Myanmar Pig Partnership Project Expansion

Diarrhoea and vomiting, caused by contaminated food of animal origin, are deeply damaging but often unrecognized blights on human health and well-being, particularly for poor people in low and middle income countries. Farming households are also likely exposed to these zoonotic animal-derived infections through direct contact, as well as through consumption of contaminated foods of animal origin. Our ongoing ZELS-funded project, "An integrated management-based approach for surveillance and control of zoonoses in emerging livestock systems: Myanmar Pig Partnership (MPP)" has already pointed towards opportunities for culturally sensitive and livelihood-relevant interventions to improve animal health, farm productivity, rational use of antibiotics and awareness of occupational and food-borne zoonotic risks. These opportunities for improved livelihoods of farmers exist on farms with lesser as well as greater intensities of production.

We propose that information on the human burden of foodborne and occupational (directly acquired) zoonotic disease from pig meat, and better understanding of the pathways for medical support of affected persons, would help greatly in the design and pilot delivery of preventive health advice for consumers as well as farmers, building further on the data already acquired in MPP. We also propose that better knowledge of this human burden of pig or pig meat-acquired disease would help us in prioritising and broadeing which government departments and policy makers we should talk to in order to make best use of our newly emergent data from MPP. This data includes detailed information on existing hygiene practices at slaughter and processing, and practices relating to selection, use and recording of antibiotics in pigs.

The key objectives of this proposal are:
(1) To set up pilot diarrhoea surveillance to obtain preliminary data on the leading pathogens causing infectious diarrhoea in Myanmar, focusing on our already identified farming households but also on acute hospital admissions in Yangon City.
(2) To develop, pilot and evaluate consumer and occupational health advice for the prevention of pig and pig meat associated zoonoses in Myanmar.
(3) To convert research outputs from the originally funded Myanmar Pig Partnership into useful evidence presented in the best format for informing policy development in food safety and antibiotic resistance, for strengthening veterinary expertise in pig health management, and to enable understanding and uptake of relevant finds by the widest possible group of stakeholders.

Endemic bacterial zoonoses, especially gastrointestinal infections, are a deeply damaging but often unrecognized limiter to human health and well-being, particularly of poor people in low and middle income countries. Our ongoing ZELS-funded project, "An integrated management-based approach for surveillance and control of zoonoses in emerging livestock systems: Myanmar Pig Partnership (MPP)" has pointed towards opportunities for interventions to improve animal health, farm productivity, rational use of antibiotics and awareness of occupational and food-borne zoonotic risks. Now we propose that data on the human burden of zoonotic disease especially from pig meat, and pathways for medical support of affected persons, would help in the design and pilot delivery of farmer and consumer targeted preventive health advice. We also propose that better knowledge of this human burden of pig or pig meat-acquired disease would help us in prioritising which government departments and policy makers we should talk to in order to make best use of our newly emergent data from MPP.

The key objectives of this proposal are:
(1) To set up pilot diarrhoea surveillance to obtain preliminary data on the leading pathogens causing infectious diarrhoea in Myanmar, focusing on our already identified farming households but also on acute hospital admissions in Yangon City.
(2) To develop, pilot and evaluate consumer and occupational health advice for the prevention of pig and pig meat associated zoonoses in Myanmar.
(3) To convert research outputs from the originally funded Myanmar Pig Partnership into useful evidence presented in the best format for informing policy development in food safety and antibiotic resistance, for strengthening veterinary expertise in pig health management, and to enable understanding and uptake of relevant finds by the widest possible group of stakeholders.

Impact-related activities in this project will benefit from the involvement of OUCRU, which has experience facilitating engagement activities with farming communities in SE Asia around zoonoses; MOCRU, which has local research and patient engagement expertise; and IDS, which has experience with high-level convening and managing impact-related communications, including those with a One Health focus. Relationships developed during MPP, in particular with national and international (OIE and FAO especially) stakeholders will be exploited and key to ensuring impact in this new project. The involvement of the Government of Myanmar, via our LBVD partner, will present opportunities for direct influencing.
The project will benefit people in poor rural communities by reducing the incidence of foodborne infections from pigs/pig meat to people. We will do this by organising culturally relevant events (for example, a village meeting or performance) in which we will impart key messages on how best to prevent infection from zoonotic pathogens such as Salmonella and Strep. suis. Messages will be developed in consultation with LBVD and MOCRU in Myanmar to ensure they are clear and practically feasible (where relevant) in the low-resource setting of Myanmar rural households. We will develop communications products to ensure these messages remain 'live' within the communities. Such products may include posters printed domestic items (such as plates and T-shirts) and stickers, which we will distribute at the events.
We will extend the impact of these messages beyond the participating communities by producing a short video which we will promote via social media, most likely Facebook, which is popular in Myanmar. Also, by seeking opportunities with the Myanmar Farmer Channel (TV), with which LBVD has links. Further, we will use our new links with village drug shops, Township Medical Officers, and high-level officials from the Ministry of Health to encourage their take-up, leading to the fast-tracking of public health education programmes for broader uptake of food safety, as well as AMR control, messages.
We anticipate making tangible step-changes in infrastructure, capacity and training for surveillance and diagnostic investigation of bacterial endemic zoonoses in humans in Myanmar. This will be achieved via laboratory up-scaling and up-skilling. We anticipate further impact in this regard as we expect the lab we support in Yangon to obtain subsequent research funding through, for instance, links to FAO-Myanmar.
We aim to influence shifts in national food safety policy and legislation. We will do this by maintaining and building upon the relationships with policy stakeholders made at local, national and regional levels in MPP, as well as extending them into the human clinical and public health areas. We will use research updates, newsletters and policy briefs to supplement one-to-one contact to communicate with our stakeholders. Our final stakeholder meeting will allow us to influence and promote a One Health agenda in Myanmar as we bring our range of key stakeholders together.
We will achieve international impact by convening a pig specialist veterinarian conference in Naypyidaw. We will communicate our key findings at this event, which will also strengthen national, regional and international pig specialist vet links - and provide an opportunity to launch a Myanmar national specialist pig vet association which can build upon this network, providing lasting impact in terms of access to knowledge and technical support.
Learning from our project will also be taken up at the international level by non-governmental development, animal health and One Health agencies. Our strong links with the regional OIE and FAO offices will in particular strengthen dissemination of our findings.
Academic impact will be achieved chiefly via open access publication in peer-reviewed journals and presentation at our pig specialist veterinarian conference.