Eliminate rabies through stricter human and animal health policies

Jhe Covid-19 pandemic has set back many global health goals for 2030. One of the easiest to recover is the goal of eliminating human deaths from rabies, through an effective and inexpensive vaccine for dogs.

Yet this ambition, backed by the United Nations, is under threat as public health budgets to control the disease are often skewed towards treating people who are exposed to it, even though the greatest public health risk comes from infected dogs. .

Rabies control strategies in dogs, wildlife and humans have been around for a long time, but too often have been applied in isolation, which is why the disease continues to kill nearly 60,000 people each year.

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By implementing policies and strategies that treat rabies as a common “One Health” threat – preventable in humans through prevention in dogs – the world can get back on track and achieve zero deaths from here 2030.

Over the past two years, most countries where rabies is endemic, such as South Africa and the Philippines, have seen an upsurge in rabies cases. This coincided with a decline in dog vaccination. Some 60% of countries reduced funding for canine rabies vaccination in 2020, while only 5% conducted vaccination campaigns as planned.

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The progress made against rabies before the emergence of the Covid-19 pandemic demonstrates the value of best practices based on the principles of One Health, which take into account the links between people, animals and the environment.

Investing in canine vaccination as a public health policy is a cornerstone in the fight against rabies. An integrated rabies elimination program in the Philippine province of Bohol, which cost just $450,000, vaccinated 70% of dogs within a year of its launch in 2007, reducing the number of human cases to zero in 18 months. The program drew on expertise in agriculture, education, environment, internal and local government legal affairs, and public health and safety to provide a comprehensive vaccine interventions.

More recently, through dog vaccination, the state of Goa in India succeeded in eliminating human rabies and reducing cases in dogs by 92%, saving more than 2,000 years of life that might otherwise have been lost. lost to disease. Latin America is also on the verge of completely eliminating canine rabies by shifting efforts from treatment to prevention, with Brazil having had no human cases in dogs for more than five years.

In addition to vaccinating dogs, educating communities, especially children, about rabies and its risks raises awareness of the links between animal health and human health. Dedicated information campaigns also reduce the risk of misinformation about the disease and enable individuals to get vaccinated for their pets and for dogs in the community.

Rabies lessons have been incorporated into the public elementary school curriculum in parts of the Philippines, resulting in an increase in awareness linked to a decrease in the incidence of dog bites. Children with increased knowledge of rabies are more likely to pay more attention to dogs and report a bite, while developing an understanding of responsible pet ownership.

Developing effective systems that monitor dog bites and canine rabies cases can help guide vaccination programs and community health programs more effectively and strategically, especially in resource-limited regions and countries. . For example, a bespoke vaccination tracker developed by the Global Alliance for Rabies Control, where I work, and an integrated rabies surveillance system have helped focus dog vaccination efforts on Unguja Island in Tanzania, where rabies incidence has fallen by more than 70% in 16 months.

Advances in rabies surveillance in wild animals, such as raccoons in the United States, may allow authorities to target their control efforts using oral vaccine baits and reduce the risk of spreading rabies. rabies to domestic animals and humans. Even a 0.5% increase in positive identification of rabies in wildlife can improve the efficiency of resource allocation to vaccination or disease surveillance, helping to achieve the goal of elimination of rabies.

With better integration of veterinary and human medicine under the umbrella of One Health, the world can finally be rid of one of its oldest and most traumatic deadly diseases.

Terence Scott is the technical lead for the Global Alliance for Rabies Control.

Boyd S. Abbott