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In the future, animal health services in developing countries will need to operate in a continuously changing policy, institutional and commercial environment. Firstly, the changing policies and priorities of national policy-makers regarding public and private sector roles, reinforced in Africa by the donors, have reduced funding and support for the large number of tasks that animal health services have traditionally performed, and there is continuing pressure from policy-makers to focus on what the public sector can do best. Secondly, poverty reduction has become one of the main criteria guiding the allocation of official development assistance, which has major implications for the main target clientele of veterinary services. Thirdly, population growth, increasing income and urbanisation are causing a marked increase in demand for livestock products in the developing world. As a result, the entire livestock commodity chain is undergoing major structural changes, which has significant implications for the definition and control of food safety standards. Fourthly, globalisation, and increasing trade and travel have greatly increased the risk of disease transmission between different countries and continents. Veterinary institutions in the developing world need to adapt to these challenges. They will have to be able to focus on the essential public sector roles. At the same time they must deliver those essential services to the poor, and provide the policy framework to ensure that the inevitable structural changes in the commodity chain take place in an equitable and sustainable fashion, with an acceptable level of health risk for the consumer. According to the weight given to these different objectives, changes in the institutional set-up need to be considered. This issue of the Scientific and Technical Review addresses these challenges. It begins by reviewing the basic economic characteristics underlying the provision of animal health services, and then examines the alternative delivery systems that are emerging in the developing world and their strengths and weaknesses. The implications for food safety and trade are specifically highlighted. Also included are the practical experiences of countries, from all along the development continuum, that have introduced alternative systems. This paper deals with implications for the future, and while the growing importance of veterinary care for companion animals is acknowledged, the focus is on veterinary services for food animals.

As the final contribution to this important World Organisation for Animal Health (OIE) publication, this paper provides some relevant background and contextual information and identifies a number of strategically significant international activities that will influence the future direction of animal welfare internationally. The assumption of an animal welfare leadership role by the OIE, with the full support of its 167 Member Countries, is an international development of major strategic significance. As an inter-governmental organisation, the OIE is committed to a science-based approach to the development of animal welfare guidelines and standards and to working closely with all stakeholders. This paper covers the use of animals in both agriculture and science, reflecting the OIE's dual remit for both animal health and animal welfare and the importance of animal-based research and testing to the OIE's animal health and reference laboratory roles.

Male hormonal contraception has been shown to confer reversible infertility for at least one year; however, while clinical trials refine hormonal regimens, their acceptability, cultural meanings, and implications for study of men's sexualities remain under examined. This paper presents findings from interviews conducted with men and their female partners in a male hormonal contraception clinical trial in Jakarta and Palembang, Indonesia, and describes the ideas expressed about this new contraceptive technology. Fourteen men and their partners in Jakarta and ten men and their partners in Palembang were interviewed about their motivations to participate in the trial and their perceptions of the injection's physical, psychological and social effects. Concerns such as excess fertility and attendant economic liability shaped one quarter of motivations reported by men, while many women highlighted how a male method could help them prevent pregnancy without physical complications. Intimacy and sexual relations between couples were key themes within interpretations of contraceptive acceptability. Taken together, the narratives presented in this study call attention to the need for more nuanced analyses of contraceptive acceptability, as well as to the importance of studies of new male contraceptives for the understanding of masculinities.

This paper examines the social construction of 'choice' in women's use of the oral contraceptive birth control pill. Using social and historical critiques of neo-liberalism, it is argued that the contemporary priority placed on 'choice' positions women in contradictory ways-requiring them to be both 'choosing' reproductive subjects and reproductive subjects with very few options. The paper works to de-construct contemporary understandings of choice and finds that women's use of the birth control pill is less an exercise of idealized individual agency than it is an act of repetition, tied to ambiguity around what a lived experience of choice might be. To elaborate elements of the theoretical discussion, findings from a qualitative study of women's use of the oral contraceptive are discussed. These reveal that women's articulations of 'choice' challenge the notion of genuinely available and viable alternatives for women, and demonstrate how the use of a technology can silence understandings of contraception as something other than an individual responsibility.

This paper explores the power hierarchies that shape the reproductive health of Kam village women with the purpose of identifying key potential causes of reproductive morbidity. The analysis is based on one year's fieldwork undertaken in a minority ethnic village in Guizhou in southwest China. Data from women's narratives reveal the ways in which power hierarchies, including the sex/gender system, shape daily life, dominance and resistance as well as actual health outcomes. Findings demonstrate how the sex/gender system intersects with other aspects of the village hierarchy, and how both affect villagers' reproductive decisions and reproductive health. Suggestions are offered on how to improve women's sexual and reproductive health in Kam areas.

The definition of an invasive species will depend on the viewpoint of the observer, who in some cases may be responsible for introducing the species. History has taught us that humans are the species that has invaded the largest surface area of the planet. So, before going on to propose a few definitions, this article describes three different examples or types of example in which domestic animal species, wild animal species and microorganisms (for biological pest control) have been transported intentionally. By doing so, this paper uses a variety of situations to support the definitions. A contemporary argument would counter a strictly biogeographical definition with a more ecological definition. The two are probably complementary. In any case, these definitions should remain practical. The consequences of species movements vary. However, their health impacts should not be underestimated.

This paper reviews approaches to vulnerability in public health, introducing a series of 10 papers addressing vulnerability in health in Africa. We understand vulnerability as simultaneously a condition and a process. Social inequalities are manifest in and exacerbate three key dimensions of vulnerability: the initial level of wellbeing, the degree of exposure to risk, and the capacity to manage risk effectively. We stress the dynamic interactions linking material and social deprivation, poverty, powerlessness and ill health: risks or shocks and their health impacts are intimately interconnected and reinforce each other in a cycle which in the absence of effective interventions, increases vulnerability. An inductive process which does not begin with an a priori definition or measurement of 'vulnerability' and which does not assume the existence of fixed 'vulnerable groups' allowed us both to re-affirm core aspects of existing conceptual frameworks, and to engage in new ways with literature specifically addressing vulnerability and resilience at the population level as well as with literature - for example in ecology, and on the concept of frailty in research on aging - with which researchers on health and poverty in Africa may not be familiar. We invite conceptual and empirical work on vulnerability in complex systems frameworks. These perspectives emphasize contexts and nonlinear causality thus supporting analyses of vulnerability and resilience as both markers and emergent properties of dynamic interactions. We accept a working definition of vulnerability, and recognize that some definable groups of people are more likely than others to suffer harm from exposure to health risks. But we suggest that the real work - at both intellectual and policy/political levels - lies in understanding and responding to the dynamics, meanings and power relations underlying actual instances and processes of vulnerability and harm.

The One Health concept is responsible for a shift towards practices, policies and partnerships that better link the health of people, animals and our shared environments. The papers in this issue of the World Organisation for Animal Health Scientific and Technical Review illustrate a myriad of ways in which a One Health approach could advance or has already advanced human and animal well-being. Independently, the authors conducted their own thematic analysis of One Health activities and found strong support for the notion that One Health has inspired a renaissance in veterinary public health, increased our basic knowledge of the mechanisms and natural history of many animal diseases, promoted systems approaches to health issues and encouraged stronger cross-sectoral collaboration. Unfortunately, many collaborations often end when funding ends and many remain distinct partnerships. One Health still suffers from a lack of strong environmental stakeholders and has mostly worked on infectious disease rather than addressing many of the pressing determinants of health that will confront us in the next century. There is no shared conception of health across veterinary, medical and environment sectors, and this is an issue that must be confronted if there are to be programmes that are truly integrated across people, animals and the environment.

Animals contribute to the lives of humans in developed and developing countries in numerous ways. Here, the focus is on how grazing animals can contribute to human lives and on the many ways in which dogs are of benefit to humans. Grazing is a sustainable practice which allows uncultivable land to be used for the production of food, prevents the degradation of land, and does not lead to the depletion of groundwater, thus contributing to food security. Dogs provide help during rescues, companionship, and support for livelihoods. It is vital to ensure the welfare of the farm animals that provide us with so much, and the author discusses outcome-based welfare indicators, such as lameness, sickness and lesions, that can be used in both developed and developing countries to prevent suffering. In recent times, animal welfare science has begun to look at the emotional state of animals, but it is important to recognise that in developing countries, where finding enough food is the biggest concern, the animal's positive emotions cannot be a top priority. The paper ends by emphasising the importance of local solutions for improving the health and welfare of both animals and humans. There is a need for successful local programmes to be rolled out on a wider basis. To encourage the spread of effective programmes, people need to write about them.

The role of aquatic animals in global food and nutrition security is increasingly recognised. The global demand for fish is increasing, leading to a need to significantly increase its supply. Securing future fish supplies through sustainable production is a challenge as major resources such as fresh water and land are becoming limited worldwide. Aquaculture and capture fisheries face various threats from both human-mediated and natural environmental change, including climate change. Aquaculture systems and practices are vulnerable to such changes. Moreover, aquatic animal diseases are currently considered one of the most important constraints to sustainable global fish production. The need to increase global production, combined with climate change, may increase losses due to diseases. This paper examines key vulnerabilities, their impacts and management to achieve increased and sustainable global fish production. The authors focus on the need to apply international standards, and to develop biosecurity and capacity in aquatic animal health to improve global fish health. Research needed to underpin the development of improved detection and control of fish diseases is also discussed.

Aquaculture is an important industry both economically and socially. The majority of this industry is focused on the production of aquatic animals, which may be substantially adversely affected by disease. Economic analyses may be used to inform decision-makers on the aquatic animal disease control choices that are economically optimal. Examples of such analyses are presented in this paper, ranging from basic cost estimates of disease impact to complex, spatial- temporal, bio-economic models. Regardless of the complexity of the analysis, there is a consistent need to collect and analyse good quality data measuring both the production and health of aquatic animals. This would require a variety of individuals and groups, including farmers, scientists and the government, to collaboratively contribute to this end. Given the necessary data, more sophisticated models may be better used to inform decision-making from the farm to the national level. Finally, economic analyses should not be limited to simple aggregated cost and benefit results but rather should include the social and gender impacts of financial decisions, as well as the potential externalities both within and among the various impacted sectors in order to optimise investment at both the farm and national levels.

Aquatic animal disease outbreaks affect both the public (represented by the government) and the private sector (represented by the aquaculture and fisheries industry). However, all too often, the responsibilities and costs of responding to an outbreak may not be shared. Without a mechanism for public and private sectors to work together, the outcomes of an emergency response may not be ideal, or of common benefit to all potentially affected parties. In Australia, a mechanism is being developed for public and private sectors to share the responsibilities and costs of responding to aquatic animal disease outbreaks, through an industry- government aquatic emergency animal disease response agreement. The agreement provides an approach for both public and private sectors to share the responsibilities and costs of responding to a disease outbreak and to coordinate disease prevention activities to reduce their shared risk. The key elements of the agreement include provisions to incentivise faster notification of disease outbreaks, facilitate a faster response, share decision-making and costs (including compensation for affected businesses), clarify the responsibilities of all parties and, most importantly, strengthen risk mitigation activities. This paper describes how the draft agreement has been developed among 18 industry and government parties, how key elements of the agreement may contribute to improved aquatic animal health outcomes, and the principles which could be applied by other OIE Member Countries.

The World Organisation for Animal Health (OIE) has made leading contributions to the discipline of test validation science by providing standards and guidelines that inform the test validation process in terrestrial and aquatic animals. The OIE Manual of Diagnostic Tests and Vaccines for Terrestrial Animals, and the Manual of Diagnostic Tests for Aquatic Animals describe the test validation pathway in the context of fitness for purpose, elaborate on the importance of diagnostic sensitivity (DSe) and specificity (DSp) as measures of test accuracy, and designate additional factors (e.g. test cost, laboratory throughput capacity and rapidity of test results) that influence choices of a single test over others or the inclusion of a new test in a diagnostic process that includes multiple tests. This paper provides examples of each of the six main testing purposes listed in the Terrestrial Manual and describes additional metrics such as ruggedness and robustness that should be included in the validation of point-of-care tests. Challenges associated with new diagnostic technologies and platforms are described. Validated tests with estimates of DSe and DSp are needed to measure confidence in test results for OIE-listed diseases, to facilitate risk assessments related to animal movement, to estimate true prevalence, and for certification of disease freedom and use in epidemiological (risk factor) studies.