Assessing the Effectiveness of a Disease Management Program

Abstract

Management or control of disease in any population, human, domestic livestock, or wild animal, is a costly and controversial exercise. For these reasons, it is imperative that the effectiveness of such programs must be scrutinized carefully, so that the scarce resources available are allocated rationally and so that no unnecessary action is taken. It is fair to characterize almost all methods currently in use for disease management in wild animals as being of unproven and untested efficacy. Even such a basic technique as the collection and disposal of carcasses during epizootics has not been tested objectively to determine: (a) if a significant proportion of the carcasses present are collected, (b) whether or not carcass disposal has a significant effect on the outcome of an outbreak and, (c) whether the same resources committed to other methods might be equally or more effective. Some such techniques seem intuitively correct and may be used in part because “an action program is appealing to the public” (Davis, 1974); however, intuition and public appeal should not be viewed as a substitute for careful objective appraisal. Reliance on untested methods may result in wasted effort that might have been used more productively, it may hinder the development of new methods that are effective, (as in “we have always done it this way and it seems to work, so why try anything different?”) and may allow the progression of a disease to a point where it becomes unmanageable. One must always be cognizant that learning from experience is not the same as making a mistake repeatedly until you are good at it!

“The ultimate practical aim of epidemiological investigations is to establish effective disease control measures, whose effect in turn should be evaluated by epidemiological methods in order to ensure that the highest health benefits are derived from available resources and techniques” Cvjetanovic (1976).