (CCPP) is a highly infectious disease of goats with a mortality rate of more than 70%. A vaccine for CCPP is available but difficult to access by women in the rural areas. This study examines the gaps and barriers that prevent women smallholder farmers from effectively accessing and adopting CCPP vaccination for their animals in the Machakos district of Kenya. Our results indicate that key constraints to vaccine access and adoption for rural smallholder women farmers are lack of a cold chain for vaccine maintenance, inadequate and late delivery of veterinary services, lack of information and training, and limited financial capacity to purchase the vaccine. If more resources, information, and training is made available to women smallholder farmers through government or the private sector, there would be improved livestock productivity, better livelihoods, and increased opportunities and agency for women.

Abstract

Most rural women smallholder farmers in Kenya generate income from the sale of small ruminant animals. However, diseases such as Contagious Caprine Pleuropneumonia (CCPP) prevent them from optimizing earnings. A crucial aspect for the control of CCPP is vaccination. In Kenya, CCPP vaccines are distributed through a government delivery mechanism. This study examines gaps and barriers that prevent women smallholder farmers from accessing CCPP vaccines. Qualitative data collection tools used were focus groups discussions, focus meals, jar voices and key informant interviews. Using outcome mapping (OM) methodology, critical partners and stakeholders in the CCPP vaccine value chain (CCPP-VVC) were identified to be the manufacturers, importers, distributors, agrovets, public and private veterinarians, local leaders, and farmers. Respondents highlighted the barriers to be limited access to vaccines due to cold chain problems, inadequate and late delivery of services, lack of information and training on vaccines, and financial constraints. Identified opportunities that can support women’s engagement in the CCPP-VVC are the Kenya Governments two-third gender rule, which requires that not more than two thirds of the members of elective or appointive bodies shall be of the same gender, and positive community perception of female veterinarians. We conclude that more resources and training should be made available to women farmers, and that gender perspectives on policy development related to livestock production and disease prevention are urgently needed to improve livestock productivity and increase agency for women.

Women’s Empowerment and Livestock Vaccination: Evidence from Peste des Petits Ruminants Vaccination Interventions in Northern Ghana

Simple Summary

Small ruminants (goat and sheep) are key livestock species in supporting women’s empowerment (WE) in low- and middle-income countries. Animal vaccines are essential for livestock productivity, hence an important means to support WE. WE is, in turn, important for animal vaccine adoption. Little is known, however, of how WE is associated with animal vaccination for women-controlled livestock assets (e.g., goats and sheep). Our analysis explores the link between domains of WE and knowledge of, access to, and use of peste des petits ruminants (PPR) vaccines. Such knowledge can help inform the design of livestock vaccine systems that are better able to reach women and support their empowerment. Using a partial least squares structural equilibrium model (PLS-SEM), we analyzed data collected using the Women’s Empowerment in Livestock Index (WELI) tool from goat keepers in Northern Ghana, which included a module on the PPR vaccine. We found a strong direct positive association between women and men’s knowledge about animal health and PPR vaccination and a strong indirect positive association between access to PPR vaccines and empowerment. Moreover, women and men goat keepers differed in the dimensions of empowerment that the PPR vaccine facets were strongly associated with—asset ownership and input into decisions concerning livestock was significant for women but not for men. Consequently, policy and actions towards enhancing women’s asset ownership, input into decisions about livestock production, knowledge of animal health and vaccines, and access to vaccines are important in designing effective and equitable livestock vaccine systems.

Abstract

Healthy livestock provide meaningful opportunities to enhance women’s empowerment (WE) in low- and middle-income countries. Animal vaccines are important to keep livestock healthy and productive. However, gender-based restrictions limit women’s access to animal health services, thereby affecting the potential of livestock to enhance their empowerment. While growing empirical evidence reveals that women-controlled livestock (e.g., small ruminants) have important implications for WE and support better household nutrition outcomes, little empirical evidence exists from rigorous analyses of the relationship between WE and animal vaccines for women-controlled livestock species. Our analysis explores the relationship between WE and involvement with PPR vaccination in Ghana. Data collected using the Women’s Empowerment in Livestock Index (WELI) tool from 465 women and 92 men farmers (who keep goats) from northern Ghana, and analyzed using PLS-SEM, revealed a significant direct positive association between knowledge about animal health and PPR vaccines and a significant indirect positive association between access to PPR vaccines and empowerment. The empowerment of women goat farmers, as revealed by our model’s results for the relationship between empowerment and vaccine facets, was significantly represented by asset ownership and input into decisions concerning livestock. These study results reveal important considerations in designing effective and equitable livestock vaccine systems.

Who Has Access to Livestock Vaccines? Using the Social-Ecological Model and Intersectionality Frameworks to Identify the Social Barriers to Peste des Petits Ruminants Vaccines in Karamoja, Uganda

Access to veterinary services is important in Karamoja, northeastern part of Uganda, as livestock is a primary source of livelihood. Gender is often overlooked in animal health programs, let alone intersectionality. However, given the socio-cultural intricacies of Karamoja, ignoring these factors may hinder animal vaccination practices, limiting the success of programs designed to control and prevent animal diseases, such as peste des petits ruminants (PPR). The study used qualitative research methods, including focus group discussions, individual interviews, and key informant interviews in a participatory research approach to investigate the constraints faced by livestock keepers when accessing vaccines. The study was carried out in Abim, Amudat, Kotido, and Moroto, four districts in the Karamoja Subregion of Uganda. A modified version of the socio-ecological model (SEM) blended with an intersectional approach were used as frameworks to analyze underlying individual, social and structural determinants of vaccine access with intersecting factors of social inequalities. The results show there are seven intersecting factors that influence access to vaccination the most. These are: gender, ethnicity, geographic location, age, physical ability, marital status, and access to education. The impact of these intersections across the different levels of the SEM highlight that there are vast inequalities within the current system. Access to vaccines and information about animal health was most limited among women, widows, the elderly, the disabled, geographically isolated, and those with unfavorable knowledge, attitudes, and practices about vaccination. Cultural norms of communities were also important factors determining access to PPR vaccines. Norms that burden women with household chores and beliefs that women cannot manage livestock, combined with gender-based violence, leaves them unable to participate in and benefit from the livestock vaccine value chain. Trainings and sensitization on gendered intersectional approaches for those involved in the distribution and delivery of vaccines are necessary to avoid exacerbating existing inequalities in Karamoja.

Beyond the Gender of the Livestock Holder: Learnings from Intersectional Analyses of PPR Vaccine Value Chains in Nepal, Senegal, and Uganda

Simple Summary

The peste des petits ruminants (PPR) is one of the deadliest viral diseases of small ruminants and is endemic in Africa, the Middle East, and Asia. While PPR vaccination programs exist in these contexts, many factors restrict their reach and effectiveness, which go beyond the often cited financial, technological, and logistical constraints. This paper examines these less investigated factors, in particular the role of gender norms and other social and cultural factors, in affecting which livestock keepers are unable to access PPR vaccines and which groups are less reached by the vaccine distribution systems. Across three countries selected for our study, we find that, overall, women derive fewer benefits from the system than men; in addition, belonging to certain ethnic groups, being of low caste, or living in remote regions are additional markers of exclusion and marginalization from accessing livestock vaccines.

Abstract

The peste des petits ruminants (PPR) is a deadly viral disease of small ruminants, which are an important source of livelihood for hundreds of millions of poor smallholders throughout Africa, the Middle East, and Asia. PPR vaccination efforts often focus on overcoming financial, technological, and logistical constraints that limit their reach and effectiveness. This study posits that it is equally important to pay attention to the role of gender and other intersecting social and cultural factors in determining individual and groups’ ability to access PPR vaccines or successfully operate within the vaccine distribution system. We compare three study contexts in Nepal, Senegal, and Uganda. Qualitative data were collected through a total of 99 focus group discussions with men and women livestock keepers and animal health workers, 83 individual interviews, and 74 key informant interviews. Our findings show that there are not only important gender differences, but also interrelated structures of inequalities, which create additional sites of exclusion. However, these intersections are not generalizable across contexts—except for the intersection of gender and geographic remoteness, which is salient across vaccine distribution systems in the three countries—and social markers such as caste, ethnicity, and livelihood are associated with vulnerability only in specific settings. In order to address the distinct needs of livestock keepers in given settings, we argue that an intersectional analysis combined with context-dependent vaccination approaches are critical to achieving higher vaccination rates and, ultimately, PPR disease eradication by 2030.

Transboundary Animal Diseases, an Overview of 17 Diseases with Potential for Global Spread and Serious Consequences

Animals provide food and other critical resources to most of the global population. As such, diseases of animals can cause dire consequences, especially disease with high rates of morbidity or mortality. Transboundary animal diseases (TADs) are highly contagious or transmissible, epidemic diseases, with the potential to spread rapidly across the globe and the potential to cause substantial socioeconomic and public health consequences. Transboundary animal diseases can threaten the global food supply, reduce the availability of non-food animal products, or cause the loss of human productivity or life. Further, TADs result in socioeconomic consequences from costs of control or preventative measures, and from trade restrictions. A greater understanding of the transmission, spread, and pathogenesis of these diseases is required. Further work is also needed to improve the efficacy and cost of both diagnostics and vaccines. This review aims to give a broad overview of 17 TADs, providing researchers and veterinarians with a current, succinct resource of salient details regarding these significant diseases. For each disease, we provide a synopsis of the disease and its status, species and geographic areas affected, a summary of in vitro or in vivo research models, and when available, information regarding prevention or treatment.

Gender and intersectional analysis of livestock vaccine value chains in Kaffrine, Senegal

Among livestock species, poultry and small ruminants are of particular importance to rural women in low- and middle-income countries, as means to generate income, provide nutritious food for the family, accumulate wealth, and confer social status. Newcastle disease (ND) and Peste des Petits Ruminants (PPR) are widespread livestock diseases of poultry and small ruminants, respectively. While both diseases are vaccine preventable, numerous constraints limit the availability of and access to livestock vaccines, especially among the most vulnerable populations in developing countries. The literature on equity and effectiveness of livestock vaccine distribution systems has emphasized many of these constraints, however a gendered analysis and deeper understanding of the vaccine system remain insufficient. This paper applies a gendered and intersectional transformational approach, or GITA, to highlight how gender and other social factors affect the provision and utilization of vaccines for ND and PPR diseases in the region of Kaffrine, Senegal. We first articulate and describe the vaccine value chains (VVCs) for these diseases in Kaffrine, and then analyze the gendered and intersectional dynamics at different nodes of the VVCs, including actors at the national level, through the regional and district levels, down to providers of animal health at community level and the livestock keepers themselves. Our findings indicate that actors’ various experiences are shaped and defined mainly by rigid gender norms, location and remoteness, and to a lesser degree by other social stratifications of age, ethnicity, and livelihood. Given the significant role that gender norms play in the livestock vaccine value chains, differences according to the livestock species, regulation of vaccine administration, and vaccine distribution systems emerge as highly relevant for understanding barriers that women specifically face within the livestock vaccination system.

Eradicating the Scourge of Peste Des Petits Ruminants from the World

Peste des Petits Ruminants (PPR) is a highly contagious viral disease of both domestic (goats and sheep) and wild ruminants. Caused by a morbillivirus, that belongs to the family Paramyxoviridae. The disease is clinically and pathologically similar to rinderpest of cattle and human measles. PPR is one of the most economically devastating viral diseases of small ruminants. In April 2015, the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE) launched the PPR Global Control and Eradication Strategy (PPR GCES) with the vision for global eradication by 2030. There is a strong and lasting international consensus to eradicate the disease in order to protect the livelihoods of the world's poorest populations. As with any disease, eradication is feasible when, policy, scientific and technical challenges are addressed. Ten majors challenges are described in this paper namely: understanding small ruminant production, facilitating research to support eradication, refining laboratory testing, improving epidemiological understanding of the virus, defining infection of wildlife and other species, optimizing vaccine delivery and novel vaccines, developing better control of animal movement, heightening serological monitoring, understanding socio-economic impact, and garnering funding and political will.