Policy and Programs
	EPHS #5: Develop Policies and Plans That Support Ind. and Comm. Health Efforts
	Objectives
	Outline
	Policy: Definition
	Types of Policies
	How is Policy Made?
	Two Examples of Policy Making
	Evidence-Based Public Health (EBPH)
	Why is EBPH So Important?
	The Importance of Data
	What IS Evidence?
	What is NOT Evidence?
	Evidence-Based Medicine (EBM)
	EBM
	EBM (continued)
	Clinical Presentation in a Dog
	EBM – Step 1
	EBM – Step 2
	EBM – Step 3
	EBM – Step 4
	EBM – Step 5
	Obstacles to Using EBM
	EBM
	What is Evidence-Based Public Health?
	Evidence-Based Public Health
	Evidence-Based Population Health
	Evidence-Based Population Health
	EBM vs. EBPH
	EBPH Types of Evidence
	When the Evidence Is Not Enough
	Key Characteristics of EBPH Decision Making
	Strength of the Evidence Base for Population Health
	Are These Concepts Applicable to Other Animal Populations?
	In what circumstances are these concepts applicable?
	In what circumstances are these concepts applicable?
	Context for Policy Development: Authorization and Allocation
	Context for Policy Development: Funding
	Context for Policy Development: Funding
	Context for Policy Development: Funding
	Context for Policy Development: Funding
	Context for Policy Development: Funding
	Context for Policy Development: Funding
	Administrative Policy: The Case for and Against Cefquinome
	Food and Drug Administration (FDA)
	FDA Organization
	Organization of FDA’s Center for Veterinary Medicine (CVM)
	Cefquinome
	History
	History
	History
	Reaction
	The Washington Post
	The New York Times
	Background
	FDA Perspective
	Public Health Perspective
	Public Health Perspective
	WHO
	Industry Perspective
	Animal Health Institute
	Large Animal Veterinarian Perspective
	Overview of Issues: Use of Antimicrobials in Animals
	Introduction
	Facts about Antibiotics in Animals and the Impact on Resistance (FAAIR) Project, 1999
	Antimicrobial Use for Animal Growth Promotion
	Regulatory Framework for Approval of Veterinary Antimicrobials and Feed Additives in the US
	Regulatory Framework for Approval of Veterinary Antimicrobials and Feed Additives in the US (2)
	Regulatory Framework for Approval of Veterinary Antimicrobials and Feed Additives in the US (3)
	Animal Health Product Manufacturing and Distribution Networks
	Animal Health Product Manufacturing and Distribution Networks (2)
	Animal Health Product Manufacturing and Distribution Networks (3)
	Existing Estimates of Animal Antimicrobial Use in the US
	Existing Estimates of Animal Antimicrobial Use in the US (2)
	Existing Estimates of Animal Antimicrobial Use in the US (3)
	Additional Sources for Animal Use Data in the US
	Recommendations from International Expert Groups
	Human Use Data Collection Systems in the US
	FDA: Center for Veterinary Medicine Guidance #152 for Industry
	Guidance #152
	Criteria for Evaluation
	Scope
	Risk Analysis Methodology
	Definitions
	FDA Concerns
	Data Sources
	Hazard Characterization
	Relative Importance of the Drug in Human Medicine
	Relative Importance of the Drug in Human Medicine
	Classification of Drugs
	Classification of Drugs
	Classification of Drugs
	Qualitative Risk Assessment
	Release Assessment
	Release Assessment
	Summarizing the Release Assessment
	Exposure Assessment
	Exposure Assessment
	Per Capita Consumption Data for Meat, 2001
	Food Commodity Contamination
	Commodity Contamination Data for Salmonella, 2001
	Summarizing Exposure Assessment: an Example
	Consequence Assessment
	Risk Estimation
	Possible Risk Estimation Outcomes
	Risk Management Considerations
	Risk Management Considerations
	Risk Management Considerations
	Hurricane Katrina, August 2005
	Hurricane Katrina
	Background and History
	Outcome: Human
	Rapid Community Needs Assessment after Hurricane Katrina
	Outcome: Animals
	Hurricane Katrina: Response
	Hurricane Katrina: Legal and Administrative Barriers to Evaluation, Rescue and Treatment Efforts
	Hurricane Katrina: Legal and Administrative Barriers (2)
	State Administrative Responses
	State Legislative Initiatives: Louisiana
	State Legislative Initiatives: Louisiana (2)
	State Legislative Initiatives: Louisiana (3)
	Legislative Initiatives in Other States
	Legislative Initiatives: Federal
	Legislative Initiatives: Federal
	PETS Act (Public Law 109-308, 109th Congress)
	PETS Act (Public Laws 109-308, 109th Congress)

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