Evaluation for action - Assessing animal disease surveillance capacities The Kyrgyz Republic - FAO
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The Kyrgyz Republic Evaluation for action Assessing animal disease surveillance capacities October 2019
The Kyrgyz Republic Evaluation for action Assessing animal disease surveillance capacities October 2019 FOOD AND AGRICULTURE ORGANIZATION OF THE UNITED NATIONS Rome, 2021
Required citation: FAO. 2021. The Kyrgyz Republic – Evaluation for action - Assessing animal disease surveillance capacities (October 2019). Rome. The designations employed and the presentation of material in this information product do not imply the expression of any opinion whatsoever on the part of the Food and Agriculture Organization of the United Nations (FAO) concerning the legal or development status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or products of manufacturers, whether or not these have been patented, does not imply that these have been endorsed or recommended by FAO in preference to others of a similar nature that are not mentioned. The views expressed in this information product are those of the author(s) and do not necessarily reflect the views or policies of FAO. © FAO, 2021 Some rights reserved. This work is made available under the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo/legalcode). Under the terms of this licence, this work may be copied, redistributed and adapted for non-commercial purposes, provided that the work is appropriately cited. In any use of this work, there should be no suggestion that FAO endorses any specific organization, products or services. The use of the FAO logo is not permitted. If the work is adapted, then it must be licensed under the same or equivalent Creative Commons license. If a translation of this work is created, it must include the following disclaimer along with the required citation: “This translation was not created by the Food and Agriculture Organization of the United Nations (FAO). FAO is not responsible for the content or accuracy of this translation. The original [Language] edition shall be the authoritative edition. Disputes arising under the licence that cannot be settled amicably will be resolved by mediation and arbitration as described in Article 8 of the licence except as otherwise provided herein. The applicable mediation rules will be the mediation rules of the World Intellectual Property Organization http://www.wipo.int/amc/en/mediation/rules and any arbitration will be in accordance with the Arbitration Rules of the United Nations Commission on International Trade Law (UNCITRAL). Third-party materials. Users wishing to reuse material from this work that is attributed to a third party, such as tables, figures or images, are responsible for determining whether permission is needed for that reuse and for obtaining permission from the copyright holder. The risk of claims resulting from infringement of any third-party-owned component in the work rests solely with the user. Sales, rights and licensing. FAO information products are available on the FAO website (www.fao.org/publications) and can be purchased through publications-sales@fao.org. Requests for commercial use should be submitted via: www.fao.org/ contact-us/licence-request. Queries regarding rights and licensing should be submitted to: copyright@fao.org. Cover photograph: FAO/Ryan Aguanno
Contents
Acknowledgements ....................................................................................... vi
Abbreviations.................................................................................................vii
Background..................................................................................................... 1
General context ..................................................................................................... 1
Development of SET .............................................................................................. 1
Context of the SET mission to the Kyrgyz Republic ............................................... 2
Objective of SET missions ...................................................................................... 3
Evaluation methodology ................................................................................. 4
The SET toolkit and expected outputs ................................................................... 4
Phases of SET missions .......................................................................................... 4
The SET mission in the Kyrgyz Republic .......................................................... 6
Local situation and livestock production ............................................................... 6
Composition of the Evaluation Team .................................................................... 8
Mission summary .................................................................................................. 8
Evaluation results ......................................................................................... 11
Description of surveillance system ...................................................................... 11
SET outputs ......................................................................................................... 16
Core results ......................................................................................................... 16
Performance attributes ....................................................................................... 17
Recommendations........................................................................................ 20
SWOT analysis ..................................................................................................... 20
Strengths ......................................................................................................... 20
Weaknesses ..................................................................................................... 20
Opportunities .................................................................................................. 21
Threats ............................................................................................................ 21
Recommendations and action plan ..................................................................... 22
Action plan ...................................................................................................... 23
References .................................................................................................... 29
iiiFigures
Figure 1. Areas visited during SET evaluation mission in the Kyrgyz Republic,
October 2019 (Source: UN). Blue stars denote location of laboratory or veterinary
services staff (four) transported to Bishkek for interviews. .................................... 10
Figure 2. Organisation of the State Inspectorate showing number of employees in
brackets, Kyrgyz Republic, October 2019 ................................................................ 11
Figure 3. Animal disease reporting lines in the Kyrgyz Republic .............................. 14
Figure 4. Comparative SET graphical outputs for the Kyrgyz Republic by category,
October 2019. ......................................................................................................... 16
Figure 5. SET outputs for the Kyrgyz Republic by performance attribute of the
system, October 2019. ............................................................................................ 19
ivTables
Table 1. Categories and areas evaluated by SET ....................................................... 4
Table 2. Number and type of livestock in the Kyrgyz Republic .................................. 7
Table 3. Evaluation team during the SET mission to the Kyrgyz Republic, October
2019. ......................................................................................................................... 8
Table 4. Notifiable animal diseases in the Kyrgyz Republic ..................................... 11
Table 5. SET outputs for the Kyrgyz Republic October 2019 ................................... 17
Table 6. Performance attributes evaluated by the SET ........................................... 18
Table 7. Prioritized recommendations from SET outputs, Kyrgyz Republic, October
2019 ........................................................................................................................ 22
vAcknowledgements
This report is the result of a collaborative effort between Ryan Aguanno (FAOHQ),
Dinara Imanbayeva (FAOREU), Marina Kichinebatyrova (FAOKG) and Daniel Beltran-
Alcrudo (FAOREU).
The authors of the present evaluation report would like to thank all the stakeholders
met, as well as all the people who contributed to the success of this evaluation
mission in the Kyrgyz Republic (Kyrgyzstan), including:
In addition, the authors would like to thank those who contributed to the
development of SET and its methodology: Gaël Lamielle (Veterinary Epidemiologist,
FAOHQ), Subhash Morzaria (FAO Senior Animal Health Adviser), Sophie von
Dobschuetz (Veterinary Epidemiologist, FAOHQ), Sibylle Bernard-Stoecklin
(Veterinary Epidemiologist, formerly of FAOHQ), Magali Ruiz (Veterinary
Epidemiologist, formerly of FAOHQ), Eran Raizman (FAOREU), Ryan Aguanno
(Veterinary Epidemiologst, FAOHQ), Madhur Dhingra (Veterinary Epidemiologist,
formerly of FAOHQ), Asma Saidouni (Veterinary Epidemiologist, FAOHQ), Béatrice
Mouillé (EMPRES Lab Unit Deputy Coordinator, FAOHQ), Pascal Hendrikx (Veterinary
epidemiologist ANSES), Aurélie Courcoul (Veterinary epidemiologist ANSES), and
Jean-Philippe Amat (Veterinary epidemiologist ANSES).
viAbbreviations
AITS Animal Identification and Traceability System
AHS African Horse Sickness
ANSES Agence nationale de sécurité sanitaire de l’alimentation, de
l’environnement et du travail
CDC Centers for Disease Control and Prevention
CVO Chief Veterinary Officer
EAEU Eurasian Economic Union
ELISA Enzyme-Linked Immunosorbent Assay
FAO Food and Agriculture Organisation of the United Nations
GIS Geographic Information Systems
GHSA Global Health Security Agenda
IFAD International Fund for Agricultural Development
IHR International Health Regulations
IO International Organizations
ISELEK Information System “Elek”
IT Information Technology
JEE Joint External Evaluation
Kyrgyzstan Kyrgyz Republic
LSD Lumpy Skin Disease
LIMS Laboratory Information Management System
LMT Laboratory Mapping Tool
MAFIM Ministry of Agriculture, Food Industry, and Melioration
MoEP Ministry of Environmental Protection
MoU Memorandum of Understanding
NADIS National Animal Disease Information System
OIE World Organisation for Animal Health
OASIS Outil d’Analyse des Systèmes de Surveillance
RADIS Raion Animal Disease Information System
REU Food and Agriculture Organisation of the United Nations Regional
Office for Europe and Central Asia
PCR Polymerase Chain Reaction
PH Public Health
PVS Performance of Veterinary Services
viiSET Surveillance Evaluation Tool
SIVPS State Inspectorate on Veterinary and Phytosanitary Safety
SOP Standard Operating Procedures
SWOT Strengths Weaknesses Opportunities Threats
USAID United States Agency for International Development
WHO World Health Organisation
viiiBackground
General context
Outbreaks of animal disease can have a devastating impact on people’s livelihoods if
not detected in a timely manner. In addition, over 70 percent of emerging infectious
diseases are zoonotic in nature (WHO, 2020) and identifying them in animals can
prevent their transmission to humans. Good-quality data is therefore essential to
better prepare and respond to known and new threats to both livestock and people.
Strong surveillance systems represent the cornerstone to provide decision-makers
with adequate information to implement disease control programs.
Many assessments exist to help countries develop their animal health capacities,
including the Joint External Evaluation (JEE) led by the World Health Organization
(WHO) and the Performance of Veterinary Services (PVS) developed by the World
Organisation for Animal Health (OIE). Although both JEE and PVS address some aspects
of animal disease surveillance, their primary focus is to address general capacities
related to One Health and veterinary services, respectively.
African countries working with the Food and Agriculture Organisation of the United
Nations (FAO) therefore requested in 2016 a comprehensive evaluation methodology
to guide activities aimed at enhancing national animal disease surveillance capacities.
Development of SET
In response to the request received, FAO developed the Surveillance Evaluation Tool
(SET) during 2017 to support prevention and control of animal disease threats,
including zoonoses. The tool provides veterinary services and ministries with an
objective, standardized, comprehensive and systematic evaluation of animal health
surveillance systems. The initial development of SET was supported by the United
States Agency for International Development (USAID) for use in African nations under
the Global Health Security Agenda (GHSA) project.
The basis for SET was the surveillance network assessment tool “Outil d’Analyse des
Systèmes de Surveillance” (OASIS) developed by the French “Agence Nationale de
Sécurité Sanitaire de l’alimentation, de l’environnement et du travail” (ANSES)
(Hendrikx, et al., 2011). Additional assessment criteria from FAO’s Epidemiology
Mapping Tool (EMT) were also included for the following indicators: cross-sectoral
collaborations, epidemiology workforce capacities, outbreak investigation, and risk
assessment. Finally, the tool’s structure, scoring system (1 to 4) and graphical outputs
were harmonized with FAO’s Laboratory Mapping Tool (LMT) and EMT.
In past SET missions, JEE indicators for “Real Time Surveillance”, “Workforce
Development” (D.4.1 and D.4.3) and “Zoonotic Diseases” (WHO, 2016) were
incorporated into SET and assessed in order to further characterise these indicators
from the perspective of animal health. Following the publication of the new JEE
indicators and guidelines in 2018 by WHO (WHO, 2018), this aspect of the SET
assessment was discontinued.
Two piloting sessions were conducted in Tanzania (12–21 June 2017) and Liberia (4–
13 September 2017) to test SET in real-time situations in the East and West African
1contexts. Following these missions, outcomes were compiled in final reports that were
distributed to key-decision makers of the surveillance system in both countries. The
toolkit and evaluation methodology were also updated to reflect feedback and lessons
learned during each of those piloting missions. Lastly, the final version of SET was
distributed in English and French for implementation in the rest of project countries.
Following the successful implementation of SET in 14 countries in West, Central and
East Africa between 2017 and 2019, the tool was made available for use in other
regions.
Context of the SET mission to the Kyrgyz Republic
SET was requested by the FAO regional office for Europe and Central Asia (REU) under
the Technical Cooperation Programme “Establishing a Network on Priority Livestock
Diseases in Central Asia” (TCP/SEC/3702).
FAO, through the REU office, will function as the initial driver of the network that
includes Tajikistan, Uzbekistan, Kazakhstan, Kyrgyzstan and Turkmenistan. The
network was officially launched In Tashkent, Uzbekistan on 14–15 November 2019 and
was named Central Asia Animal Health Network (CAAHN). The agenda, concept note,
presentations and recommendations of the meeting are available at
http://www.fao.org/europe/events/detail-events/en/c/1238290/.
Animal health networks offer a framework for building strong technical capacity,
competency, leadership and a critical mass of regionally networked specialists in
veterinary medicine, epidemiology, surveillance and diagnosis – all of which are
essential to coordinate actions to manage the risks of transboundary animal diseases
and zoonoses.
Experience from regional animal health networks in other regions has already proved
to be successful. FAO, in cooperation with other international agencies, has led the
establishment and support of several regional animal health networking initiatives in
various regions of the world, e.g. RESEPI and RESOLAB in Western and Central Africa,
EARLN and EAREN in East Africa, REMESA in Northern Africa, and also in Southeast and
South Asia. The examples above are valuable resources to build synergies and
efficiency in terms of animal health expertise and to enhance transparency and mutual
confidence in disease information exchange.
Regional animal health networks offer a framework for building strong technical
capacity, competency, leadership and a critical mass of regionally networked
specialists. A regional animal health network will join forces to: 1) exchange
information and experience, 2) standardise laboratory, field prevention/control,
operating, communication and other procedures, 3) identify gaps, weaknesses and
priorities, and 4) fulfil these gaps, e.g. by providing training, capacity building. This can
be done by means of specific meetings, exchange of people, training and capacity
building, organization of ring trials, joint work plans, etc.
The initial driver of the network will be brucellosis, which is a high priority for all Central
Asian countries. Bovine and small ruminant brucellosis can be controlled and, as the
primary responsibility of all governments is to protect all people leaving no one behind,
it is their duty to give high priority to reducing risks associated with zoonotic diseases.
FAO and the U.S. Centers for Disease Control and Prevention have jointly developed a
Stepwise Approach for the Progressive Control of Brucellosis (SPCB) to aid countries
along the progressive control process.
2This report details the SET mission conducted in the Kyrgyz Republic during October
2019, and highlights outcomes and recommendations for the improvement of the
local animal disease surveillance system.
Objective of SET missions
The main objective of the mission was to conduct an external evaluation of the animal
health surveillance system in the Kyrgyz Republic using the SET tool, with specific focus
on:
• Institutional organization and legal frameworks at central, intermediary, and field levels
• Timeliness and quality of laboratory analyses
• Surveillance activities and methodology
• Epidemiology workforce capacity and management, and epidemiological training
• Outbreak investigation mechanisms and resources
• Data management and analysis
• Communication and reporting of results to internal, local, multi-sectoral and international
stakeholders
• Sensitivity, specificity, representativeness, rapidity, simplicity, flexibility, acceptability, data
quality, stability, and utility of the surveillance system
Examining each of these areas in the Kyrgyz Republic context allowed for the
identification of strengths and areas of improvement for the surveillance system.
Recommendations on tangible actions were then made in the form of an action plan
to reach realistic goals for improvement.
Given the importance of brucellosis for CAAHN and all participating countries,
including Kyrgyzstan, particular attention was paid to capture and gather brucellosis-
specific information related to surveillance.
3Evaluation methodology
The SET toolkit and expected outputs
SET was developed to provide a comprehensive evaluation of the animal health
surveillance system of a country, using a scoring grid composed of 90 indicators. These
indicators are grouped into 19 “categories”, which constitute seven “areas” (Table 1).
Using the information gathered during the evaluation mission, a score from 1–4 (or
“N/A” if the indicator is not applicable) must be assigned to each one of these 90
indicators. Finally, after the scoring session, outputs are generated to identify the
strengths and the gaps of the evaluation system, including:
• Core-results for the operation of the surveillance system, assigning a score for each category and
area evaluated by SET.
• Performance attributes of the surveillance system (sensitivity, specificity, representativeness,
rapidity, flexibility, reliability, stability, acceptability, simplicity and utility). These performance
indicators are calculated using weighted coefficients assigned to the scores obtained for each
indicator.
Table 1. Categories and areas evaluated by SET
Area Category Nº of indicators
Central institutional organisation 7
Institutional
Field institutional organisation 8
organization
Intersectoral collaborations 4
Operational aspects 2
Laboratory Technical aspects 8
Analytical aspects 3
Objectives and context of surveillance 4
Surveillance data collection 14
Surveillance
Surveillance procedures 9
activities
Animal health investigations 2
Risk assessment 2
Epidemiology Workforce management 5
workforce Training 4
Information system 2
Data management
Data processing and exploiting 5
Internal communication 4
Communications
External communication 3
Internal evaluation 2
Evaluation
External evaluation 2
Total indicators 90
4Phases of SET missions
SET evaluation missions consist of four main phases:
• Preparation and document review. Preparation of the mission starts at the latest one month
prior to the arrival of the team into the country. During this phase, team members finalise the
mission’s program, stakeholders to interview and logistics in the field. The full SET package is
also shared with each evaluator so that they can familiarise themselves with the toolkit and its
methodology. A number of documents to support the information provided during the
interviews must be shared by the national focal points prior to the mission – these include
standard operating procedures (SOPs), protocols and other written documents describing how
the surveillance system functions.
• Data collection during stakeholder interviews. Detailed information on the country’s animal
surveillance system is elicited through participatory interviews with various stakeholders at
each level of the system (national, subnational and field) and in the field (livestock owners,
traders, abattoirs, markets, public/private sector and more). A structured questionnaire is
available to identify the information required for a complete evaluation. Nevertheless, a key
element of the SET methodology is to embrace dialogue with stakeholders and therefore the
questionnaire may only be utilized as a guideline during the interview process.
• Scoring session. The evaluation team enters the information gathered during interviews into
the SET scoring grid (Excel file), by assigning a score (1–4) to each of the 90 indicators
evaluated, along with a justification.
• Development of country-specific recommendations. Based on the scores entered into the SET
scoring grid, graphs highlighting the system’s strengths and weaknesses are automatically
generated. These outputs become the basis from which recommendations are identified. A
final restitution meeting reports the evaluation’s conclusions and recommendations to key
decision-makers for their feedback, and allows for discussion and amendments to the
recommendations to be made.
5The SET mission in the Kyrgyz Republic
Local situation and livestock production
Livestock play an important role in the Kyrgyz Republic as a source of income for 64
percent of the rural population. They are a source of employment, both at the
production and post-harvest/processing stages, accounting for about half of the
agricultural contribution to the national gross domestic product while also possessing
export potential. In addition, livestock products represent a substantial part of the diet
in the Kyrgyz Republic. At the end of 2018, the livestock industry accounted for 6.1
million sheep and goats, 1.6 million cattle (including yaks), 0.5 million horses, and 6.0
million poultry (Table 2). The Kyrgyz Republic has a very particular production
environment due to the geographic and climatic conditions, with extensive livestock
production expected to continue as the priority system into the future. Animals are
kept primarily in smallholder systems. Cattle, sheep, goats and poultry constitute the
most economically dynamic and promising species, along with horses which are used
in transport and in meat/milk production.
There is a significant variation in livestock populations and species composition across
the country:
• Osh, Jalal-Abad and Chui lead in cattle population; Jalal-Abad, Osh and Naryn in sheep and
goat populations;
• Naryn, Osh and Issyk-Kul in horse population; and
• Chui in poultry population.
Mainly due to differences in proximity to internal and external produce markets, as
well as the transfer of live animals for use / slaughter from other oblasts (provincial
level), Chui, Osh and Jalal-Abad oblasts have the highest meat production amongst all
oblasts. Chui is also a dynamic leader in egg production, and Osh and Jalal-Abad
oblasts in wool production.
The livestock sector is the country’s largest land user, natural mountain pastures with
rich grass occupy 83 percent of agricultural land, or 9.3 million hectares. The type of
seasonal use divides the pastures into the summer distant pastures (rangelands, 3.9
million hectares), spring and autumn pastures (2.8 million hectares), and winter
pastures (near villages/settlements, 2.4 million hectares). In 2009, a the new Pasture
Law was adopted which delegated the authority for pasture management and use
rights from Aiyl Okmotu to the Pasture Users’ Union and their executive bodies, the
Pasture Committees (PC). In total, 456 Pasture User Associations have been
established and are operating throughout the country.
The cattle population is comprised of the Alatau brown cattle and the Aulieatanskaya
breeds. All animals have been identified (tagged) and entered into the Animal
Identification and Traceability System (AITS), as well as undergo strict veterinary
records for all preventive measures. In the valley areas of the country, dairy processing
factories purchase milk from the rural population. This system is well developed in the
Chui Oblast, in the eastern part of the Issyk-Kul Oblast, and in Talas, Osh, and Jalal-
Abad oblasts. At the time of this writing, the price of 1 litre of milk was about 17–20
soms/0.29USD.
Yaks are mainly concentrated in high mountain pastures, in the summer altitudes
ranging from 3 200–4 200 meters above the sea level, and in the winter at altitudes of
62 000–2 300 meters above sea level with a small amount of additional fodder in the
spring during the calving period. Gourmet yak meat is mainly sold in the domestic
market all year round.
Table 2. Number and type of livestock in the Kyrgyz Republic
# KR/regions Cattle Yaks Horses Sheep and Poultry
(oblasts) Goats
1 Kyrgyz Republic 1 627 296 38 488 498 684 6 167 949 6 009 697
2 Batken 149 012 1469 7774 504 002 281 429
3 Osh 366 327 5950 96 439 1 142 087 638 953
4 Jalal-Abad 329 623 305 71 444 1 305 833 1 114 212
5 Issyk-Kul 237 564 9769 105 606 916 615 950 268
6 Naryn 174 650 18 810 119 367 1 064 767 204 510
7 Chui 289 952 1195 70 074 655 618 2 480 455
8 Talas 67 596 611 26 836 552 706 257 674
9 City Bishkek 589 0 261 1864 18 252
10 City Osh 11 362 0 737 24 328 62 959
11 Special 621 379 146 129 985
recording*
* These are animals that belong to the farms of the Ministry of Internal Affairs
The horse industry is traditionally highly profitable due to the low cost of winter feed.
Gourmet meat and koumiss (a fermented liquor prepared from mare's milk) are mainly
sold at the domestic market. The cost of 1 litre of koumiss ranges from 40–80
soms/1.15 USD, the milking period is 100–120 days with an average of 5–6 litres per
day from one mare. Recently, racing breeds are being imported in to the country, such
as the English thoroughbred, Russian fine harness horse (trotter), American
Standardbred breed, and partially heavy breed.
Sheep are mainly represented by the coarse wool breed and meat–and-fat breed,
these are crosses of the Hisar breed and cross of the Edilbaev breed. The remains of
the former Kyrgyz fine-fleece breed represent the wool sheep breeds; there are about
300 000 head.
Goats are represented by the local breeds for the production of fluff and meat, with
many goat farms in the southern regions of the country in areas of rocky steep knolls
and with a semi-desert type of pasture. In the valley zones where it is possible to
produce abundant feed, intensive animal husbandry is well developed. There are many
dairy farms in stall barn housing and farms engaged in year-round fattening of young
cattle and horses for meat.
With the onset of the warm weather period, animals move to the pastures. The grazing
period on average starts from 1 April–25 May before cattle move to the summer
pasture until 20 September. After harvesting crops in the field, cattle are grazed on
crop residues. From November, some herds move to winter pastures and some to stall
barn housing.
7Regarding wild fauna, in the Kyrgyz Republic today, there are 83 specially protected
natural areas with a total area of approximately 800 000 hectares, which is four
percent of the total area of the country. There are six reserves, eight national parks,
and 67 natural parks (subdivided into forests, botanical, geographical, and hunting). In
addition, there are two biosphere reserves recognized by the United Nations
Educational, Scientific and Cultural Organization (UNESCO). Deer (550 animals), argali
(22 000 animals), Rocky-Mountain goat (38 000 animals), roe deer (5 000 animals), and
wild boars (1 000 animals) are found in the Kyrgyz Republic.
Composition of the Evaluation Team
The evaluation team consisted of eight members of the Kyrgyz Republic Veterinary
Inspectorate, FAO Kyrgyzstan, FAO Regional Office for Europe and Central Asia in
Budapest, and FAO Headquarters in Rome (Table 3).
Mission summary
Identification of the stakeholders and areas to visit reflected the need for a
representative assessment of the Kyrgyz Republic animal disease surveillance system,
balanced with logistical limitations of field work. The mission started on 23 September
2019, when members of the evaluation team met at the FAO Kyrgyzstan office in
Bishkek to finalise the agenda and ensure adequate coverage of all identified
stakeholders. Immediately afterwards, a launching meeting was held at the Ministry
of Agriculture, Food Industry, and Melioration (MAFIM) together with 20 key decision-
makers of the animal disease surveillance system in the Kyrgyz Republic, including
Table 3. Evaluation team during the SET mission to the Kyrgyz Republic, October 2019.
Team member Title and organisation
Ryan Aguanno Veterinary epidemiologist, FAO Rome
Dinara Imanbayeva Veterinary epidemiologist, FAOSEC Ankara
Marina Kichinebatyrova Veterinary epidemiologist, FAOKG Bishkek
Larisa Ermakova Center for Veterinary Diagnostics and Expertise in the
northern region of the Kyrgyz Republic
Chyngyz Romanov Head of Animal disease monitoring department, State
Inspectorate for Veterinary and Phytosanitary Safety
under the Government of the Kyrgyz Republic (SIVPS
GKR)
Adilet Sotovaldiev Chief Inspector of Animal disease monitoring
department, SIVPS GKR
Murat Kenjebaev Inspector of State veterinary surveillance unit, SIVPS
GKR
Ozot uluu Erlan Inspector of Internal veterinary surveillance
Department, SIVPS GKR
Danyar Januzakov Chief Inspector of State veterinary surveillance unit,
SIVPS GKR
Aichurek Baitova Lawyer, SIVPS GKR
8representatives from various departments within the State Inspectorate on Veterinary
and Phytosanitary Safety (SIVPS). The launching presentation highlighted the
development of the SET, as well as the goals for the mission. Interviews with the Chief
Veterinary Officer (CVO), Deputy Director, Head of the Southern Region Central
Veterinary Laboratory, and Oblast veterinary services from Batken, Jalal-Abad and Osh,
who had been specifically transported to Bishkek for interviews immediately, followed
the launching meeting. This allowed for representation from the southern part of the
Kyrgyz Republic, which could not be visited during field interviews.
The first two days of interviews allowed the evaluation team to gain a clearer
understanding of the structure and function of the system at the central level, as well
as the integration between human and animal surveillance systems in place in the
Kyrgyz Republic at the time of the mission. Interviews at the central level also included
the following: State veterinary surveillance unit, Animal Health Control Department,
Internal Veterinary Surveillance Department, Animal Disease Monitoring Department,
Food Safety Sector, Identification and Traceability Unit, Border Control Unit, Agency of
Environmental Protection, and Public Health, before travelling to the Northern Region
Central Veterinary Laboratory.
The evaluation team then commenced the field portion of the mission (Fig.1).
Stakeholders selected for interviews originated from various district/raion and city
veterinary offices and laboratories, as well as livestock farmers and associations,
abattoir workers, and private veterinarians. A total of 104 interviewees were
interviewed at all levels of the system to obtain a thorough understanding of the
context of surveillance in the Kyrgyz Republic.
Following the data gathering phase, the team reconvened in Bishkek on 30 September
to summarize the information from the interviews and begin scoring the system using
the SET tool. A strengths, weaknesses, opportunities and threats (SWOT) analysis was
done to help identify specific recommendations to improve on the gaps identified.
A closing meeting took place on 3 October 2019 where findings of the mission and
recommendations were presented to key decision-makers, who were then provided
an opportunity to comment on the preliminary findings. Following this meeting, the
evaluation team met one last time to provide feedback on the mission in order to
improve future iterations.
9Figure 1. Areas visited during SET evaluation mission in the Kyrgyz Republic, October 2019 (Source: UN).
Blue stars denote location of laboratory or veterinary services staff (four) transported to Bishkek for
interviews.
10Evaluation results
Description of surveillance system
Central and Sub-national Organisation
The State Inspectorate on Veterinary and Phytosanitary Safety is a subordinate
organization of the Government of the Kyrgyz Republic, with a clearly identified
management structure headed by the CVO. Central level activities are supported by
the relevant subordinate divisions (Fig. 2), which play an important role in the animal
disease surveillance system.
Figure 2. Organisation of the State Inspectorate showing number of employees in brackets, Kyrgyz
Republic, October 2019
Effective national, as well as Eurasian Economic Union (EAEU) regulations are in place.
Government decree 81 from 10 February 2014 covers all emergencies involving
government representatives (Ministries), as well as establishes the Veterinary Service
Steering Committee that is in charge of general issues, including surveillance. The
Kyrgyz Republic has prioritised eight diseases (Table 4) that play a key socio-economic
and trade role for the country, with strategic plans developed for each disease. Lumpy
skin disease (LSD) and African horse sickness (AHS) are in draft legislation to be
included as future priority diseases. It was noted during the evaluation that many of
these strategic plans need to be revised based on more comprehensive risk
assessments.
At the field level, there is zoning based on administrative divisions covering the entire
country, with supervision of the private veterinary professionals conducted by raion
veterinarians. The number of veterinary epidemiologists is limited at regional and field
levels. Private veterinarians operate in each village on a contract basis implementing
the vast majority of state activities on disease prevention (e.g. vaccination, animal
identification and sampling), and providing other services for farmers. Private
veterinarians are responsible for the entire total population in the administrative unit,
but difficulty accessing remote pasture areas due to transportation issues and reduced
Table 4. Notifiable animal diseases in the Kyrgyz Republic
Notifiable animal diseases (VSD)
Foot and mouth disease Anthrax
Sheep and goat pox Peste des petits ruminants
Echinococcus Brucellosis
11profitability of these visits was noted. Equipment is often out of date or inadequate for
all surveillance capabilities (e.g. it was mentioned that a cold-chain for disease sample
submission is often unavailable). These issues continue to impact disease reporting,
though overall the provision of supplies by the veterinary services is commendable.
A new animal identification system is in place currently covering every individual cattle,
including yaks. The system is planning to begin incorporating horses and donkeys
before the end of 2019.
Intersectoral Collaboration
Collaboration with other ministries is governed by a Government decree with
guidelines in place. Legislation is also present which defines the role of the private
veterinary industry in the delivery of ground-level animal health services. There are no
functioning private animal health institutes or laboratories operating within the
territory at this time, apart from small private laboratories operating in markets that
are capable of performing basic food safety testing. A memorandum of understanding
(MoU) related to epidemiological investigation and the exchange of information on
zoonotic disease with public health (PH) authorities, the Ministry of Environmental
Protection (MoEP), military services, and scientific institutes has been signed. Rapid
response teams have also been created under this MoU and cover oblast, raion, and
village levels, who are able to respond within 48 hours. Meetings of all stakeholders
involved are conducted once yearly or more frequently in the face of emergencies.
During interviews, PH authorities demonstrated interest in improving and coordinating
joint surveillance activities. Though the MoEP is included in the MoU and collaboration
has increased since 2017, there was a noted need for improvement in this area. There
are no international organisations such as FAO captured under the MoU.
Laboratory
The Kyrgyz Republic has two central level laboratories (Northern and Southern regions,
Bishkek and Osh respectively) that perform standardised and harmonized testing
activities. The laboratory system is well structured and fully involved in epidemiological
surveillance, implementing diagnostic activities according to the State Plan.
There is an agreement in place with international reference veterinary laboratories for
sample shipment and testing. The Federal Centre for Animal Health of the Russian
Federation (FGBI ARRIAH) is the most commonly utilised to conduct testing unavailable
within the Kyrgyz Republic. Unfortunately, the lack of a proper provider to ship
samples limits the laboratory from conducting proficiency testing with internationally
recognized reference laboratories in a regular manner.
In cases of emergency events, the central laboratories are able to provide support to
the raion level laboratories with respect to staffing, diagnostic testing, or other
equipment needs. A mobile team is available to accompany private veterinarians in
the field, however the team is not comprised of specific focal points and greater
availability of rapid testing kits are warranted.
Currently, accreditation has been received at only the two central level laboratories
for 18 tests, however the development of additional tests for priority diseases is
planned, as is the accreditation of zonal laboratories. Quality control managers have
already begun working to prepare this eventuality. Though the central laboratories are
confident in the testing methodologies applied, at the raion level there is a need for
the improvement of work standardisation. However, inter-laboratory proficiency
testing is conducted for all priority diseases. Varying diagnostic techniques are
12available to differentiate suspect cases versus confirmed cases, but case definitions
have not been clearly defined in national regulations (default OIE definitions are most
often used). Data management of laboratory samples is organized using a combination
of paper and Excel files, covering the process of sample registration to results delivery.
This system would benefit from the introduction of a laboratory information
management system (LIMS), capable of reducing human error and improving
laboratory efficiency across the entire system. Reports from laboratory submissions
are communicated separately to the field and central levels.
Surveillance Activities
Though formal surveillance protocols are in place, some of those (which originated
before independence in 1991) could benefit from revision. The Programme of
Veterinary Service Development for 2018–2023 was approved by Government decree
and includes disease-specific surveillance objectives in a basic but not easily
measurable format. These objectives have been created in collaboration with
identified partners such as FAO. In some instances, objectives lack aspects of disease
surveillance such as identifying prevalence or incidence, as well as differentiating
between confirmed vs. suspect case definitions. Moreover, field level private
veterinarians are not overly familiar with the definitions provided.
Priority diseases are identified based on a variety of factors (including socio-economic)
and the list is continually assessed during meetings and discussions with stakeholders.
There is a plan to update the list of priority diseases by adding LSD, AHS, and African
swine fever.
A draft law on anti-epizootic activities, which dictates the notification and response
procedure, is expected to be approved in 2020. At the moment, notification and
response are covered by disease-specific legislations where they exist.
Private veterinarians currently submit disease reports monthly, with the central level
confirming that over 95 percent of report forms were filled in at the time of the
evaluation mission. At the field level, it was stated that the forms, which are reviewed
for format annually, are simple to fill out but too high in number. A current pilot project
in the Alamudun raion allows private veterinarians to submit disease reports
electronically. Reports to the EAEU are required monthly based on the forms. In
addition, six-monthly reports and annual reports are submitted to OIE. There are also
bilateral agreements with neighbouring countries on disease situation reporting.
13Figure 3. Animal disease reporting lines in the Kyrgyz Republic
Overall, there is a strong understanding of the importance of the surveillance system
amongst private veterinarians and farmers. In the case of disease suspicion, a farmer
is obligated to notify the private veterinarian or paraveterinarian immediately. There
was no indication from farmers or private veterinarians that a disease would not be
reported. Private veterinarians are covered by the necessary legislation when they
require farm access, with fines permitted if access is not allowed. However, due to the
current moratorium on private sector inspection (e.g. farmers, production facilities) to
allow for acceptance and uptake of new legislation, few visits are being conducted at
this time.
Objectives of the surveillance system are generally met, and active and passive
surveillance is planned accordingly. Geographic coverage is taken into consideration
to ensure the population is appropriately covered. For brucellosis, all milking cattle are
sampled, with calves vaccinated at three months of age. For FMD, random selection is
performed based on geographic coverage.
It was reported that nearly all active surveillance plans for the country are completed
on an annual basis. For brucellosis, this includes seromonitoring of the entire cattle
population. Investigations are conducted systematically based on SOPs. Sampling as
well as sample packaging and transport SOPs were developed by FAO based on
International standards.
Epidemiology Workforce
Terms of reference are in place for each individual, including private veterinarians,
which are reviewed and approved annually. The Deputy Head of the Raion Veterinary
Department is in charge of all epidemiological activities, planning, and response. An
epidemiology expert is employed at the raion level who is supported by the
epidemiological department at the central level. These experts must hold at least five
years of experience.
Each veterinarian at the raion level and central level is required to have a veterinary
degree, which is considered equivalent to a Masters level. At the central level there
are several employees holding PhDs.
14All veterinarians receive continuous on-the-job training and initial support upon entry
to the system (e.g. mentorship), however there is no standardised initial training
programme. Ongoing trainings are organised by either the central level and/or
international organizations (e.g. FAO), with field-level interviewees specifically
requesting more surveillance training and a higher frequency of training overall.
Data Management
A variety of databases exist to manage epidemiological data for the veterinary services.
The Raion Animal Disease Information System (RADIS) and National Animal Disease
Information System (NADIS) are utilised to input animal disease events at the raion
and national level, respectively; DOGSKG is used to store information of canine
identification; the Animal Identification and Traceability System (AITS) records ear tag
data, and; the Elek Information System (ISELEK) is used to monitor veterinary
certificates. Where appropriate, there is planned improvement of these systems
including interoperability between existing national databases and with the databases
of the EAEU.
Entering disease data into RADIS at the field level was viewed by interviewees as time-
consuming since currently private veterinarians do not have access to data entry. As a
result, all records are entered at the raion office over a period of several days each
month. Though this process is not streamlined, it does allow for data verification and
is governed by a formalised set of procedures. However, improvements could be made
into tracking which users have not submitted monthly reports and allowing for
horizontal access to reports across raions. Overall, it was mentioned by multiple field
actors that the number of forms to fill in could be reduced and due to separate EAEU
record keeping there is duplication in data submission.
Data analysis is currently performed at only a basic level due to unavailability of
appropriate software or training. Geographic Information System (GIS) software is not
utilised and mapping of disease events is not regularly conducted. Analyses are
currently conducted by a team of six people within the Risk Analysis Unit. Analyses are
conducted at the central level only and not shared back with the field.
Communication and Evaluation
Monthly meetings are held with private veterinarians within the raions where report
submissions are reviewed, data is validated, and missing data is sought. Similarly, the
central level holds monthly meetings with raion veterinarians and the veterinary
association. Two to three times annually there are also workshops, with quarterly
meetings related to surveillance. The central unit makes quarterly visits to the field for
supervisory purpose.
Due to financial constraints, there is currently no epidemiological newsletter being
regularly released, though leaflets or bulletins do exist. When released, newsletters
are available on the veterinary services website, however no example was seen.
Communication regulations state that one person for each raion is responsible for
horizontal and vertical communication, however this is mostly done through informal
WhatsApp groups. Horizontal communication across raions also requires
improvement.
There is mandatory communication with the EAEU, OIE, and FAO managed by a unit
for international relations and communication. Greater financial and material
resources are required for a variety of communication needs including
videoconferencing, printing, publishing of scientific articles, improvements to internet
15connectivity, and an information technology (IT) specialist. Currently there is only one
person at the central level employed for communications.
Formal performance indicators for the surveillance system are absent, though the
central level does perform ad-hoc internal evaluations which may cover aspects of
surveillance. Veterinarians are assessed individually on an annual basis against their
ToRs. The surveillance system could benefit from complete, regular, and measurable
evaluation of activities. Excluding this evaluation, the surveillance system has partially
been externally evaluated by the OIE (PVS Gap Analysis Mission Report) and
International Fund for Agricultural Development (IFAD), with many recommendations
captured in the "Development of the Veterinary Service of the Kyrgyz Republic for
2018–2023" approved by the Government of the Kyrgyz Republic, 17 October 2017.
SET outputs
Two different types of outputs are provided by the evaluation:
• Core results (Table 3, Fig. 4)
• Performance attributes (Table 4, Fig. 5)
Core results
The core results describe the operation and general status of the surveillance system,
assigning a score to subcategories within each area evaluated by the SET (Table 1). All
scores are expressed as percentages, based on an ideal situation where scores of 4 are
given to all indicators (100 percent).
The strongest individual category scores were “Laboratory – Operational aspects” and
“Animal health investigation” (100 percent), which scored highly due to a well
organised and incorporated laboratory structure, as well as the presence of multi-
tiered rapid response teams governed by clearly defined protocols. These were
followed by “Internal communication” and “Intersectoral collaboration” (91.7
percent). Categories that received the lowest scores included “Risk assessment” (50
percent), “External communication and resources” (44.4 percent), and “Epidemiology
workforce training” (41.7 percent) (Table 5, Fig.4).
Figure 4. Comparative SET graphical outputs for the Kyrgyz Republic by category, October 2019.
16Table 5. SET outputs for the Kyrgyz Republic October 2019
Score by area Score by category
Area Category
(%) (%)
Central institutional organization 85.7
Institutional 36.8 Field institutional organization 79.2
Intersectoral collaborations 91.7
Laboratory - Operational aspects 100.0
Laboratory 41 Laboratory - Technical aspects 62.5
Laboratory - Analytical aspects 77.8
Objectives and context of surveillance 75.0
Surveillance data collection 78.6
Surveillance activities 48.4 Surveillance procedures 83.3
Animal health investigation 100.0
Risk assessment 50.0
Score by area Score by category
Area Category
(%) (%)
Epidemiology Workforce management 86.7
44.4
workforce Training 41.7
Information system 83.3
Data management 52.4
Data processing and exploitation 73.3
Internal communication 91.7
Communications 38.1
External communication and resources 44.4
Internal evaluation 50.0
Evaluation 50
External evaluation 83.3
Performance attributes
Qualitative attributes have been identified and used by several international
organisation to evaluate the general performance of a surveillance system (Table 6)
(CDC, 2001; CDC, 2004; Health Canada, 2004; WHO 1997). The SET Excel spreadsheet
calculates the progress of the surveillance system relative to these performance
attributes and generates visual outputs in the form of a spider graph (Fig. 5). Scores
for indicators are weighed according to their importance to a specific attribute and
outputs are generated as percentages of an ideal situation (scores of 4 on all
indicators). An exhaustive list of the relationship between indicators and attributes is
available upon request.
Performance outputs for animal disease surveillance in the Kyrgyz Republic revealed a
surveillance system with lower scores for “specificity” (53 percent) and “rapidity” (63
percent). This is in part explained by the need for more specific laboratory testing.
Likewise, “rapidity” received a 63 percent score in part from a combination of low
numbers of rapid testing kits for the field and poor accessibility to some areas under
surveillance. On the other hand, the “representativeness” of the surveillance system
received the highest score (100 percent) due to both reliable and evenly distributed
reporting across the entire country.
17Table 6. Performance attributes evaluated by the SET
Attribute Definition
Sensitivity The ability of a surveillance system to detect true health events i.e. the
ratio of the total number of health events detected by the system over the
total number of true health events as determined by an independent and
more complete means of ascertainment.
Specificity A measure of how infrequently a system detects false positive health
events i.e. the number of individuals identified by the system as not being
diseased or not having a risk factor, divided by the total number of all
persons who do not have the disease or risk factor of interest. Because of
the difficulties in ascertaining the total population at risk in surveillance,
determination of the number of misclassified cases (false positives) can be
used as a measure of the failure of the system to correctly classify health
events.
Representativeness A surveillance system that is representative accurately observes both the
occurrence of a health event over time and the distribution by person /
animal and place of that event in the population at any point in time.
Rapidity/Timeliness The interval between the occurrence of an adverse health event and (i)
the report of the event to the appropriate public health agency, (ii) the
identification by that agency of trends or outbreaks, or (iii) the
implementation of control measures.
Flexibility The ability of the surveillance system to be easily adapted to new
reporting needs in response to changes in the nature or the importance
of the health event, the population monitored, or the resources available.
Data quality Reflection of the completeness and validity of the data recorded in the
public health surveillance system.
(reliability)
Stability The surveillance system’s ability to collect, manage, and provide data
properly, and its availability (the ability to be operational when it is
needed).
Acceptability Assessed by the willingness of persons conducting surveillance and those
providing data to generate accurate, consistent and timely data.
Simplicity Refers to both its structure and ease of operation. Surveillance systems
should be as simple as possible while still meeting their objectives.
Utility/usefulness The usefulness of a surveillance system is assessed by whether it leads to
prevention or control or a better understanding of health events.
18Attribute Score
Flexibility 84%
Utility 88%
Acceptability 78%
Data quality 75%
Sensitivity 83%
Specificity 53%
Stability 74%
Simplicity 77%
Representativeness 100%
Rapidity 63%
Figure 5. SET outputs for the Kyrgyz Republic by performance attribute of the system, October 2019.
19Recommendations
SWOT analysis
A strengths-weaknesses-opportunities-threat (SWOT) analysis was conducted to gain
a better understanding of the animal disease surveillance system in place in the Kyrgyz
Republic. In this context, the strengths of a surveillance system refer to those aspects
that are done well and need to be maintained or reinforced. On the contrary,
weaknesses are characterised by areas where the system needs improvement in order
to function better. Opportunities and threats refer to external factors that can
positively or negatively impact the system, respectively.
Strengths
Network
• Multiple stakeholders involved in surveillance planning (e.g. laboratories staff) and
approval of action plans (strategic plans) for disease control.
• Well-developed laboratory network with powerful diagnostic capabilities, especially at the
central level (accredited).
• Movement of livestock to pastures managed through pasture control points and the
Association of Pasture Users allowing for surveillance hot spots.
• Significant number of private veterinarians employed who conscientiously carry out their
work and are supplied with equipment.
• Good communication at all levels in the system (feedback and frequent discussion
among participants in the system).
• Professional staff at all levels who respect importance of surveillance in disease prevention.
Modernisation
• Five electronic information systems (ISELEK, NADIS, RADIS, DOGSKG, AITS), which are
consistently reviewed for improvement (e.g. granting greater access to users).
• Identification system for cattle and pigs implemented, with horses and donkeys in the pipeline,
and sheep and goats planned for the future.
• Several newly built slaughterhouses in accordance with international standards which have
been designed to facilitate surveillance of carcasses.
Administration
• Independence for planning and financing activities, including internal control to assess the use
of funds (randomly selected) and internal auditing.
• Strict selection of veterinary candidates entering the government system.
• Legislation updated with some frequency and well respected and enforced.
• Priority diseases are often selected because of social, technical, historical, and political factors.
Weaknesses
Funding
• Careers as veterinary services personnel, and to lesser extent private veterinarians, are not
viewed favourably by younger generations due to relatively low pay.
• Field level veterinary services are privatised, which means isolated farms or households may
not be financially profitable to include in surveillance or that private veterinarians may not
have transport means (e.g. vehicle, horses) to enable access.
• MoEP is in charge of wildlife surveillance, but does not have a budget line for veterinary
activities.
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