Building the road to a regional zoonoses strategy: A survey of zoonoses programmes in the Americas.
BACKGROUND
In recent years, global public health security has been threatened by zoonotic disease emergence as exemplified by outbreaks of H5N1 and H1N1 influenza, SARS, and most recently Ebola and Zika. Additionally, endemic zoonoses, such as rabies, burden countries year after year, placing demands on limited finances and personnel. To survey the baseline status of the emerging and endemic zoonoses programmes of the Latin American and the Caribbean (LAC) countries, the Pan American Health Organization (PAHO) conducted a survey of priority emerging and endemic zoonoses, countries´ prioritization criteria and methodologies, and suggestions to strengthen countries capacities and regional approaches to zoonoses control.


METHODS
A fillable online questionnaire was sent to the zoonoses programme managers of the Ministries of Health (MOH) and Ministries of Agriculture (MAg) of 33 LAC countries from January to April of 2015. The questionnaire comprised 36 single, multiple choice and open-ended questions to inform the objectives of the survey. A descriptive exploratory analysis was completed.


RESULTS
Fifty-four ministries (26 MOH, 25 MAg, and 3 combined responses) in 31 LAC countries responded to the survey. Within the ministries, 22 (85%) MOH, 5 (20%) MAg, and 2 (67%) combined entities indicated they had specialized zoonoses units. For endemic zoonoses, 32 of 54 ministries responded that they conduct formal prioritization exercises, most of them annually (69%). The three priority endemic zoonoses for the MOHs were leptospirosis, rabies, and brucellosis while the three priorities for the MAgs were brucellosis, rabies, and tuberculosis. Diagnosis for rabies and leptospirosis were cited as the capacities most in need of development. The most needed cross-cutting capacity was coordination between stakeholders. For emerging zoonoses, 28 ministries performed formal prioritization exercises. The top prioritization criteria were probability of introduction into the country and impact. The three priority emerging zoonoses for the MOHs were Ebola viral disease, avian influenza, and Chikungunya while for the MAgs were avian influenza, bovine spongiform encephalopathy and West Nile virus disease. Surveillance for avian influenza and Ebola, and diagnosis for BSE were quoted as the capacities most needed. For all zoonoses, the majority of respondents (69%) ranked their relationship with the other Ministry as productive or very productive, and 31% minimally productive. Many countries requested a formal regional network, better regional communication and collaboration, and integrated surveillance.


CONCLUSIONS
The survey is the first comprehensive effort to date to inform the status of zoonoses programmes in LAC. The information collected here will be used to develop a regional strategy for zoonoses (both endemic and emerging), increase efforts, advocacy, and promote prompt identification and management of EIDs and improvement of endemic programmes.
PANAFTOSA (PAHO/WHO), Rio de Janeiro, Brazil.
Melody J
http://orcid.org/0000-0003-2475-781X
MJ
Maxwell
PANAFTOSA (PAHO/WHO), Rio de Janeiro, Brazil.
Mary H
MH
Freire de Carvalho
Veterinary Public Health Program, Veterinary Preventive Medicine Department, College of Veterinary Medicine, and Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, United States of America.
Armando E
AE
Hoet
PANAFTOSA (PAHO/WHO), Rio de Janeiro, Brazil.
Marco A N
MA
Vigilato
PANAFTOSA (PAHO/WHO), Rio de Janeiro, Brazil.
Julio C
JC
Pompei
PANAFTOSA (PAHO/WHO), Rio de Janeiro, Brazil.
Ottorino
O
Cosivi
PANAFTOSA (PAHO/WHO), Rio de Janeiro, Brazil.
Victor J
VJ
Del Rio Vilas
D000818:Animals; D017691:Caribbean Region; D002489:Central America; D003140:Communicable Disease Control / Q000458:organization & administration* / Q000706:statistics & numerical data; D006292:Health Priorities / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D013020:South America; D011795:Surveys and Questionnaires; D015047:Zoonoses / Q000517:prevention & control*