Managing Bovine Tuberculosis: Successes and Issues 227
annual milestones to enable regular measure-
ment of progress and performance. Where nec-
essary, objectives or sub-objectives should apply
to all domestic and wildlife species where intra-
or interspecies transmission of M. bovis has been
identified and where infection poses zoonotic,
trade or production risks. For stakeholders to
select the best strategy, they need to be presented
with benefit–cost analyses for a range of pro-
gramme options, to enable them to objectively
choose the one that will most cost effectively
meet desired SMART objectives. This may
require development of a series of detailed and
costed plans in an iterative process.
Regardless of the objectives of the TB pro-
gramme, its effective implementation requires:
(i) a sound understanding of the impacts and
costs of both the disease itself and any planned
control measure; (ii) sufficient technical, mana-
gerial and systems capacity for programme
delivery; (iii) adequate and secure funding, and
(iv) recognition of the needs of farmers, land
users and stakeholders (Thrushfield, 2007;
Osterholm and Hedberg, 2015).
15.2.4 Programme developmentHistory has shown that developing and imple-
menting an effective bovine TB programme at a
national, regional or local level is no simple pro-
cess. It may take some years to evaluate and
address multiple technical, economic and policy
considerations and to gain necessary stake-
holder and political agreement (Palmer and
Waters, 2011; Livingstone et al., 2015b). His-
torically, this has usually been undertaken by
government agencies, but increasingly there has
been a shift to farmers and farmer organizations
being involved with approving strategies and
plans, as well as shouldering an increasing share
of funding (Cousins and Roberts, 2001; Max
et al., 2011; Enticott, 2014; Livingstone et al.,
2015a).
A successful cattle TB programme normally
goes through various phases. Most programmes
have legacies of policy and knowledge derived
from literature and local TB management his-
tory. Over time, experience, knowledge and
research findings have honed these programmes
such that it is possible to identify a range of
factors that generally appear to be important in
achieving success.
Following the identification of programme
purpose and definition of strategic objectives to
achieve that purpose, a successful bovine TB
programme requires adequate funding, effective
legal status, stakeholder support for the objec-
tives based on a benefit–cost analysis, a sound
science-based technical plan, and policies that
take account of TB aetiology, epidemiology and
costs, as well as consideration of farming, indus-
try and societal contexts. Once agreed, the TB
programme then needs to be delivered by
a competent administrative organization or
management agency, whose role is to ensure
that an auditable, cost-effective and coordinated
programme meets annual milestones, within
budget.15.2.5 Legal statusA number of national TB programmes began as
regional or national voluntary programmes,
with varying proportions of the cattle popula-
tion being brought under TB testing regimes,
assisted by surveillance of TB in cattle at abat-
toirs or slaughter plants (Livingstone et al.,
2015a). However, voluntary programmes have
generally been found inadequate, leading
to introduction of compulsory programmes
( Cousins and Roberts, 2001; Palmer and Waters,
2011; Livingstone et al., 2015a) supported by
legislation to ensure farmer compliance with
programme policies and rules. Legislation may
also be required to secure programme funding,
such as from taxes or levies. Ideally, such legisla-
tion should be enabling, rather than prescrip-
tive, and be based around meeting strategic
objectives, as well as setting out disease control
policies, legal powers and funding responsibili-
ties agreed to by stakeholders (Enticott, 2014;
Livingstone et al., 2015b).15.2.6 Stakeholder supportStakeholders for a TB programme could be
defined as ‘those groups without whose funding
support the programme would cease to exist’
(adapted from Freeman et al., 2010). Under this