Perspectives on Global Bovine Tuberculosis Control 249
tuberculosis. However, current available esti-
mates indicate that the global incidence of
human TB caused by M. bovis in 2015 was
approximately 149,000 new cases and 13,400
deaths. Thus, to achieve the ambitious goals of
the WHO End TB strategy (http://www.who.int/
tb/post2015_strategy/en/) and the STOP TB
Partnership Global Plan for TB (http://www.
stoptb.org/global/plan/) in which every single
case of TB counts whether it is human or zoo-
notic TB, a comprehensive and multisectorial
‘One Health’ approach, including the veterinary
and human health sectors, will be needed to bet-
ter prevent, diagnose, and treat zoonotic TB in
humans.
In this regard, the OIE (Chapter 1) is pro-
moting a collaborative ‘One Health’ approach at
international and national levels for the control
of zoonotic diseases, including bovine TB. Spe-
cifically, Olea-Popelka et al. in Chapter 2 proposed
three critical action points required to address
the challenges posed by zoonotic TB. These are (i)
governments must first acknowledge M. bovis in
official national policies as a source of human TB
and warranting attention; (ii) knowledge, atti-
tudes and practices of both healthcare providers
and communities at risk must be improved in
order to identify gaps and develop appropriate
interventions; and (iii) existing laboratory meth-
ods that differentiate M. bovis from M. tuberculo-
sis should be more widely implemented.
With regard to a ‘One Health’ approach to
control bovine TB, Azami and Zinsstag sug-
gested, in Chapter 3, implementing and promot-
ing dialogue between different stakeholders as
well as creating a greater environment of trust
between the different sectors (farmers, decision
makers, scientists, the veterinary and human
health sectors). Also, it is vital to inform farmers
and decision makers about the economic losses
(impact) caused by bovine TB and about the
different approaches required to control this
disease and minimize economic losses.
The importance and necessity of modelling
the epidemiology of M. bovis in cattle is high-
lighted by Conlan and Wood in Chapter 4, who
also show the gaps in our knowledge that con-
tribute to the weaknesses of predictive model-
ling. The effects of herd size and age and the
value of abattoir surveillance are well known.
Although the current limitations reflect the
huge variation in parameters required for
incorporation into models, recently developed
models provide guidance relating to inter-herd
transmission and how much intervention might
be required where sympatric host species might
be involved in infection. Although these models
have been developed for countries such as the
UK, the inclusion of data pertaining to genetic
resistance and additional information arising
from a greater understanding of the host
response (see Chapters 10 and 11) may increase
value for countries where the pattern of trans-
mission is very different.
As discussed by Skuce and colleagues in
Chapter 5, the decreasing cost, increasing speed
of turn-around and exquisite resolution offered
by bacterial whole-genome sequencing (WGS)
‘looks set to revolutionize the way we do veteri-
nary bacteriology, much as it is doing for human
medical microbiology’. A number of studies
have highlighted the utility of WGS to resolve
M. bovis transmission chains between wildlife
and cattle populations and provide greater
understanding of the epidemiology of infection.
WGS data also provides a window into evolu-
tionary analysis and dating of the most recent
common ancestor (MRCA) of M. bovis popula-
tions. An example of such evolutionary analysis
is that of Crispell et al. (2007) who used WGS to
date the MRCA of M. bovis isolates sampled from
New Zealand to approximately 1859, agreeing
well with previous estimates that M. bovis has
been circulating in New Zealand since the mid-
19th century. WGS analysis of global M. bovis
populations will also allow increased insights
into the evolution of M. bovis, and to our mind
there is no doubt that WGS will become the
standard method of M. bovis molecular typing in
the coming years.
Michel, in Chapter 6, summarized the cur-
rent knowledge and challenges presented by
M. bovis infection and as a cause of clinical dis-
ease in other domestic species such as sheep,
goats, pigs, water buffalo, farmed deer and
camel. There is a general paucity of information
on the true prevalence and distribution of
M. bovis infection in domestic species other than
cattle, especially where they are farmed exten-
sively or live under semi-free roaming condi-
tions. Water buffalo and small ruminants have
maintenance host potential and, given the high
risk for economic losses and zoonotic M. bovis
transmission, there is a need to integrate those