Time to invest in defeating human rabies transmitted by dogs

New report by WHO, OIE, FAO and GARC demonstrates the feasibility of global rabies elimination

The Global Alliance for Rabies Control (GARC) is urging countries to develop appropriate investment strategies to eliminate human rabies. The disease is mainly transmitted to humans through the bite of an infected dog and is widespread in low-income countries.

Pilot programmes have successfully demonstrated that elimination of rabies is achievable through mass dog vaccination campaigns, supported by improved access to post-exposure prophylaxis (post-bite treatment) to people immediately after a suspected dog-bite. Over 95% of human cases of rabies are due to dog bites and, unlike many other diseases, the control methods and vaccinesrequired to tackle this neglected disease are available.

Professor Louis Nel, Executive Director, GARC said, “We have all the tools and evidence that dog rabies can be controlled and eliminated and that human rabies can be prevented. Rabies can be eliminated using a One Health approach with the human and animal health sectors working together.”

Dr Louise Taylor, Spokesperson for GARC, said, “No-one should die from rabies. It is entirely preventable. Vaccines have existed since Louis Pasteur successfully vaccinated 9 year old Joseph Meister in Paris in 1885. And yet, even today, 160 people die every day from this horrific disease. We have the clinical know-how to eliminate human deaths from rabies – we just need political leadership and international funding. World Rabies Day marks the anniversary of the death of Louis Pasteur. On this year’s World Rabies Day, we want to send a clear message to national governments that if we work together, we have the chance to make rabies history.”

Professor Deborah Briggs, Chair of the GARC Board, said, “Rabies is a horrific way to die. Once symptoms show, it is 99.9% fatal. However, it is 100% preventable. It is a tragedy that rabies still claims thousands of lives every year. We have the tools to eliminate rabies – we have done for some time. However, it requires political commitment and funding for dog vaccines, to beat rabies once and for all. World Rabies Day is a reminder to every-one that the disease has not gone away – and won’t go away until sustained action is taken by national governments and international agencies.”

To mark World Rabies Day (28th September), the World Health Organization (WHO), The Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE) along with the Global Alliance for Rabies Control (GARC) have published a Rationale for investing in the global elimination of dog-mediated human rabies which calls on countries to invest in cost-effective and sustainable control programmes, particularly in the mass vaccination of dogs.

Rabies, a major public health problem affecting mainly the rural poor and marginalised populations, continues to killaround 59,000 people every year. Almost 40% of victims exposed to dogbites are children under the age of 15.

Post-exposure prophylaxis (PEP – treatment immediately applied after an animal bite) can be effective in preventing human rabies deaths. However the approach is costly and can only protect individuals who have prompt access to health facilities that provide the treatment. Mass vaccination of dogs is proven to be the most cost-effective means of preventing human rabies deaths and eliminating its transmission.

Indeed, vaccinating 70% of dogs in rabies affected areas is sufficient to eliminate canine rabies worldwide, at a much lower cost than post-exposure medication.

The Rationale for investing in the global elimination of dog-mediated human rabies makes the case that global freedom from dog-mediated human rabies is feasible. Investment is needed to involve communities and strengthen local initiatives in training people and volunteers to carry out coordinated dog vaccination campaigns to enable geographical and wider dog population coverage in endemic countries.

Investment is also needed to support and sustain control programmes at national and regional levels. For example, setting up regional rabies vaccine banks can support countries in their control efforts. Rationale for investing in the global elimination of dog-mediated human rabies highlights the conditions that are needed for a successful rabies control programme:

• effective and safe vaccines for dogs and for humans;
• practical guidance to implement rabies control programmes;
• education and awareness modules for community involvement;
• data collection, and surveillance and notification systems, which are critical for evaluating the progress of control and elimination campaigns.

Collaboration between human and animal health sectors through the ‘One Health’ approach is essential to achieve success at national, regional and global levels.

WHO, OIE, FAO and GARC will hold a Conference on the “Global elimination of dog-mediated human rabies: The Time is Now!”, on 10-11 December 2015 at WHO headquarters in Geneva, that will convene key participants from Ministries of Health and Veterinary Services, national rabies coordinators, veterinary and human health experts, NGOs and the private sector.