 Good afternoon. My name is Augusta Kebunzia. I work for the County Government of Kittwee. And today, I'm presenting national strategy for prevention and control of anthrax in humans and animals in Kenya 2021 to 2036, and bring this on behalf of Zoonotic Disease Unit. Anthrax is a Zoonotic Disease caused by Bacillus anthraxis, sub-bacterial disease. And in Kenya, it is ranked the top most zoonotic disease. This is based on systematic analysis of the burden of the disease, socioeconomic impact, severity of the disease, and the potential to cause outbreak. Based on a records review from the veterinary department and public health from the national level, it has indicated that more than 10 outbreaks occur every year in Kenya with the spillover to humans. And this data is based on passive surveillance. However, it is considered to be underestimating the outbreaks. Because of this nature of surveillance, some of the outbreaks may go unreported or they are detected very late. Lack of one year strategy for control of anthrax has been noted in a number of reports. The OIE performance veterinary service report 2018 and the WHO joint external evaluation 2017 have noted the lack of one year strategy in control of anthrax and therefore recommendation we are meant to develop and implement one health to implement anthrax strategy. The objective of this strategy is to eliminate human anthrax, reduce the incidence of anthrax in animals to less than 1% of the baseline of 2021 by the year 2036. This strategy was developed through a quantitative meeting drawing stakeholders from the academia, from the relevant ministries, and from non-governmental organization. A series of meetings were held, drafts were developed, were reviewed, and are validated through workshops. The strategy is based on guiding principles that anthrax prevention and control requires a multisectoral and multidisciplinary collaborative approach and effectively reduces the negative impact on public health and national economy. And it involves breaking the cycle of infection and that community is key in prevention and control of anthrax. National committees will be developed at the national level, at the sub-count level and the county levels. And these committees will involve various stakeholders from the government ministries, from the county government, the national government, plus or involve professional bodies such as KVA and KMA, farmers and community-based organization. Other stakeholders will involve to be the regional and the national stakeholders. And all this will work to guided by certain thematic area as we discussed to go on. The anthrax and prevention control strategy will have seven pillars on which its implementation will be based. One, coordination, collaboration and partnership. And the objective of this is to enhance collaboration between ministries and other partners and NGOs to ensure that anthrax is well-prevented and controlled. Two is surveillance, reporting, systems and outbreak response. During implementation of this strategy, this existing surveillance system will be enhanced. This to ensure that we receive timely reporting of outbreaks and also response to any outbreak before it spills to the humans. Third will be prevention and control anthrax. These both in animals, wildlife and in human. The objective will be to ensure that vaccines are available, quality vaccines that are available and affordable to the communities. And also that guidelines on ensuring that any cases confirmed of anthrax are well-handled to prevent contamination of the environment and also infection of humans. Resource mobilization, this will be done through advocacy, holding meetings, seeking to get funds which will be very key in implementation and control of this strategy. Recommunication will be key. And the main objective is to increase awareness across the communities, which will be very important while controlling anthrax. Sex will be conduct, promote, operational and applied research. These studies will be very important as they will help us to get data and inform on the progress of the implementation of this strategy. Then the seventh one will be anthrax diagnostics, laboratory capacity. The objective of this pillar is to ensure that the capacity of the laboratories, both the regional and national, they were announced such that they can confirm in anthrax cases as well as promote networking of labs, both in the human and the public, such that they can share information on anthrax. The implementation of anthrax elimination strategy will follow four phases. These phases will systematically eliminate or reduce the cases in animals aiming at elimination of the disease in humans. And in each phase, we will have a set of activities which will be synchronized to ensure synergy and leverage. In stage one, which will run from 2021 to 2023 to involve the preparation and option phase, which will be phase one. And in this phase, it is assumed that anthrax is present, but the socioeconomic impact is not known. The burden of the disease is not known. In stage two, it will involve the implementation of the strategy in the iris zones, which will run from 2024 to 2027. In this phase, the situation is that we know the disease impact, the burden. We have implementation plan in place. And from that implementation plan, we'll have identified areas where anthrax is more, causing more burden. And this will be the iris areas. And this is where the implementation of the strategy will start to eliminate human anthrax in these areas. As we move to stage three, where the implementation of the strategy will be done across the country, from 2028 to 2032. In this stage, we'll sustain the efforts we have done in phase two and apply the lessons we have learned in the iris zones. And now control this disease across the whole country. Then in phase four, this is the stage where anthrax will be eliminated in humans, such that we have zero cases of human cases and rare cases in livestock. In phase one, these were most of the activities will be done because we do not know exactly the burden of the disease and a number of things have to be put in place to implement, to operationalize the strategy. And one will start with developing guidelines and start operating procedures which will enable us to operationalize this strategy. Guidelines such as vaccination guidelines, treatment guidelines, among others. Then we'll strengthen surveillance to ensure that we receive all the data, all the outbreak on timely, and also response to an outbreak. We'll also have a resource mapping, a resource mobilization, where in this we have to develop resource mobilization plans, have meetings and anti-focusing meetings in the national and the county governments and others decoders to source for funds to implement the strategy. Prevention and control measures in both human, animals, and wildlife to ensure that there is no spillover of the disease to humans and also contamination of the environment. We'll also develop communication plans. I identify the audience and also the communication channel will be identified at this stage and also conduct research so that we may identify the high risk and the low risk areas and also know and understand the economic burden of anthrax in the country. It is at this stage that we'll also form the elimination committees. At the national level we'll have the national prevention and control committee which will be a subcommittee of the zoonotic technical working group and zoonotic disease unit will be the secretariat. This committee will coordinate and oversee anthrax prevention control across the country. This committee will also have members from the international, regional, and other national partners. At the national level, a similar committee will be formed which will be called the county zoonotic committee and the county one earth units will be the secretariat. They will be reporting direct to the national prevention and control committee which in turn will report to zoonotic technical working group and this group will now report to the ministries of agriculture, livestock and fisheries, the minister of health. At the sub-count level, similar committee will be formed which will be direct to the communities where the implementation will be taking place and the information will flow now from the community to the sub-count level, to the county level, to the national level. High risk areas will be identified but from the review of records although this anthrax is endemic in the country it has been reported in some counties more often than others and it's from that review that this map was developed. Sat Narok, Kiambo, Meru, Nyeri had reported more anthrax cases in the past five years than other counties and these were identified as the high risk areas where the pilot of this anthrax strategy will be developed, will start being implemented. However, in the first phase through the operational research the risk map of anthrax will be developed and now it will be updated in the strategy which will be the real risk map for anthrax and it will be used for implementation of this strategy. Within these areas where anthrax will be occurring there will be odd spots and this will range from one to 50 kilometers based on production systems. Raw risk areas will are those areas where anthrax outbreaks has not occurred in the last five years. However, if anthrax outbreaks occurs in these areas it will be now classified as high risk areas and activities taking place the high risk areas will now be done in that area. Phase two, it is assumed that all structures will be put in place and now we are ready to start implementation of the strategy and this implementation will start in the high risk zones where advocacy, communication, social mobilization will be done vaccines will be procured distributed anthrax cases will be collected data on outbreaks will be collected and fed to national anthrax database assessment of economic cost analysis intervention will be done outbreak investigation and response will be done as well as communication across the counties across the border and impact of the vaccination will also be assessed as well as the vaccination survey and also training of the human and the veterinary personnel to ensure that they understand the control of anthrax. To move from this phase to the next phase we will ensure that some indicators will be used to show that we need to move to the next step and this will include vaccination of 80% of the livestock in the high risk areas and three rounds of vaccination will be key during that period that any outbreaks which will be reported in that phase at least 80% of these outbreaks are laboratory confirmed and reduce the incidence of anthrax in both human and livestock by 50% of the baseline also reduce the anthrax case of human livestock wildlife interface by 50% of the baseline at phase 3 it will aim to sustain the achievement of the stage 2 and this will be implemented the anthrax prevention control strategy across the country and here we will apply the lessons which will be learned in the high risk areas and the activities will include advocacy communication and social mobilization items surveillance to make sure we get information on time of any outbreaks vaccination figures sustained livestock vaccination will review and update the national anthrax risk map and evaluate the effectiveness of programs or the intervention which will be applied as well as communication across the counties to move from this phase the last phase the incidence of anthrax in animals and livestock will have reduced by 80% of the baseline as well as reduction of human livestock wildlife interface by 80% and the country will have at least vaccinated life 80% of the susceptible animals against anthrax elimination of anthrax in humans will be the last phase and this will be defined by having no human anthrax in a certain region and in this region there will be surveillance going on to make sure that there is no human case which is missed at the same time there will be sustained elimination activities in areas where the anthrax cases will be reported these areas which have not reported anthrax cases at least for two consecutive years will be declared as anthrax free this implementation will monitor and evaluated both internally and externally and for the internal monetary it will be led by a zoonotic disease unit whereby they have developed very viable indicators they will measure the progress and assess the achievement of the program in line with the strategy while external evaluation will be independent to assess the program and identify any modifications we want to acknowledge this organization for financial support while developing the strategy thank you and this is the strategy thank you very much Dr. I am sure that my good friend Dr. Nningi was happy to see the strategy Mr. Nningi Mark just a few questions for you which might be critical for you to address before we move on to the next session one a former DVS doctor is asking the strategy has moved to 2031 to 2036 what has shifted maybe you might not be the competent authority to answer there is a DVS representative who might help you the second bit of it is we are in the preparatory adoption phase which should run from 2021 to 2023 2021 is over 2022 might be lost due to elections how far have you done the preparations again you can pick those together and the last bit of it is how far have you gone for private sector in the strategy and have they been sensitized engaged because I think a lot of strategies have been developed internally as a government but maybe the to drive PPPs private sector that might need to play an important role need to also be engaged and is that part of the process and lastly there was a question by Maureen the challenges in getting vaccines and essentially the strategy is hinged on vaccinating a certain number of the population so would you have any comments around the vaccines and vaccination bits of it I'm sure Dr. Ayas might be able to put in one or two but we'll start with Augusta then Dr. Ayas can put in one or two then we can close the session thank you for the questions we are in phase one and we have undertaken some of the activities we have developed guidelines and we are developing the risk map as well as preparing to undertake other activities in the near future we have involved the private sector during the development of the strategy and is also one of the key stakeholders which will be involved in implementation of the strategy we aim at vaccinating at least 80% of the population and we believe that this will build the idea and such that this will be 70 to 80% vaccination coverage is always made to be effective in control of our disease thank you can request Dr. Ayas to chip in thank you Dr. Kebunze for the good presentation on the anthrax strategy mine is to react to the comments that have come in one was the question of when will it start I would say it has already started in the sense that for us to come up with a strategy there is a lot of epidemiological work that has already been undertaken so the first phase of knowing the extent of the threat of anthrax has been undertaken and from there is when we now move to developing the strategy itself so it's evidence based the various pillars that have come up based on evidence that has been collected over a long time the strategy itself has not been officially launched but we are planning to have it done within the next coming one month with the launch of the document we will now go full steam ahead to do the roll out with our country the challenge is that we have 47 governments disease control is devolved the money to do the control is out there in the counties but this is a priority and that they need to now work on it as one of the key deliverables in the coming years the private sector role again with the launch we expect that we will bring them on board there will be part of the people who will be invited to the launch key private sector people so that they can contribute they can take it home and look for their niche within the programs that are there I must admit vaccines can be a challenge but we do expect that once the counties take it up in their CIDP as one of the activities we can then work with them to access the vaccines the OIE has made a good offer that they can supply vaccines at a very good cost if we go as a country so we can take the various requirements of the counties the OIE and get the vaccine at a reasonable cost thank you you can be engaged on the chat and I'm sure your office is accessible so those of us who are interested can easily get to that space can easily get to that space can easily get to that space