Socio‐economic impact of Foot‐and‐Mouth Disease outbreaks and control measures: An analysis of Mongolian outbreaks in 2017

Mongolia is a large landlocked country in Central Asia and has one of the highest per capita livestock ratios in the world. During 2017, reported foot‐and‐mouth disease (FMD) outbreaks in Mongolia increased considerably, prompting widespread disease control measures. This study estimates the socio‐economic impact of FMD and subsequent control measures on Mongolian herders. The analysis encompassed quantification of the impact on subsistence farmers’ livelihoods and food security and estimation of the national‐level gross losses due to reaction and expenditure during 2017. Data were collected from 112 herders across eight provinces that reported disease. Seventy of these herders had cases of FMD, while 42 did not have FMD in their animals but were within quarantine zones. Overall, 86/112 herders reported not drinking milk for a period of time and 38/112 reduced their meat consumption. Furthermore, 55 herders (49.1%) had to borrow money to buy food, medicines and/or pay bills or bank loans. Among herders with FMD cases, the median attack rate was 31.7%, 3.8% and 0.59% in cattle, sheep and goats, respectively, with important differences across provinces. Herders with clinical cases before the winter had higher odds of reporting a reduction in their meat consumption. National‐level gross losses due to FMD in 2017 were estimated using government data. The estimate of gross economic loss was 18.4 billion Mongolian‐tugriks (US$7.35 million) which equates to approximately 0.65% of the Mongolian GDP. The FMD outbreaks combined with current control measures have negatively impacted herders’ livelihoods (including herders with and without cases of FMD) which are likely to reduce stakeholder advocacy. Possible strategies that could be employed to ameliorate the negative effects of the current control policy were identified. The findings and approach are relevant to other FMD endemic regions aiming to control the disease.     

The nationwide tuberculosis drug resistance survey in Mongolia, 1999.

SETTING: Mongolia, a country in the Western Pacific Region burdened with many cases of tuberculosis, with rapid expansion of DOTS over the last several years. OBJECTIVE: To determine the prevalence of resistance to major anti-tuberculosis drugs among tuberculosis patients who have never been treated previously. DESIGN: Sputum specimens were collected from all smear-positive tuberculosis patients identified from 1 November 1998 to 1 May 1999. RESULTS: Resistance to any of the four major drugs (streptomycin, isoniazid, rifampicin, and ethambutol) was as high as 28.9% (95%CI 24.7-33.5), primarily due to high streptomycin resistance of 24.2% (95%CI 20.3-28.6). Isoniazid resistance was also high, at 15.3% (95%CI 12.1-19.1). Resistance levels to ethambutol and rifampicin were relatively low, at 1.7% (95%CI 0.8-3.5) and 1.2% (95%CI 0.5-2.9), presumably because these drugs were only recently introduced into Mongolia. Multidrug resistance was also rare, at 1.0% (95%CI 0.1-1.8). Drug resistance rates were higher in middle-aged patients than in younger and older age groups combined (P = 0.006). Males tended to have higher resistance than females, although this was of statistically marginal significance (P = 0.08). No significant regional differences in drug resistance were found. CONCLUSION: While multidrug resistance was rare, isoniazid resistance was very common, which necessitates closer monitoring of the treatment outcomes of individual patients as well as long-term follow-up for drug resistance on a nationwide scale.