Veterinary Epidemiology In Latin America
melissarod12 de Septiembre de 2013
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Veterinary epidemiology began in different Latin American countries during the 1960s and the 1970s in different universities and state-run institutes of animal health. The discipline evolved as a continuation of the activities veterinarians carried out in the areas of public health, infectious diseases, biostatistics, and the planning and administration of animal health programs. From the outset, the concepts were oriented towards covering the whole spectrum of factors involved in animal health, including political and social factors.
Subsequently, the aforementioned factors were complemented with scientific and methodological support, backed by post graduate qualifications offered by the North America and European universities, together with financial support from intergovernmental organizations.
One important contribution for the Latin American veterinary epidemiology and economics community was the ISVEE 10 which took place in Chile in 2003, which served to link many professionals and scientists with the world of people working in those themes.
Whilst the study programs of veterinarians of the Latin American universities have different forms and depths when delivering competencies in epidemiology, most have similar conceptual and methodological elements.
Ideally, the profile of an epidemiology teacher should include the qualities of dreamer and explorer of new theme worlds, combined with simplicity and openness to the world. A teacher’s knowledge should transcend worlds and be enriched by what takes place outside the bounds of their geographic or university frontiers.
Introduction: influence of epidemiology in Latin America
Historically, the influence of epidemiology in Latin America (L.Am) developed in three areas: the public sector (primarily Ministries of Health and Agriculture), the private sector (principally in animal production establishments) and in universities or research centers.
In practically all L.Am countries, epidemiology was introduced first in Ministries of public health, particularly in areas related to zoonoses, food inspection, and environmental factors, which utilize epidemiologic methodologies.
From there, it later moved to the Ministries of Agriculture, where it was used in programs for control of animal diseases of economic and commercial importance such as Foot and Mouth Disease (FMD), brucellosis, cysticercosis, tuberculosis, Newcastle disease and echinococcosis.
At the same time services of information gathering and data analysis were developed, thus creating the first clinical epidemiological surveillance units. During the 1960s and 1970s, different projects to control animal disease received loans from international banks, for example Chile’s loan from the Interamerican Development Bank to control FMD. Simultaneously, universities introduced the subjects of mathematics and biostatistics in the veterinary curricula.
Furthermore, courses in epidemiological methodology were developed for both theDVMcurriculum and graduate programs. In many cases this coursework development was assisted by international organizations such as the Pan American Health Organization (PAHO) of the World Health Organization. Examples are courses on Planning in Animal Health given by the Pan American Zoonosis Center (CEPANZO) in Buenos Aires, Argentina, and courses given by the Pan American Center of Foot and Mouth Disease (PANAFTOSA) in Rio de Janeiro, Brazil. Moreover, during this early period, Colombia, with assistance of GTZ (Deutsche Gesellschaft fu¨ r Technische Zusammenarbeit) was active in developing epidemiological activities, carrying out field studies, simulation of outbreaks of disease, and the use of computers to collect and analyze information.
There are many distinguished veterinarians who boosted the initiative in training professionals in their own countries and services and also from international organizations. Foremost among these was Dr. Pedro Acha from PAHO who understood the importance of the holistic approach of one medicine and one health, and who, in the mid-1960s assisted Dr. Calvin Schwabe in the design of the Master in Preventive Veterinary Medicine offered by the University of California, Davis. It was in the MPVM Program where veterinarians from all over L.Am have trained and where, in recent years, the object of our homage, Dr. David W. Hird, has served as Director.
From 1960 onwards, universities began to design MSc, MPVM, PhD, and MPH, programs, mostly in the United States of America and Europe. In L.Am., masters degrees in Epidemiology were developed in the 1970s and by the 1980s were offered in various countries with an emphasis on preventive veterinary medicine and epidemiology.
Most of the veterinary medicine curricula in L.Am introduced epidemiology as a preventive medicine tool.
2. Veterinary public health – how this approach influenced development of epidemiology in Latin America As previously mentioned, in L.Am the influence of epidemiology in animal health followed development of epidemiology in the area of public health, particularly with the first veterinarians who graduated with Masters or PhD degrees in public health, not only from universities in the United States and Europe, but also from universities in Latin American countries. These L.Am universities had begun to offer Master‘s degrees in public health in the 1950s in human medicine faculties or through postgraduate training offered by the public health Ministries in the different countries. As an example, beginning in 1952 the Faculty of Medicine of the University of Chile offered a Licentiate in public health with courses of health education, administration, epidemiology, economy and statistics. Activities related to zoonoses, food safety, and nutrition have been the principal fields of work for L.Am veterinarians working in public health and it is here where it has been possible to put epidemiological knowledge into practice. In the last 20 years the topics of environmental impact, basic sanitation, and pest and plague control have been added.
The contribution of public health veterinarians to the field of epidemiology in public health has been extremely important because the training of professionals in the field has included themes related to ecology, the environment, animals in the lives of humans, and, therefore, a more holistic vision of human health.
Unfortunately, participation of veterinarians in the area of public health varies greatly from country to country in L.Am at both local and national levels, and greater efforts are needed to ensure an optimal level of veterinary expertise throughout all L. Am. In spite of this, L.Am veterinarians have a good understanding of the concept of ‘‘one health system’’, incorporating both human and veterinary medicine as outlined by Schwabe (1964) and Nolen (2007), along with many professionals and academics, who are reinforcing a holistic vision of ‘‘one health’’, whereby the health of the environment, control of zoonoses and food quality and safety are becoming more and more relevant, and where collaboration between different areas of health is frequent.
On the other hand, this vision has expanded to other professions, which can be demonstrated by the post graduate courses in epidemiology in the University of Chile in which agronomists and forestry professionals have participated alongside veterinarians for over 25 years. However, there is more work to be done in order to further integrate the tasks from different professions into a more integrated, collaborative vision (King et al. (2008)).
Epidemiologic approach to animal health in governmental agencies and universities In general, the vision of animal health in public services in L.Am includes veterinary clinical medicine and animal science. This is because L.Am. Veterinary schools created at the end of the 19th century and at the beginning of the 20th century were established due to problems of livestock health and related public health issues, not pet health problems. This has had an enormous effect on livestock productivity and as a consequence, an economic impact on the cattle-farming industry. In the last 20 years more than 350 veterinary schools have been created in L.Am but just few of them have been accredited.
The animal health orientation of veterinary medicine delayed the adequate holistic understanding and analysis of problems of animal populations—especially from the point of view of State services—that would have allowed incorporation of benefits and social and economic cost in design of animal population programs. This focus on animal disease, with a strong emphasis on the agents and their characteristics, added to the development of diagnostic and immunological techniques and had a huge influence on the fragmentation of the systematic epidemiological vision, which from the outset should have been included disease control programs in the corresponding countries.
It is for this reason, despite the enormous scientific and methodological advances of epidemiology worldwide, that this approach to animal health exists in many state services in L.Am. To a large extent this is due to the influence of the entities that train veterinarians in our countries, something which will become clearer later when the development of the epidemiology curricula is presented.
On the other hand, it has been difficult to convince those who require animal health services that the final objective should be creation of animal health rather than treating animal diseases. That is to say that ‘‘it is more ethical and economical for our countries to construct a fence on the top of a cliff, and not a fully equipped hospital at the bottom of the abyss.’’ Unfortunately, most State veterinary services in L.Am.
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