23 April 2021

Future pandemics are inevitable unless we invest in veterinary training and resources

To mark World Vet Day 2021, Brooke Ethiopia's Dr. Alemayehu Hailemariam (AHM), discusses the challenges facing veterinary professionals in Ethiopia and the wider dangers of failing to invest in animal health systems.

A vet treats a horse at the Abosa Ademogne animal clinic, which opened in 2019

It’s been over a year since the first Covid-19 case was recorded in my home country, Ethiopia. As a veterinarian working with Brooke Ethiopia, I wanted to mark World Vet Day by looking at the challenges that veterinary professionals face here, and around the world, and how we need to invest in the profession if we are to avoid future pandemics.

Ethiopia has the second largest population in Africa, with over 110 million people. It’s also home to the largest livestock population in Africa and over 9 million donkeys are included within this. Putting food on the table for this growing, mainly young population, is by far the number one challenge for the government. As such, the livestock sector is under extreme pressure to ensure food security despite years of under-investment in veterinary training and resources that have left animal health systems in desperate need of strengthening.

According to Klara Saville, Brooke Head of Global Animal Health, Welfare and Community Development, “Globally 1.3bn people depend on healthy animals for their livelihood, yet access to animal health systems is poor or non-existent in many areas. To stop global pandemics from happening again, we must invest in vets and veterinary supplies whilst properly monitoring animal disease. We are only as strong as our weakest health system, and that is the animal health system.”

At least 75% of all new, emerging or re-emerging diseases affecting humans have zoonotic nature; examples of which include Covid-19, Rabies, Ebola and SARS. This reminds us of how vulnerable we are and the crucial role veterinarians must play in keeping animals healthy if we are to prevent future outbreaks.

I hear many talking proudly that Ethiopia is producing thousands of vets annually without appreciating the challenges the sector faces, such as a lack of resources and good training. They forget the health workforce is only one of the key components required within a properly functioning animal health system.

Although many vets are being produced, the primary animal healthcare is delivered by animal health assistants that receive a low level of practical training, usually classroom based, with little opportunity to develop their practical clinical skills using essential medicines. Animal health assistants work at the frontline of the animal health systems and are expected to also manage challenging clinical conditions in the field that require critical reflection, triangulation and thinking with no proper diagnostic tools and skills. 

Of course, to do their job properly, these professionals must also have access to essential medicines. The Ethiopia Veterinary Drug and Animal Feed Administration and Control Authority (VDFACA) list contains 209 products. However, just 6% of these registered medicines are frequently used within government clinics.

Notable essential medicines that do not feature on the registered list include:

  • Pain relief/NSAIDs-  (oral PBZ is registered due to Brooke) no other NSAID suitable for livestock is registered
  • Alpha-2’s such as Xylazine
  • Euthanasia meds- barbiturates or KCl
  • Adrenaline
  • Opioids
  • Ophthalmic preparations

Data collected by Brooke in 2020 found that of 695 health cases analysed, 60% required some form of pain relief or anti-inflammatory drugs. However, only less than 2% received any form of pain relief; Parecetemol, diprone, dichlofenac and PBZ. In fact, 87% of all cases were treated with one or a combination of three drugs only; Oxytetracycline (27%), PenStrep (24%) and Ivermectin (37%). 

These statistics support our theory that lack of access to non-steroidal medicines (pain relief) can result in an over reliance on antimicrobials and anthelmentics, therefore directly contributing to anti-microbial resistance and an immense threat to One Health.  

As such, Brooke has made three commitments in our fight to ensure a better future for Ethiopia’s animals. First, we will continue to promote the need for better investment in the livestock sector. As part of this, Brooke is funding and co-supervising a PhD programme that will provide much needed evidence to support the investment needs for the sector. Secondly, we will continue to train animal health providers. Brooke is part-funding an app, developed by AAU-CVMA, Adama Science and Technology and the University of Strathclyde. It will support disease diagnosis, surveillance and treatment for livestock, including working equines. And thirdly, Brooke will work to ensure essential medicines are increasingly available for professionals working in the field.

Simply put, if essential medicines are not available for veterinary professionals, our ability to address animal health care and welfare needs is restricted and we are unable to fulfil our Hippocratic Oath. As doctors around the world continue to battle the Covid-19 fall out, let our key lesson be this – we must prioritise the training of veterinary professionals and ensure they have access to essential medicines if we are to prevent future pandemics. You get what you invest.