Advisory report
RLG 03/8a: A Generally Accepted Policy on Animal Disease
Advice on the control of highly contagious animal diseases - December 2003
Context and summary of the advice
On February 6, 2004, Mr Veerman, Dutch Cabinet Minister for Agriculture, Nature Management and Food Quality received the advice on the question how to deal with the public's emotions about the way highly contagious animal diseases are combated. The advice is a joint production of two advisory councils. The Council for the Rural Area is an independent advisory body that gives advice to the Cabinet and Parliament on food and the rural area; the Council for Animal Matters is a consultative platform between the government, trade and industry, and societal organisations about health and welfare of kept animals on the basis of the Animal Health and Welfare Act. The advice elaborates on the Minister's question how the policy can take the societal values and interests better into account when combating animal disease is concerned. The outbreaks in the last few years of highly contagious animal diseases such as Avian Influenza, Foot and Mouth Disease and Classical Swine Fever made one thing clear: there is little public acceptance of the way these outbreaks were combated. (Preventive) destruction of all animals in an area around the infected farm has far-reaching social, psychological and economic consequences. A representative survey of the Dutch population showed that, out of respect for the animals' natural course of life, the majority rejected the killing of healthy animals. However, because of the European Union's policy and export interests, it is difficult for the Dutch government to resolve the dilemma over the policy that has so far been pursued, and the policy that society wants. A solution may be found in an adjustment of the policy that can only be implemented with the efforts of all stakeholders from the entire society.
Recommendations to the Government
The Government can reduce large-scaled culling by vaccinating the animals in case of an outbreak. Vaccinations with marker vaccines make it possible to distinguish between the vaccinated and the infected animals, and will eliminate or at least strongly reduce the problem that animals are no longer marketable after vaccination. The Councils endorse the Cabinet’s efforts to adjust EU’s non-vaccination policy. It is also necessary to improve the communication about the policy: (continuously) explaining why measures are necessary, listening to suggestions and, where possible, acting on them. The Government must keep state control and the final responsibility for eradicating highly contagious animal diseases and, for competitive reasons, must permanently bear a share of the costs. Other parties must also accept more responsibilities than is the case now.
Recommendations to other parties
The parties in the food chain itself, farmers, slaughterhouses, the dairy industry, the supermarkets and the consumers, can do much to reduce the risk of an outbreak and its consequences. This starts with a system whereby the animals are kept with more buffer capacity in the stables and with better hygienic conditions, and whereby there is more awareness in the contacts between groups of animals, and people and animals. As animal movements always involve risks, they must be strongly reduced. Further regionalizing of the production chain as a whole is unavoidable. As there is no risk involved in consuming products from vaccinated animals, supermarkets, the dairy industry and slaughterhouses must therefore guarantee the sale of these products.
Conclusions and recommendations
The Council for the Rural Area and the Council for Animal Matters advised the Minister of Agriculture, Nature Management and Food Quality on his request about the social support for the policy on combating highly contagious animal diseases. The livestock diseases that are relevant within the framework of this advice occur elsewhere in the world, and could take hold in the Netherlands if introduced. These are only the diseases mentioned in list A drawn up by the Office International des Epizooties (OIE). (More recently, OIE has drawn up a single list of notifiable terrestrial animal diseases. This list replaces both Lists A and B.) The diseases on List A are highly contagious diseases that can be very serious and can spread rapidly and even cross borders, can have serious socio-economic effects on or consequences for public health and are crucial for the international trade in animals and animal products. The reason for the advice was three large outbreaks in the Netherlands of Classical Swine Fever (1997), Foot and Mouth Disease (FMD),(2001) and Avian Influenza (2003). These outbreaks had disastrous consequences for the holders of the affected animals, the animals themselves, for the various production sectors and chains, led to disruption in the areas, and stirred up resistance in society. This undermined the social support for the policy.
No social support without changing the policy
Both Councils are of the opinion that the social support for the policy - and for any policy, for that matter - cannot be dissociated from its contents. Hence, the advice will not only go into the feelings and interest that are at issue from the societal angle, but also into the contents of the policy on animal disease. The Councils are of the opinion that, in spite of the complications attendant on contagious livestock diseases and the present lack of social support, there is still enduring room in the Netherlands for sustainable livestock production that produces for the market. But there is no longer social support - both within the sector and in society - for unaltered continuation of the present policy. In case of a next outbreak, the implementation of the policy will be faced with so much resistance that the policy is no longer effective. Additionally, there is the risk that even the social support for livestock production in the Netherlands will disappear because of the policy. This makes it paramount to adapt the policy and to work proactively on social support.
The risk of contagious livestock diseases will always be present, but can be reduced
Keeping animals will always be connected with the risk of contagious diseases. However, the risk and the consequences can be reduced when livestock farming systems are more robust, which means a more careful dealing with contacts between livestock enterprises, more buffer capacity in stables, better hygienic conditions, with prompt diagnostics and measures for the transportation of animals. With a view to reducing the risk of seeding a disease, the transportation of live animals must be drastically reduced. On the European level, work is already being done to set more stringent preconditions to the transportation of livestock in view of animal welfare. A far-reaching form of regionalizing livestock breeding may not be feasible in the short term; it is unavoidable in the long term. There is also the risk of seeding of the disease when persons travel to and from countries where these diseases occur. This does not only apply to those who work in the professional livestock breeding, but also to those who keep and breed animals as a hobby. Equally important in this connection is a higher level of hygiene, though the interpretation may differ. However, this should not lead to the suggestion that animals can no longer graze or that farms are no longer accessible for people to buy products on the farm, or to recreate there. Here the basic principle is that keeping animals as a hobby and animals for production must be possible in various systems. On the one hand, the policy on animal diseases must be clear and unambiguous, but there is the challenge that the policy should give in as much as possible to the increased diversity in the rural area: diversity between the various groups of animal keepers, various management systems and the various interests that come into play.
Ending the non-vaccination policy to avoid large-scale culling as much as possible
In combating animal diseases, there is the need for liberalisation of vaccination initiation in case of an outbreak. On this point, the EU policy is in motion but does not offer enough leeway for the Dutch situation with an export-oriented livestock breeding, where the density of farms and animals is high, and in some places even very high, and with a strongly urbanised rural area. Culling cannot be avoided if vaccination is carried out during an outbreak, but the necessity and the scale on which it must be done can greatly be reduced.
If this policy is to be successful, and vaccination has been carried out to combat the disease, the marketability of animals and products within the EU, and at a later stage outside the EU, of vaccinated, non-infected animals must be equal to the marketability of non-vaccinated non-infected animals within the shortest possible time.
Preventive vaccination should be carried out on animals kept as a hobby of which it is certain that they will not enter the food chain. These smallholders must assume the responsibility for it, which requires a self-organised and sound registration of the animals; the costs of which should be borne by the owners.
Other categories of animals, such as animals in nature areas and in zoos demand a made-to-measure regulation. Both categories must be excluded from culling if the animals are not infected. Infected and ill hobby animals that have been vaccinated must however be destroyed.
Intensifying research efforts
More prevention and precaution, monitoring and early warning, prompt and on-site diagnostics and the availability of marker vaccines would necessitate a permanent group that is engaged in all these aspects, both on the national levels and for harmonisation on the European level. Equally important is research into the significance of animals having more resistance to animal diseases. However, a higher level of general resistance is no option for combating the diseases mentioned in List A.
Products of vaccinated animals can be consumed as usual
Animals do receive preventive vaccination against a number of other diseases. The products of animals that are vaccinated in case of an outbreak of a List A-disease can be consumed as usual. The government must inform the public about this. Considering the moral views people have, the destruction of animal products suitable for consumption is repudiated. Agreements with partners in the chain (slaughterhouses, wholesalers, retailers) are needed to steer the processing and marketing in the right direction when the occasion arises.
Sharing the costs
In principle, the cost of combating these diseases must be borne by the keepers of the animals. However, the government must continue to contribute to the cost, because public interest is also a contributory aspect in setting out the policy and because production-oriented livestock farming cannot pass on all of the cost to the buyers. This is because of the market relationships and because of competitive supply from other countries against prices in which these expenses are not incorporated. It is advisable to support initiatives that give shape to a system of combined public and private funding (Animal Welfare Fund), also on the European level. The damage of outbreaks inflicted on third parties will largely be decreased by the proposed policy.
Give respect for animals explicitly a proper place
Normative-ethical research proved that the population finds respect for the animals' normal course of life an important moral argument. The majority finds killing infected and ill animals acceptable if there is an outbreak of a highly contagious disease; only a small minority finds killing healthy animals acceptable in such a situation. The majority of the population see economic and export interests or international agreements as insufficient arguments for killing non-affected animals.
Involve stakeholders more in specifying the details of the policy
All groups of stakeholders must be offered the opportunity to participate in specifying the details of the policy, including the overhaul of the contingency plans and scenarios. When preparing this advice, it proved that group meetings were effective enough to promptly generate valuable contributions. The strength of these meetings is the wide range of views and the large amount of information that became available in a short time. The councils are of the opinion that the experiences with Multi Criteria Analysis (MCA) indicate that this analysis can contribute towards listing the interests, but cannot serve as an integral decision framework. As it is, making a comparative assessment is after all a political and administrative responsibility.
Making the implementation of the policy more effective
Both Councils are of the opinion that in the prevention and the operation public support will be much stronger and the operation much more effective if better use is made of local knowledge, local structures and local contacts.
A proper preparation of crises includes contingency plans and scenarios for each animal disease that are of current interest, that are known and available and that are practised. Permanent facilities are needed to be responsible for the maintenance of the emergency measure: updating the scenarios and practising them, both within the organisation and outside with the persons involved.
There was much frustration, anger and resistance in the crises of the last six years because there was the impression that the government and the executive services would not listen. In a crisis, the executive organisation must therefore be organised to be able to listen, to enter into a dialogue, and to adopt a suggestion when there is room for it. For that matter, this shows an upward trend: except for the culling of the chickens that were kept as a hobby, the way the Avian Influenza was dealt with was more appreciated than the way the Foot and Mouth Disease outbreak was handled.
Improving care in case of social and psychological consequences
The revised scenarios must include social assistance to the affected persons. Care and guidance in case of culling must primarily be offered by people who know and understand the specific situation the animal keeper is in. This will take place within the framework of the Social Economic Plan; a number of persons will even need help for a longer time after the crisis has been halted. As to professional assistance offered by mental welfare organisations, a timely mobilisation of support is a specific issue.
Taking advantage of the EU Chairmanship
The Dutch government is going to spearhead the abolition of the European non-vaccination policy, for which the Dutch EU chairmanship in the second half of 2004 will be a good opportunity. Core issues are the liberalization of the vaccination method, the marketability of the products, and funding these measures.
Reply to two specific questions for advice
1.
The Minister has asked the Council to describe what normative-ethical aspects and public feelings are involved with combating animal diseases, such as classical swine fever and foot and mouth disease; animal diseases against which the measures often have far-reaching economic, social and psychological consequences.
Emotions were running high when pictures of the culling were released during the recent outbreaks; it intensified the idea that the animal does not count in mainstream farming, especially in factory farming. The majority of the population and even the politicians often did not understand the images of the farmers' genuine emotions. The culling of animals kept as a hobby during the Foot and Mouth Disease and the Avian Influenza criss - animals that have for many families a status to be compared with that of a pet, also evoked much emotion and even resulted in acts of civil disobedience. On the other hand, people who eat meat do not question what life the animal has had, and rather leave the responsibility to the authorities and to societal organisations. Nevertheless, for combating highly contagious animal diseases, the following question is crucial: what is the Dutch opinion on killing animals?
In 2001 and 2002, a representative sociologic and normative-ethical research was carried out into the social and ethical aspects of killing animals (L.J.E. Rutgers, J. Swabe and E.N. Noordhuizen-Stassen, 2003.) The objective of the research was to gain insight into the reasons that people deem acceptable for ending the life of an animal, and what the grounds for this justification are. Both the outbreaks of Swine Fever and FMD constituted motives for this research. The survey showed that the vast majority of the population approves of keeping animals for the production of meat. A vast majority also finds it acceptable if a healthy animal is killed if it does not produce enough. But for the majority of the population, the cost of a veterinary treatment forms in itself insufficient grounds to remove an animal untimely; this is seen as a business risk. However, the majority of the population does find it acceptable to kill animals if they are a great risk for public health, or if the animals are incurably ill or endure great suffering. When there is an outbreak of a highly contagious disease under the animals that threatens the health of other animals, the majority finds it acceptable that the infected animals are killed and destroyed.
The majority of the population sees economic interests of export or international agreements on this subject as invalid arguments for killing non-infected animals. Especially "the respect for a normal course of life" is here an important moral argument. For production animals, the normal course of life is the usual production period, and for household pets until the animals normally die of old age or a killing disease. As explained above, the majority finds killing infected and ill animals acceptable in case of an outbreak of a highly contagious disease, but only a small minority finds the killing of healthy animals acceptable in an outbreak. Many respondents believe that more use should be made of alternatives: vaccination, and increasing the buffer capacity that makes that there is less chance for welfare problems in overcrowded stables. Worries have been expressed about the structure and the dependency on export of the Dutch livestock sector that leads to killing healthy animals in case a highly contagious disease breaks out.
In three group meetings, a consultation of representatives of groups of people involved in the FMD crisis has produced much information about the experiences and the feelings about this subject. Even now, two years after the crisis, the subject released emotions, which were vented to the executives of the policy in no uncertain words. In the upshot of the meetings, the experiences were listed as pressure points they had to face, as comments on the approach taken by the government, and as suggestions for adaptations to the policy to overcome the crisis. They can be summarized in five themes, which are described below.
First theme
The first theme is the proportion of the risks, and the translation thereof in measures. The experts' perception of the risks on the basis of which policy is pursued, was challenged by the parties that felt themselves to be the victims of the policy that was pursued during the outbreak. The discussion about whether there was indeed a great risk that justified the eventual culling of pet chickens in the last crisis, nurtured these doubts. Uncertainty about the risks made the policy lose much of its public support. The individual parties, whose support had totally disappeared, felt that these harsh measures were an infringement on their own integrity. Suggestions for this theme were, in the first place, to do more research to determine the real risks (the nature and the proportion) without any reasons for doubt. In the second place, there was the need for more tailor-made policy to take into account the vast differentiation among the animal owners: between farmers and smallholders, such as those who breed and keep animals as a hobby, nature conservationists, and etceteras, but also between the farmers themselves with their variety in management systems and management styles. The question is here whether it is technically feasible and veterinary responsible to have more tailor-made policies.
Second theme
The second theme is the use of the potential of prevention. We all know that prevention is better than cure, but how to prevent a next outbreak (or an escalation) is for all stakeholders an interesting point in the discussion. A large (heterogeneous) group believes that (continuously preventive) vaccination is the best prevention strategy, and does not want to make concessions on this point. On the other hand, more and more people advocate improving hygiene protocols and keeping animal-animal and man-animal contacts to a minimum. There is a clear need for differentiation within the prevention strategy. It is believed that the optimum prevention strategy differs per animal species, per enterprise, per region and per disease, and there is a great need for taking own responsibilities. That a sound overall prevention policy based on this differentiation is available on the national level, is considered to be the responsibility of the government. Not only seeing to it that the various groups of stakeholders are actively taking their own responsibility, but also taking care that the various strategies are keyed to one another and that the result meets the European and national preconditions. One aspect of preventive vaccination under discussion is whether a fitting identification and registration system is a feasible option. To make preventive vaccination an effective preventive measure, a fitting registration is an absolute must.
Third theme
A third theme is the division of responsibilities. The Ministry of Agriculture, Nature Management and Food Quality is responsible for the policy on animal disease, but it is bound by international agreements. In deciding on its policy, the government is expected to consider what consequences the opted policy will have. However, various interest groups have indicated their wish to have more responsibility, such as for realising a custom-made prevention policy as explained above. This raises the question where the government can share the responsibility for the policy on animal disease. For items for which the responsibility cannot be shared, the government is responsible for taking measures that limit, relieve and repair the damage as much as possible. For items for which the responsibility can be shared, there is the view that the government and the executive authorities must make use of local knowledge, structures and contacts. This involves the planning, the implementation and the evaluation of the policy on animal disease. An area where the question of dividing the responsibility is an issue is the domain of public (mental) health. The question is how the government in its animal disease policy takes account of the psychosocial consequences of a certain measure, and with whom the responsibility for a collateral psychosocial policy can be shared.
Fourth theme
The fourth theme is about ethics. The ethic judgements from Rutgers et al.'s research have already been referred to in broad terms. In the consultations for this advice it appeared that there is the general acknowledgment that, for economic interests, values were violated that should not have been violated. Not only does this involve the welfare of animals, but also, and especially, the autonomy, the integrity and the welfare of the persons involved. Taking as a basis the various values and interests that came into play, a more careful appraisal should have been made of how much risk one is willing to take in favour of respecting these values and interests. To make this appraisal consciously, it is necessary to analyse the ethic implications of the various elements of the policy and possible adaptations. Public support must be scrutinized for each element (to vaccinate or not, the criteria for culling animals in the surrounding area, etc.): it is not clear what is ethically responsible from the very start, but it depends on the context. The challenge in formulating a new policy on animal disease is to build a bridge between the groups that fear escalation when the present line is deviated from, and the groups that find the present policy irresponsible from the ethical point of view.
Fifth theme
The fifth theme is the poor communication before, during, and after a crisis. This includes the communication between all parties, but in particular the communication by the Government. This was generally seen as an important obstacle. It is expected that with improved communication much of the current friction in the present policy can draw the sting by making well-founded adaptations to the contents. And that done, bringing changes for the better into force, aided by proper communication. Only by means of interaction can the government secure a broader public support.
2. To support the political societal assessment process, the Minister asked the Council to advise on the way in which the aspects must be evaluated.
The weighing of all aspects and interests and the translation thereof in choosing a certain policy on prevention and control is a political and social assessment that takes place between the government and the parliament; the Minister and the Houses of Parliament cannot pass the responsibility onto others. Nevertheless, the second request for advice also contains the invitation to the Councils to assist on this subject.
Ten years ago, the choice of the Netherlands to consent to the EU change into a non-vaccination policy was made in a very small circle. The foundation of this policy in analyses was limited, and was focussed on sector economic and veterinary aspects. But after having to experience three major outbreaks, of which two were on an unforeseeable scale, and with great impact on the rural area in social, socio-psychological and regional-economic sense, the adjustment of the policy can only be made with participation of all stakeholders.
An important observation is that the demand for public support for the policy on animal diseases must not only be found with the broad public and groups in society that are hindered or troubled by major outbreaks and their consequences, but also with the persons who are directly involved. An outbreak and the related consequences have such impact on them that they can be labelled as traumatising, infringements on their autonomy, and isolation. Not only the farmers, but also the families with pet animals and animals kept as a hobby, the breeders of rare breeds of domesticated animals and the keepers or managers of zoos, children's farms and nature areas. In Dutch society, the number of people that keep domesticated animals for purposes other than production is many times larger than the number of farmers that keep animals for production purposes. People that must implement the policy, including veterinary surgeons, are also faced with a dilemma as to their professional ethics for the way the outbreak is handled. The key questions are about the ethical judgements on the integrity of animals vis- à -vis economic interests, having regard for the social consequences of controlling the disease (destruction of animals) for those involved, and the question of where to draw the line on government actions.
In his correspondence with the Lower Chamber, the Minister indicated that he will add an 'environment criteria' in the revision process of the policy scenarios. These scenarios will also pay attention to the identification of the interests, and to the question of how to deal with them: "how these interests must be weighed." In his letter about the debate on factory farming, the Minister emphasised the importance of a shared problem analysis. To achieve this, an extensive exchange of insights and a survey of the interests will be required.
The Councils are of the opinion that, if public support is essential for an effective policy, it can only be achieved by optimising the potential of interaction with the stakeholders. To effectively and properly carry out his important task as policymaker and executive in the domain of contagious animal diseases, the Ministry of Agriculture must enter into far-reaching partnerships. Only if the Ministry maintains contact with its environment will it be able to make a well-founded assessment in the dynamic field of societal values.
The request for advice refers to a report of the LEI, the Agricultural Economics Research Institute, (Huirne R.B.M. a.o., 2002) whereby a method has been developed for making the choice between alternative policy scenarios for animal disease control more transparent. The group meetings for this advice with representatives of groups of people involved in or affected by the Foot and Mouth Disease crisis, were used to assess this method as an aid to support the decisions on the policy on animal disease. This Multi Criteria Analysis (MCA) is a universal method with which policy options can be assessed for different groups of indicators, such as economy, ecology and social aspects. Unlike the cost-benefit analysis, this method includes aspects that cannot be expressed in money but that carry much weight for the assessment and the choice.
An MCA carried out with a group of stakeholders starts with listing a number of alternative disease control strategies. Discussion in these group meetings must make clear what amendments to these strategies are desirable and possible. The next step is to compare how these different strategies will score for the indicators that are important to the stakeholders. However, when an indicator is included in the MCA, there is the condition that there is also sufficient knowledge to indicate whether a policy option - a given control strategy - will score worse or better with the indicator involved. Apart from listing the indicators it must be stated what weight they should have in the decision-making; the participants assess these weights.
Conclusion
The group meetings in the form of Group Decision Rooms (GDR), that is to say, holding a meeting supported by a computer network, proved to be an adequate and quick way of working to list much contribution. The power of it lies in the broadness of the views and the large amount of information that becomes available in a short period of time. However, the results of the three sessions that were held do not induce the Councils to advise positively about the benefit of MCA to simulate an integral assessment process.
Strong points
The innovative aspect of these group meetings is mainly that, by formulating the indicators and assessing them, a broad group of stakeholders can make clear what interests and values are at stake in combating FMD and other List A diseases. By capturing the dynamics in these values and interests, such meetings can support interactive decision-making processes. This makes these meetings an aid to the public need for transparency and participation. By their flexible nature, these meetings are suitable for building a basis for a communication structure. Mainly the discussion partners that do not belong to the traditional consultation circuit expressed a need for such a structure.
Weak points
In the set-up chosen by us it proved that one session was not enough for making both an inventory of values and interests, and getting a creative thinking process going to make a comparative assessment between all these different values and interests. The stakeholders in the meeting were too different: not only in their values and interests, but also in their knowledge about the policy on animal diseases, and the difference in power. Taking also into account that they had limited understanding of the MCA as a method, it is understandable that reaching a fruitful result was impossible in only one afternoon. Here lies a distinct challenge for designing the environmental analysis by a process. Moreover, a Group Discussion Room in this form and with a limited number of stakeholders on which the MCA process was based, can hardly be seen as representative due to the rather limited number of participants that can practically be involved. The selected structure of an MCA, whereby we must think in indicators that can make distinctions in the selection of a control strategy, did not work. One may even ask whether it is at all possible to make an objective choice with an MCA on the basis of indicators, the more so because the present models in this form are still mainly epidemiological and economic in nature.
Final observation
Though the Councils are reserved about the usefulness of Group Decision Rooms as a way of working for the environment analysis in revising the scenarios and therefore rejecting the use of MCA, the Councils make some suggestions for improvement if the Ministry does want to follow this approach. The calculation model lacks basic information for including aspects other than economy and epidemiology, such as social impacts and psychological damage. In principle, the latter could have a place in the model through empirical research and expert judgement. This would do justice to the strong need of society to base the choice of a Dutch policy on animal disease on all interests that come into play in this issue.
To accomplish exchange, reflection and deepening of insight, it is advisable to structure future group meetings differently than on the basis of the presently applied MCA. To have a policy that can count on a broader public support it seems advisable to let participants indicate what the important values and interests are, and let them devise new policy variants that take the listed values and interests more into account. Strictly speaking, the MCA model is not necessary for this.
The interaction between the participants is desirable to arrive at a shared problem analysis and a mutual appreciation. This requires interest groups to be in discussion with each other for a longer time, perhaps even about one aspect of the policy on animal disease at a time, e.g. the problems of marketing the meat of vaccinated animals.
References
L.J.E. Rutgers, J. Swabe and E.N. Noordhuizen-Stassen, 2003. Het doden van gehouden dieren, ja mits … of nee tenzij?
Huirne R.B.M. a.o., 2002. MKZ – Verleden, Heden en Toekomst, over de preventie en bestrijding van MKZ