226 P. Livingstone and N. Hancox
overall purpose of the programme. This must
then be underpinned by development of clear
and achievable strategic objectives to meet this
purpose. It is only in this context that the success
or otherwise of management can be meaning-
fully evaluated.
This section seeks to identify the key
technical and managerial issues that need to be
addressed to effectively manage bovine TB in
livestock. While the focus is on TB programmes
involving only cattle, it addresses management
issues that would apply equally to programmes
for control or eradication of M. bovis from other
domestic species, or for controlling other mem-
bers of the Mycobacterium tuberculosis complex
affecting domestic livestock. It is largely targeted
towards national or countrywide TB freedom or
eradication programmes, but would be suitable
for regions or states to use. Similarly, the concept
outline would provide guidance for a commu-
nity wanting to develop a programme to manage
TB in its livestock.
15.2.2 Defining programme purposeThe foundation of an effective TB programme is
clarity of purpose. Historically, TB programmes
have been introduced to reduce economic pro-
duction losses due to M. bovis infection in cattle
(Good and Duignan, 2011). For example,
Olmstead and Rhode, cited by Palmer and
Waters (2011) identified annual benefits from
the United States Department of Agriculture
(USDA) TB eradication programme as being
‘equivalent to 12-times the annual costs’ during
the period 1917–1962. Later programmes were
introduced to enable and facilitate international
trade in live cattle or their products (Max et al.,
2011; Livingstone et al., 2015a), or to meet
international requirements such as conformity
with EU policy (Reviriego Gordejo and
Vermeersch, 2006).
While no TB programmes appear to have
been introduced specifically to reduce the
zoonotic risk of M. bovis infection in humans,
which has largely been reliant on heat treatment
of milk, effective TB control in cattle has never-
theless contributed to reduced bovine TB inci-
dence in humans. Olmstead and Rhodes, cited
by Palmers and Waters (2011) determined that
together with pasteurization of milk, the USDA
TB eradication programme ‘prevented over
250,000 deaths annually’.15.2.3 Strategic objectivesOnce the overall purpose of TB management is
established, clear strategic management objec-
tives can then be set.
There has been a disparity in the terms used
to apply to national objectives set for bovine TB
programmes in high GNI economy countries.
Essentially, these can be classified as control,
freedom or eradication. TB control objectives are
based on measures taken to reduce TB preva-
lence or incidence on a regional or national basis
(Schwabe et al., 1977). TB freedom is where a
region or country has designed and imple-
mented a programme to meet some interna-
tional agreed prevalence target that is accepted
as free from TB, such as that set by OIE (OIE,
2016b). TB eradication designates that M. bovis
does not exist in a defined region or country. This
may be a result of a fortuitous accident in that
TB was never introduced, or as a result of a suc-
cessful TB programme, leading to the extinction
of M. bovis at a regional or national level
(Schwabe et al., 1977) as achieved by Australia
(Cousins and Roberts, 2001). Even with ade-
quate funding and a common purpose, as identi-
fied for Australia (Cousins and Roberts, 2001)
and the ongoing programme in the USA (Palmer
and Waters, 2011), regional eradication of
M. bovis requires a realistic appreciation of a
challenging, expensive and time-consuming
objective to meet. Despite this, eradication may
be the optimal objective, given that programme-
and disease-related costs fall to zero once it has
been achieved, whereas control costs continue
indefinitely (TBfree NZ, 2009). Henceforth, the
general term ‘programme’ will be used in this
chapter instead of control, freedom and eradica-
tion, unless more detail is required.
Whatever objectives are chosen, they
should meet SMART (specific, measurable,
agreed/achievable, realistic and time-bound)
criteria (Blanchard et al., 1985) and be designed
to ‘stretch’ administrators towards delivering an
innovative and cost-effective programme. Long-
term objectives should be supplemented by