ORIGINAL ARTICLE Benefit-Cost Analysis of Foot and Mouth Disease Control in Large Ruminants in Cambodia J. R. Young 1 , S. Suon 2 , L. Rast 3 , S. Nampanya 1 , P. A. Windsor 1 and R. D. Bush 1 1 Faculty of Veterinary Science, University of Sydney, Camden, NSW, Australia 2 Department of Animal Health and Production, Ministry of Agriculture, Forestry and Fisheries, Phnom Penh, Cambodia 3 Charles Sturt University, Wagga Wagga, NSW, Australia Keywords: public health; trade; cattle; buffalo; smallholder farmers; value chain Correspondence: J. R. Young. Faculty of Veterinary Science, University of Sydney, Camden, NSW, Australia. Tel.: +64211427340; Fax: +61293511693; E-mail: jyou1412@uni.sydney.edu.au Received for publication August 9, 2014 doi:10.1111/tbed.12292 Summary Foot and mouth disease (FMD) is endemic in Cambodia and throughout the Greater Mekong Subregion and causes significant losses to rural smallholders owning the majority of the national large ruminant population. However, due to underreporting, paucity of knowledge of FMD impacts, limited veterinary capac- ity and deficits of data available for analysis, the quantifiable benefits of a national FMD control programme are unknown. To address this deficit, existing literature and research data from the ‘Best practice health and husbandry of cattle, Cambo- dia’ project conducted between 2007 and 2012, were used to develop a three- phase analysis framework to: assess the impacts of the recent widespread FMD epizootic in Cambodia in 2010, conduct a value chain analysis of the large rumi- nant market and estimate the costs and benefits for a national large ruminant biannual FMD vaccination programme. A trader survey conducted in 2010–2011 provided cattle and buffalo value chain information and was matched to village herd structure data to calculate a total large ruminant farm-gate value of USD 1.271 billion in 2010. Monte Carlo simulation modelling that implemented a 5- year biannual vaccination programme at a cost of USD 6.3 an animal per year identified a benefit-cost ratio of 1.40 (95% CI 0.96–2.20) when accounting for recent prices of cattle and buffalo in Cambodia and based on an expected annual incidence of 0.2 (assuming one major epizootic in the 5-year vaccination pro- gramme). Given that the majority of the large ruminants are owned by rural smallholders, and mostly the poor are involved in agricultural employment, the successful implementation of an FMD control programme in Cambodia would be expected to avoid estimated losses of USD 135 million; equivalent to 10.6% of the 2010 farm-gate value and contributing to important reductions in rural poverty and food insecurity. Introduction Cambodia together with Myanmar, Lao PDR, Thailand, Vietnam and the Yunnan Province of China make up the six states of the Greater Mekong Subregion (GMS), a natu- ral economic area bound by the Mekong River basin com- prising 2.6 million km 2 and inhabited by ~326 million people (ADB, 2013). Cambodia has a population of ~14.3 million people, with an estimated 70% reliant on agricul- ture for employment (MAFF, 2012; The World Bank, 2013). Cambodia has a total land area of 181 035 km 2 , with 75% consisting of the Tonle Sap Basin and Mekong Low- lands. The relative contribution of agriculture to gross domestic product (GDP) in Cambodia was 36.0% in 2010 (Trading Economics, 2014) of a total GDP of USD 14 bil- lion (The World Bank, 2013). Cambodia is one of the poor- est countries in South-East Asia, ranked 136th on the Human Development Index slightly ahead of its neighbour Lao PDR at 139th (UNPD, 2014). Although significant improvements have been made in the last two decades, © 2014 Blackwell Verlag GmbH • Transboundary and Emerging Diseases. 1 Transboundary and Emerging Diseases