Livestock production in Africa is key to national economies, food security and rural livelihoods, and > 85% of livestock keepers live in extreme poverty. With poverty elimination central to the Sustainable Development Goals, livestock keepers are therefore critically important. Foot-and-mouth disease is a highly contagious livestock disease widespread in Africa that contributes to this poverty. Despite its US$2.3 billion impact, control of the disease is not prioritized: standard vaccination regimens are too costly, its impact on the poorest is underestimated, and its epidemiology is too weakly understood. Our integrated analysis in Tanzania shows that the disease is of high concern, reduces household budgets for human health, and has major impacts on milk production and draft power for crop production. Critically, foot-and-mouth disease outbreaks in cattle are driven by livestock-related factors with a pattern of changing serotype dominance over time. Contrary to findings in southern Africa, we find no evidence of frequent infection from wildlife, with outbreaks in cattle sweeping slowly across the region through a sequence of dominant serotypes. This regularity suggests that timely identification of the epidemic serotype could allow proactive vaccination ahead of the wave of infection, mitigating impacts, and our preliminary matching work has identified potential vaccine candidates. This strategy is more realistic than wildlife–livestock separation or conventional foot-and-mouth disease vaccination approaches. Overall, we provide strong evidence for the feasibility of coordinated foot-and-mouth disease control as part of livestock development policies in eastern Africa, and our integrated socioeconomic, epidemiological, laboratory and modelling approach provides a framework for the study of other disease systems.

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  1. 1.

    Tekleghiorghis, T., Moormann, R. J. M., Weerdmeester, K. & Dekker, A. Foot-and-mouth disease transmission in Africa: implications for control, a review. Transbound. Emerg. Dis. 63, 136–151 (2016).

  2. 2.

    Weaver, G. V., Domenech, J., Thiermann, A. R. & Karesh, W. B. Foot-and-mouth disease: a look from the wild side. J. Wildl. Dis. 49, 759–785 (2013).

  3. 3.

    The Progressive Control Pathway for Foot-and-Mouth Disease Control (PCP-FMD) (FAO/OIE/EuFMD, 2011); http://www.oie.int/eng/A_FMD2012/docs/Background_papers_PCP_FMD.pdf

  4. 4.

    Sumption, K., Domenech, J. & Ferrari, G. Progressive control of FMD on a global scale. Vet. Rec. 170, 637–639 (2012).

  5. 5.

    Perry, B. & Grace, D. The impacts of livestock diseases and their control on growth and development processes that are pro-poor. Phil. Trans. R. Soc. B 364, 2643–2655 (2009).

  6. 6.

    Otte, J. et al. 2012 Livestock Sector Development for Poverty Reduction: An Economic and Folicy Perspective – Livestock’s Many Virtues (FAO, 2012); http://www.fao.org/docrep/015/i2744e/i2744e00.pdf

  7. 7.

    Perry, B. D. & Rich, K. M. Poverty impacts of foot-and-mouth disease and the poverty reduction implications of its control. Vet. Rec. 160, 238–241 (2007).

  8. 8.

    Knight-Jones, T. J. D. & Rushton, J. The economic impacts of foot and mouth disease – what are they, how big are they and where do they occur? Prev. Vet. Med. 112, 161–173 (2013).

  9. 9.

    World Development Indicators Database (World Bank, accessed 20 August 2017); http://databank.worldbank.org/data/download/GDP.pdf

  10. 10.

    Pendell, D. L., Marsh, T. L., Coble, K. H., Lusk, J. L. & Szmania, S. C. Economic assessment of FMDv releases from the National Bio and Agro Defense Facility. PLoS ONE 10, e0129134 (2015).

  11. 11.

    Miguel, E. et al. Contacts and foot and mouth disease transmission from wild to domestic bovines in Africa. Ecosphere 4, 51 (2013).

  12. 12.

    Brückner, G. K. et al. Foot and mouth disease: the experience of South Africa. Rev. Sci. Tech. 21, 751–764 (2002).

  13. 13.

    Naranjo, J. & Cosivi, O. Elimination of foot-and-mouth disease in South America: lessons and challenges. Phil. Trans. R. Soc. B 368, 20120381 (2013).

  14. 14.

    Paton, D. J. & Sumption, K. J. & Charleston, B. Options for control of foot-and-mouth disease: knowledge, capability and policy. Phil. Trans. R. Soc. B 364, 2657–2667 (2009).

  15. 15.

    East, R. & Estes, R. D. African Antelope Database 1998 (International Union for the Conservation of Nature Species Survival Commission, 1999).

  16. 16.

    Paton, D. J. & Taylor, G. Developing vaccines against foot-and-mouth disease and some other exotic viral diseases of livestock. Phil. Trans. R. Soc. B 366, 2774–2781 (2011).

  17. 17.

    Bedelian, C., Nkedianye, D. & Herrero, M. Maasai perception of the impact and incidence of malignant catarrhal fever (MCF) in southern Kenya. Prev. Vet. Med. 78, 296–316 (2007).

  18. 18.

    Jost, C. C. et al. Epidemiological assessment of the Rift Valley fever outbreak in Kenya and Tanzania in 2006 and 2007. Am. J. Trop. Med. Hyg. 83, 65–72 (2010).

  19. 19.

    Lawson, D. W. et al. Ethnicity and child health in northern Tanzania: Maasai pastoralists are disadvantaged compared to neighbouring ethnic groups. PLoS ONE 9, e110447 (2014).

  20. 20.

    Knight-Jones, T. J. D., McLaws, M. & Rushton, J. Foot-and-mouth disease impact on smallholders – what do we know, what don’t we know and how can we find out more? Transbound. Emerg. Dis. 64, 1079–1094 (2017).

  21. 21.

    Vosloo, W., Boshoff, K., Dwarka, R. & Bastos, A. D. The possible role that buffalo played in the recent outbreaks of foot-and-mouth disease in South Africa. Ann. NY Acad. Sci. 969, 187–190 (2002).

  22. 22.

    Brito, B. P. et al. Transmission of foot-and-mouth disease SAT2 viruses at the wildlife-livestock interface of two major transfrontier conservation areas in southern Africa. Front. Microbiol. 7, 528 (2016).

  23. 23.

    Anderson, E. C., Doughty, W. J., Anderson, J. & Paling, R. The pathogenesis of foot-and-mouth disease in the African buffalo (Syncerus caffer) and the role of this species in the epidemiology of the disease in Kenya. J. Comp. Pathol. 89, 541–549 (1979).

  24. 24.

    Manual of Diagnostic Tests and Vaccines for Terrestrial Animals 2016 Ch. 2.1.8 (OIE, 2017); http://www.oie.int/fileadmin/Home/eng/Health_standards/tahm/2.01.08_FMD.pdf

  25. 25.

    Brehm, K. E., Kumar, N., Thulke, H. & Haas, B. High potency vaccines induce protection against heterologous challenge with foot-and-mouth disease virus. Vaccine 26, 1681–1687 (2008).

  26. 26.

    Bari, F. D. et al. Genetic and antigenic characterisation of serotype A FMD viruses from East Africa to select new vaccine strains. Vaccine 32, 5794–5800 (2014).

  27. 27.

    Sustainable Development Goals (United Nations, 2015); http://www.un.org/sustainabledevelopment/sustainable-development-goals/

  28. 28.

    Rich, K. M. & Perry, B. D. Whither commodity-based trade? Dev. Policy Rev. 29, 331–357 (2011).

  29. 29.

    Terrestrial Animal Health Code (OIE, 2015); http://www.oie.int/international-standard-setting/terrestrial-code/access-online/

  30. 30.

    Lankester, F. et al. A field vaccine trial in Tanzania demonstrates partial protection against malignant catarrhal fever in cattle. Vaccine 34, 831–838 (2016).

  31. 31.

    Nei, M. & Kumar, S. Molecular Evolution and Phylogenetics (Oxford Univ. Press, New York, 2000).

  32. 32.

    Marsh, T. L., Yoder, J., Deboch, T., McElwain, T. F. & Palmer, G. H. Livestock vaccinations. Sci. Adv. 2, e1601410 (2016).

  33. 33.

    Johnson, P. C. D., Barry, S. J. E., Ferguson, H. M. & Müller, P. Power analysis for generalized linear mixed models in ecology and evolution. Methods Ecol. Evol. 6, 133–142 (2015).

  34. 34.

    Namatovu, A. et al. Challenges for serology-based characterization of foot-and-mouth disease outbreaks in endemic areas; identification of two separate lineages of serotype O FMDV in Uganda in 2011. Transbound. Emerg. Dis. 62, 522–534 (2015).

  35. 35.

    Di Nardo, A. et al. Serological profile of foot-and-mouth disease in wildlife populations of West and Central Africa with special reference to Syncerus caffer subspecies. Vet. Res. 46, 77 (2015).

  36. 36.

    Wekesa, S. N. et al. Characterisation of recent foot-and-mouth disease viruses from African buffalo (Syncerus caffer) and cattle in Kenya is consistent with independent virus populations. BMC Vet. Res. 11, 17 (2015).

  37. 37.

    Hedger, R. S., Barnett, I. T., Gradwell, D. V. & Travassos Dias, P. Serological tests for foot-and-mouth disease in bovine serum samples. Problems of interpretation. Rev. Sci. Tech. Off. Int. Epiz 1, 387–393 (1982).

  38. 38.

    Molecular Epidemiology Reports (WRLFMD, accessed 22 August 2015); http://www.wrlfmd.org/fmd_genotyping/

  39. 39.

    Global Livestock Densities (Agriculture and Consumer Protection Department, Animal Production and Health, FAO, accessed 10 May 2011); http://www.fao.org/ag/againfo/resources/en/glw/GLW_dens.html

  40. 40.

    Robinson, T. P. et al. Mapping the global distribution of livestock. PLoS ONE 9, e96084 (2014).

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We are grateful to the Tanzania Commission for Science and Technology, Tanzania Ministry of Livestock and Fisheries, Tanzania Wildlife Research Institute, Tanzania National Parks and the Ngorongoro Conservation Area Authority for permissions and productive collaborations; the District Veterinary Officers, Livestock Field Officers and Community Animal Health Workers in Mara and Arusha regions for assistance with data and sample collection, and stakeholder engagement activities; the Frankfurt Zoological Society and Tanzania Conservation Resource Centre for logistical and administrative support in Tanzania; and colleagues in the WRLFMD for their contribution to laboratory analyses. We are indebted to R. Mahemba Shabani for his dedication and hard work throughout the study, and E. Kamani for coordinating field activities in the initial stages of the project. We are grateful to J. Yoder for valuable contributions to the socioeconomic surveys and comments on an earlier version of the manuscript. We thank G. Hopcraft and M. Shand for assistance with production of maps for this manuscript. This work was supported by the Biotechnology and Biological Sciences Research Council (BBSRC), the Department for International Development and the Scottish Government through the Combating Infectious Diseases of Livestock for International Development initiative (projects BB/H009302/1 and BB/H009175/1). The work of the WRLFMD was supported by the Department for Environment, Food and Rural Affairs (Project SE2943: Defra, UK) and funding provided to the EuFMD from the European Union. Doctoral training for M.C.-B. was funded by a BBSRC Doctoral Training Grant. T.L. and R.R. received support from the Scottish Universities Life Sciences Alliance (SULSA). R.R. was supported by BBSRC grant BB/L004828/1. R.F. and G.N. were supported by the Wellcome Trust–funded Afrique One consortium. Community- and policy-related knowledge exchange initiatives were funded through the Afrique One consortium, contributions by Merck Animal Health to the University of Glasgow and the Boyd Orr Centre for Population and Ecosystem Health. The African Development Bank funded the Southern African Development Community Transboundary Animal Diseases (SADC TADs) Project at the SADC Secretariat. Opinions, findings, conclusions and recommendations are those of the authors and do not necessarily reflect the views of the funding bodies.

Author information

Author notes

    • Felix Lankester

    Present address: Paul G. Allen School for Global Animal Health, Washington State University, Pullman , WA, USA

  1. These authors contributed equally: Miriam Casey-Bryars, Richard Reeve.


  1. Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK

    • Miriam Casey-Bryars
    • , Richard Reeve
    • , Felix Lankester
    • , Daniel T. Haydon
    • , Sarah Cleaveland
    •  & Tiziana Lembo
  2. Department of Agriculture, Food and the Marine, Dublin, Ireland

    • Miriam Casey-Bryars
  3. The Pirbright Institute, Pirbright, Surrey, UK

    • Miriam Casey-Bryars
    • , Nick J. Knowles
    • , Katarzyna Bachanek-Bankowska
    • , Veronica L. Fowler
    • , Donald P. King
    • , Anna B. Ludi
    • , Krupali Parekh
    • , David J. Paton
    • , Jemma Wadsworth
    •  & Satya Parida
  4. School of Economic Sciences and Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA

    • Umesh Bastola
    •  & Thomas L. Marsh
  5. Epidemiology Research Unit, Scotland’s Rural College (SRUC), An Lòchran, Inverness, UK

    • Harriet Auty
  6. Tanzania Wildlife Research Institute, Arusha, Tanzania

    • Robert Fyumagwa
  7. Sokoine University of Agriculture, Morogoro, Tanzania

    • Rudovick Kazwala
    • , Tito Kibona
    • , Ahmed Lugelo
    •  & Gloria Ndhlovu
  8. Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania

    • Tito Kibona
  9. Merck Animal Health, Madison, NJ, USA

    • Alasdair King
  10. Agricultural Research Council, Onderstepoort Veterinary Institute, Pretoria, South Africa

    • Francois F. Maree
  11. Tanzania Veterinary Laboratory Agency, Ministry of Livestock and Fisheries, Arusha, Tanzania

    • Deogratius Mshanga
  12. College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK

    • Brian Perry
  13. Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK

    • Brian Perry


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The study was designed by M.C.-B., R.R., H.A., D.J.P., S.P., D.T.H., T.L.M., S.C. and T.L. Field work was carried out by H.A., R.F., R.K., T.K., F.L., A.L., D.M., G.N. and T.L. Laboratory work was performed by M.C.-B., N.J.K., K.B.-B., V.L.F., D.P.K., A.B.L., F.F.M., K.P., J.W., S.P., S.C. and T.L. Modelling and data analysis was conducted by M.C.-B., R.R., U.B., N.J.K. and T.L.M. The paper was written and revised by all authors.

Competing interests

A.K. works for Merck Animal Health (known as MSD Animal Health outside USA and Canada), which manufactures FMD vaccines. The workshops described in Supplementary Notes 1 and 2 were funded jointly by the Wellcome Trust through the Afrique One Consortium, the University of Glasgow and its Boyd Orr Centre for Population and Ecosystem Health, and MSD Animal Health. MSD had no control over the design, implementation or analysis of the results of the workshops, and the MSD funding has not influenced the work presented in this manuscript in any way. A.K. had no influence on the study design or the analysis described in the manuscript as a whole, but was consulted in discussions about the feasibility of the proposed solutions and during the manuscript preparation process.

Corresponding author

Correspondence to Tiziana Lembo.

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