A presentation given at The World Organisation for Animal Health (OIE) held the 4th Global Conference on Aquatic Animal Health from 2 to 4 April 2019, in Santiago, Chile. Tilapia is very important for food and nutrition security, livelihoods and income for rural households in Asia and Africa. Importance attached to biosecurity and health management must be at the same level as for shrimps and salmon. This calls for a massive change in the way farmers, researchers and policy makers treat carps and tilapia with respect to overall biosecurity and health management.