Foot-and-mouth disease (FMD) vaccine market survey at agro-veterinary stores in rural and peri-urban areas of Nigeria

Introduction

Foot-and-mouth disease (FMD) is a viral infection that affects cloven-hoofed livestock and wildlife. Important livestock hosts of FMD virus are cattle, pigs, goats, sheep, yaks, and water buffalo (Jamal and Belsham, 2013). The virus, foot-and-mouth disease virus (FMDV), belongs to the genus Aphthovirus and the family Picornaviridae. It is a non-enveloped, single-stranded, positive sense RNA virus of approximately 8.5kb in size. There are seven serotypes of FMDV, namely O, A, C, SAT 1, SAT 2, SAT 3, and Asia 1 (Jamal and Belsham, 2013). In Nigeria, where the disease is endemic with seasonal outbreaks, the circulating serotypes are O, A, SAT 1 and SAT 2, with serotype O the most prevalent (FAO, 2021). The disease is characterized by high morbidity and low mortality (except in calves) with devastating economic losses due to the debilitating nature of the disease. The major lesions are vesicles in the oral cavity and hoof resulting in erosion and ulceration in these areas. These lesions lead to hypersalivation, unwillingness to eat, and reluctance to stand or walk in the affected animal causing decreased production.

Globally, the annual economic impact of FMD is estimated at USD 11 billion in endemic settings. The economic impact is most profound among smallholder farmers as the disease threatens their livestock productivity, income, livelihoods and food security (Alhaji et al., 2020).

To control the disease, inactivated vaccines made from Nigerian-endemic strains have been shown to be effective for protection in cattle against FMD (Mowat et al., 1975; Lazarus et al., 2012). However, the vaccine is neither readily available nor popularly known among livestock farmers, causing a huge loss especially among smallholder farmers who often lack awareness of the vaccine and its benefits (FAO, 2012).

The economic impact of FMD can be viewed as direct or indirect, with both affecting the farmers’ returns on investment. Reduced or loss of milk production, mortality, especially in calves, loss of weight and draft power, and reduced livestock market value are the direct impacts (Senturk and Yalcin, 2005; Barasa et al., 2008; FAO, 2012; Young et al., 2013). Indirect impact is seen in expenditure on disease control through vaccination, diagnostics and surveillance, treatment of secondary bacterial infections, and movement control (FAO, 2012). Although returns on investment in cases of FMD control (using FMD vaccine) have been seen to be positive, with a benefit-cost ratio of 33.6 as reported by Alhaji et al., (2020), the intentional use of the vaccine is very unpopular among farmers in Nigeria, especially the smallholder farmers who are known to keep more than 10 animals (cattle and small ruminants) (Peters et al., 2012). The major resultant effect for livestock owners is the embargo on the importation or exportation of meat from animals in FMD-affected areas (Ezeokoli et al., 1988).

Based on the findings of Alhaji et al. (2020) and Peters et al. (2012) that reported that FMD vaccination is an unpopular practice among smallholder farmers, this study aims to understand the market dynamics of FMD vaccine at the agro-veterinary stores in rural and peri-urban areas, gather information on the challenges faced by agro-veterinary stores and how they can be supported to ultimately ensure that smallholder farmers routinely use FMD vaccine to control the disease in Nigeria. This study is relevant and crucial, for should there be any effective FMD control in Nigeria, these areas with highest concentrations of livestock, which are often neglected, should be the main focal points.

Methods

Study areas: We selected a minimum of one state from five out of the six geopolitical zones of Nigeria, between November to December 2023. Most of the states selected are located far away from urban areas within each state. The selected states from each of the five geopolitical zones are found in Table 1 and Figure 1.

Figure 1. Location of study areas; A) The map shows the position of Nigeria within Africa, and the five geopolitical zones selected; B) The map shows the towns where the agro-veterinary stores are located.

OpenStreetMap was used to create the maps; OpenStreetMap is open data, licensed under the Open Data Commons Open Database License (ODbL) by the OpenStreetMap Foundation (OSMF), https://www.openstreetmap.org/copyright . The orange circles indicate the number of agro-veterinary stores per location.

Study site: We purposively selected locations relatively distant from the state capital and popular cities within the state. Interviews were conducted at agro-veterinary stores located in rural and peri-urban areas that supply smallholder farmers with animal health products.

Data collection: The questionnaire (Extended Data), composed of both closed and open-ended questions, was uploaded on Kobocollect App^®. It was read out in-person to participants in the most preferred language (English or local language) by licensed animal health service providers (veterinarians or animal health technologists). Key informant one-to-one interviews were recorded on tape to obtain information on important factors that may not have been captured by the questionnaires, and to make the discussion with the stakeholders as interactive as possible (Elelu, 2017; Chemuliti et al., 2021). Questionnaires and interviews were conducted in agro-veterinary stores and the location coordinates of each participating agro-veterinary store were recorded by global positioning system (GPS) but all participant details were anonymised.

Sample size: In total, we interviewed 290 agro-veterinary store owners from 35 local government areas of six states of Nigeria. We also conducted 65 oral interviews with the key informants among community leaders, livestock farmers, and agro-veterinary store owners.

Data analysis: The data were entered into Microsoft Excel 2010 (Microsoft Corporation) software for data cleanup, using a licensed version of Microsoft Office Excel, and later exported to IBM SPSS^® statistics version 25 software (IBM Corp.) for statistical analysis. Chi-square or Fisher’s exact test (as the number counts in some cells were less than five) was used to test the significance of associations between demographic features and business operations using GraphPad Prism 8.4.2. The level of significance was set at a value of p < 0.05.

Ethical consideration: There is no legal requirement in Nigeria for review by an Ethics Committee of such a study. However, since it was decided to aim to publish in Gates Open Research, it was felt that a retrospective review would be appropriate (rather than none at all). Ethical approval for the project, questionnaire, consent forms and other participant information materials was obtained from the University of Ibadan (UI) UCH Ethics Committee of the Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan (registration number: NHREC/05/01/2008a; UI/UCH Ethics Committee assigned number: UI/EC/24/0256), dated 08/04/2024 to 07/04/2025.

Results

Of the 290 participants who gave their consent to participate in the study, Adamawa State had the highest number of participants with 49%, while the least was in Ebonyi State with 3% of all participants ( Table 2).

Educational qualification

The educational qualifications of agro-veterinary store owners interviewed ranged from no formal education to postgraduate degree, with a moderate number of the participants (approximately 40%) having at least a graduate educational qualification (HND, bachelor or postgraduate). As seen in Figure 2, most participants from all of the states in the northern region have secondary school certificates as the highest educational qualification, while in the southern region, most of the participants have degree certificates as their highest qualification. The highest number of participants with postgraduate certificates was found in Oyo State. Furthermore, we realized in this study that more educated individuals (with at least a graduate certificate as the highest educational qualification) are joining the agro-veterinary business in the peri-urban and rural areas as seen in Figure 3.

Figure 2. Educational status of agro-veterinary store owners per state, showing the highest level of education of the store owners.

Figure 3. Highest educational qualification of agro-veterinary stores over time.

Years of operation

The agro-veterinary store owners interviewed had varied years of agro-veterinary business operations, as seen in Figure 4. The largest proportion of store owners (41%) have been in the agro-veterinary business operation in the last 1-5 years.

Figure 4. Years of agro-veterinary business operations.

Vaccine marketing by the agro-veterinary stores

The study identified that out of the agro-veterinary stores in peri-urban and rural areas, only a few (29%) sell vaccines, including ruminant vaccines, as seen in Figure 5. From Table 5, it is clear that the percentage of agro-veterinary stores selling vaccines in southern states (Ebonyi, Ogun, and Oyo) is significantly more than those selling in the northern states (Adamawa, Niger, and Sokoto). Similarly, there were more stores selling ruminant vaccines alone or with other vaccine types in the northern states than the southern states ( Figure 6).

Figure 5. Percentage of agro-veterinary stores selling vaccines in the rural and peri-urban areas.

Table 5. Geographical distribution of agro-veterinary stores selling vaccines per state and region.

State	Yes	No	Total
Adamawa	31	88	119
Sokoto	8	84	92
Niger	8	12	20
Ogun	11	8	19
Oyo	16	14	30
Ebonyi	9	1	10
	83 (29%)	207 (71%)	290 (100%)
P<0.05; (p=0.0001)
Region	Yes	No	Total
North	47	184	231
South	36	23	59
	83 (29%)	207 (71%)	290 (100%)

Figure 6. Categories of vaccine sold by agro-veterinary stores per state.

Factors that affect agro-veterinary stores no longer selling FMD vaccine

Different reasons contributed to the stoppage of sales of FMD vaccines as seen in Table 10; the vaccine was expensive, there was a problem maintaining the cold chain, and farmers were not requesting the vaccines which made some of the vaccines expire, to mention a few.

Table 10. Factors that affected agro-veterinary stores that no longer sell FMD vaccine.

Agro-veterinary store that once sold FMD but no longer sell FMD vaccines
State	(n=9)	Duration (n)	Education (n)	Reasons (n)
Adamawa	2	1-5 years (2)	Primary (1)	Farmers are not requesting for it (2)
			ND (1)	It is too expensive (2)
				My source of getting vaccine no longer sells FMD vaccine (1)
				It is no longer available (1)
				I bought some that expired before I could sell them (1)
Niger	4	6-10 years (1)	No formal education (1)	I don't have a refrigerator to maintain the cold chain (1)
		11-15 years (1)	Secondary (2)	The FMD vaccines are not effective (1)
		More than 20 years (2)	HND (1)	Farmers are not requesting for it (1)
				It is no longer available (2)
Oyo	1	1-5 years	Postgraduate	It is no longer available (1)
Ogun	1	11-15 years	Bachelor	Farmers are not requesting for it (1)
				It is too expensive (1)
				It is no longer available (1)
Sokoto	1	16-20 years	ND	Farmers are not requesting for it (1)

Among the factors that determine the type of vaccines that are purchased by agro-veterinary store owners in rural and peri-urban areas, the price of the vaccine and its availability in the market were the strongest ones, followed by accessibility of vaccines ( Figure 7). More than 44% of the agro-veterinary stores located in rural and peri-urban areas had to travel more than two hours before they could procure their vaccines of choice ( Table 11). A similar finding was reported by Chemuliti et al. (2021), reporting 33% of the agro-veterinary stores had challenges with long-distance sources of their vaccine.

Figure 7. Factors that dictate the type of vaccine purchased by agro-veterinary stores in rural and peri-urban areas.

Table 11. Travel duration of agro-veterinary stores to vaccine sources.

Time spent when traveling to get the vaccine
Time	N =83	Percentage (%)
Less than 30 minutes	3	3.6
30 min-1 hr	7	8.4
1-2 hrs	20	24.1
Over 2 hrs	37	44.6
Not sure	16	19.3

Of all the participants selling vaccines, 77 (92.8%) reported their constraints of sales of FMD vaccines by agro-veterinary stores in the rural and peri-urban. Maintenance of the cold chain during storage and logistics of the vaccine to livestock farmers topped the challenges with 32.5% of respondents. The respondents further explained that no or low power supply, no refrigerator, the high cost of running a generator and the absence of materials to maintain the cold chain during the logistics of the vaccine to the farmer discouraged not only the agro-veterinary stores but also the livestock farmers as these factors affect vaccine efficacy. Other challenges mentioned were lack of knowledge of the impact of the disease and the benefits of the vaccine among livestock farmers (27.3%), high cost of vaccine (22.1%), frequent unavailability of the vaccine when ordered (9.1%), distance of the farmers to agro-veterinary stores (7.8%), lack of vehicle for logistics of the vaccine to the farmers (6.9%) and poor knowledge of the administration of FMD vaccine (3.9%), among other factors ( Table 12).

Table 12. Challenges to FMD vaccine sales by agro-veterinary stores in rural and peri-urban regions.

Participant that responded
	Frequency (n=83)	Percentage (%)
Yes	77	92.8
No	6	7.2
Challenges	Frequency (n=77)	Percentage (%)	Challenge types
Cold chain	25	32.5	- No or low power supply - No refrigerator - High cost of running on generator - No facility to maintain cold chain during supply
Lack of knowledge	21	27.3	- Impacts of FMD - Value of FMD vaccine - Effective brand of vaccine
Price of the vaccine	17	22.1	- FMD vaccine is expensive - High forex affecting the cost of vaccine - Frequent hike in FMD vaccine price
Unavailability of vaccine	7	9.1	- Not available at all - Delayed supply if available
Distance of the farmers to agro-veterinary stores	6	7.8	- Distance of farms/farmers to agro-veterinary stores - Distance of farm owners to the animals for the decision to buy the vaccine
Transportation	5	6.5	- No vehicle to transport the vaccine - Poor road network
Vaccine administration	3	3.9	- Poor knowledge of the route of administration - Poor knowledge of the vaccine regime - Poor knowledge of the correct dosage
Vaccine efficacy	2	2.6	- Prevalence of cheap, fake FMD vaccine - Poor vaccine efficacy
Alternative therapy	2	2.6	- Trust in communal FMD treatment approach - General preference of treatment of FMD to vaccination
Seasonal market/demand	2	2.6	- FMD is a seasonally prevalent disease - Demand for vaccines is seasonal - FMD vaccine is perceived to have a short expiry date
Sourcing the vaccine	2	2.6	- Difficulty in sourcing for the vaccine - Unavailability of lower doses from the source
Security	1	1.3	- Affecting reaching some areas for the supply of the vaccine - Affecting decision-making of animal care generally
Lack of capital	1	1.3	- Buying and storing FMD vaccine is capital-intensive - No funds to get FMD vaccine
Distrust in government	1	1.3

Discussion

The study aimed to understand the market dynamics of FMD vaccine at the agro-veterinary stores in rural and peri-urban areas, and gather information on the challenges faced by agro-veterinary stores. The structured questionnaire captured data on several areas, including socioeconomics such as gender and education of agro-veterinary owners. It was observed that the proportion of female agro-veterinary store owners (5.5%) was significantly lower than the male store owners (94.5%). This is similar to the finding of Elelu (2017) that reported that among agro-veterinary store owners, 96.3% were male (3.7% female). The slight difference may be due to the state selected in their study (Kwara state) which falls under the north-central part of Nigeria. Furthermore, there were more women owning agro-veterinary stores in the southern region than in the northern region. This may be due to many factors, most notable being religion, cultural background and level of education (Enfield, 2019). The study found that the highest number of participants with postgraduate certificates was found in Oyo State. This is in contrast with the study that reported that most of the owners of agro-veterinary stores have either primary or no formal education (Elelu, 2017). This variance may be due to the time the study was conducted or the states of the country where the study was carried out. The observation that more educated individuals (with at least a graduate certificate as the highest educational qualification) are joining the agro-veterinary business in the peri-urban and rural areas is a new development, which coincides with the introduction of training of veterinary paraprofessionals in Nigeria; if well appropriated, this could provide a solution to the common practice of veterinary healthcare delivery by untrained, unprofessional owners of agro-veterinary stores in the rural and peri-urban areas (Grasswitz et al., 2004; Faramade et al., 2016).

The largest proportion of store owners (41%) were found to have been in the agro-veterinary business operation in the last 1-5 years; this suggests that more people are taking an interest in and starting an agro-veterinary business. We found that there were more stores selling ruminant vaccines alone or with other vaccine types in the northern states than the southern states. Previous studies have shown that agro-veterinary stores would rather procure and sell veterinary drugs to livestock farmers (Grasswitz et al., 2004; Elelu, 2017) instead of vaccines as there are several limiting factors to the sales of vaccines by these stores in Nigeria, such as unstable power supplies, inadequate cold chain maintenance, and inefficient logistics systems, among other things.

The questionnaire captured data on sources of vaccines and vaccine cold chain. The study found that more than 84% of agro-veterinary stores sourced their vaccine through distributors or marketers, and only a small proportion sourced them from veterinary clinics (15.7%). This finding is consistent with another study that reported that there is limited access to, and availability of, retail outlets such as agro-veterinary stores with a new range of animal health products because they are only supplied by wholesalers (Elelu, 2017). This is partly as a result of a decline in multi-national manufacturing companies that are relocating their business operations from most African countries, including Nigeria, and partly due to their focus on large-scale commercial companies as their market target (Grasswitz et al., 2004). The study showed that fewer than half (45.8%) of agro-veterinary outlets always store their vaccines in cold environments. This finding resonates with another study that reported that 61% of agro-veterinary stores could not maintain cold storage of their vaccines (Chemuliti et al., 2021). Maintenance of the cold chain during storage and logistics of the vaccine to livestock farmers was the main challenge reported (32.5%). This has been reported in previous studies as a challenge to the vaccine delivery system in low-income countries and the sale of effective vaccines in rural and peri-urban areas (Adeiga and Harry, 2006; Ashok et al., 2017; Chemuliti et al., 2021). For the vaccine to be effective, pure, safe, and potent, cold chains must be maintained to confer protection against infection (OIE, 2019). Lack of reliable power supply was reported as a constraint. Indeed, unreliable power supply is not unusual as more than a billion people around the world have no access to stable electricity and approximately 85% of them reside in rural areas of sub-Saharan Africa (Babalola et al., 2022). Other challenges listed have been previously reported by researchers who have studied agro-veterinary outlets in African countries, including Nigeria (Grasswitz et al., 2004; Elelu, 2017; Chemuliti et al., 2021).

There were some limitations in the study. Some places known for security threats and insurgencies were purposely avoided within the states during this study. The sample size of 290 participants was smaller than initially intended.

Conclusion

To commence effective control of FMD in Nigeria, there is a need to improve the sales of vaccines by the agro-veterinary stores located in the rural and peri-urban areas. Many studies have considered the activities of agro-veterinary stores located in rural and peri-urban areas selling drugs, poultry and livestock vaccines, but this study, to the best of our knowledge, is the first report on their sales of FMD vaccine which is an important component of overall livestock disease control and prevention. There is a need to develop a supply chain that deeply entrenches agro-veterinary stores in the rural and peri-urban areas, to provide support in vaccine storage, in the form of solar-powered refrigerators or to establish mobile vaccination centers/veterinary clinics that service livestock farmers in rural and peri-urban areas, and ensure availability and accessibility of FMD vaccine to the farmers in these areas, who are the keepers of the most animal protein in Nigeria.

For a control program to be successful, there is the requirement to be intentional and to plan well-structured education programs, sensitization, and awareness creation campaigns on FMD and its control measures among livestock farmers through qualified agro-veterinary owners.

Ethics and consent

There is no legal requirement in Nigeria for review by an Ethics Committee of such a study. However, since it was decided to aim to publish in Gates Open Research, it was felt that a retrospective review would be appropriate (rather than none at all). Ethical approval for the project, questionnaire, consent forms and other participant information materials was obtained from the University of Ibadan (UI) UCH Ethics Committee of the Institute for Advanced Medical Research and Training (IAMRAT), College of Medicine, University of Ibadan (registration number: NHREC/05/01/2008a; UI/UCH Ethics Committee assigned number: UI/EC/24/0256), dated 08/04/2024 to 07/04/2025.

Informed written consent was obtained from all participants before the questionnaire was administered.