Imagine a poor family that owns a cow and calf. Now imagine the impact on that family when the calf dies from foot and mouth disease (FMD), the cow’s milk production is diminished and she cannot be used to pull the harvest by cart to market, or has further complications from secondary bacterial infection. Anyone who has seen FMD can empathize with the pain and suffering the disease causes not only to resource-poor farmers, but to commercial farmers as well.

FMD affects all cloven-hoofed species such as pigs, sheep, cattle, goats and deer and loss of these animals can have devastating subsequent impacts on local communities, people’s livelihoods and food security. It decreases efficiency in all production parameters such as weight gain, quantity and quality of milk, expression of genetic potential and reproductive performance. Reduced access to nutritious foods has consequences for the needs for children’s cognitive growth, pregnancy and women’s post-maternity health.

Furthermore, exorbitant embargos can be imposed on countries with FMD, or those endemically infected, by countries recognized as FMD-free. Fighting back to FMD-free status and recuperating lost markets can be crippling after an introduction of the disease.

As medical practitioners having taken the Hippocratic Oath, we should strive to alleviate FMD and its effects and ensure that our methods of control, containment and prevention are reasonable and humane.

Globally, the livestock sector contributes approximately 40% to agricultural gross domestic product (GDP); in Australia this contribution is around 60% and in New Zealand closer to 80% (2010; FAOSTAT). However, the footprint of FMD can rapidly change for the worse, as evidenced in the recent outbreaks in new territories and the incursion of novel viruses in unprotected populations, such as in eastern Asia.  If local, national, regional and international efforts in FMD reduction are to succeed, prevention is the key and this requires investment in disease intelligence, emergency preparedness, contingency planning, and transparency in reporting.

 Over the last few years, the Food and Agriculture Organization of the United Nations (FAO) has been promoting a risk-based approach called the ‘progressive control pathway’ (PCP) for FMD in endemic settings. This involves countries and regions embarking on understanding disease dynamics through epidemiological studies ranging from production and marketing to serological evidence of virus circulation and characterisation of circulating strains. ‘PCP zero’ is the first stage, where the disease is known to occur but there is no ability for its management. The last stages, four and five, are where the World Organization for Animal Health (OIE) has recognised that the country or zone is free with or without vaccination respectively, providing countries with international disease-free status. The PCP approach is now the FAO/OIE tool and the hallmark of its global strategy to control FMD.