ASEAN Rabies Elimination Strategy: Ending Rabies Together by 2020

It is estimated that 608 million people are potentially at risk of rabies in Southeast Asia with seven out of ten ASEAN (Association of Southeast Asia Nations) Member States (AMS) endemically infected with rabies. Cambodia, Indonesia, Lao PDR, Myanmar, the Philippines, Thailand and Vietnam are all rabies endemic, with dogs remaining the most important maintenance host and 96% of documented human cases due to contact with infected dogs.

Three countries, namely Singapore, Brunei and Malaysia, are historically free of rabies. However, just this August, rabies was reported in a dog in the northern part of Malaysia which is close to Thailand and Myanmar. The last rabies case reported in a domestic animal by Malaysia was in 1999. This incident further highlights the transboundary nature of rabies as a disease and the need for a regional approach for disease elimination.

The ASEAN Rabies Elimination Strategy (ARES) provides a strategic framework for the reduction and elimination of rabies in the AMS. It anchors on the “One Health “approach through the use of STOP pillars which are defined as S-Socio cultural; T-Technical; O-Organizational and One Health Framework; P-Policy and Legislative.

The Socio cultural pillar focuses on the need to understand the motivations of different stakeholders involved in rabies elimination and developing appropriate messages for communities to protect human health, animal health and animal welfare. The Technical pillar highlights the importance of competent human and veterinary services to be able to control rabies in dogs as well as public health interventions to treat humans bitten by a possibly rabid animal. Coordination between veterinary and human health services are the key in the Organizational and One Health pillar, such as in Integrated Bite Case Management wherein both sectors are involved whenever rabies in a dog or a human is reported. The Policy and Legislative pillar emphasizes on the importance of national legislation on rabies as well as provision for human and financial resources.

The ARES was jointly endorsed by the 36th ASEAN Ministerial Meeting on Agriculture and Forestry and the 12 ASEAN Health Ministers Meeting respectively held in September 2014. Viet Nam as the lead country for rabies control, through its Ministers of Agriculture and Rural Development and Health, have further expressed confidence that through ARES, cooperation and collaboration between and among Member States and other stakeholders will be strengthened.

Other partners involved in the development and implementation of the strategy include the Food and Agriculture Organization of the United Nations, World Organisation for Animal Health (OIE), World Health Organization, World Animal Protection, and Global Alliance for Rabies Control.

The ARES was designed to complement the existing sub-regional frameworks developed to control and eliminate human rabies, such as those developed by the ASEAN Expert Group on Communicable Diseases (AEGCD) in 2010 and by the WHO South-East Asia Regional Office (SEARO) in 2012. The call to action ‘Towards the Elimination of Rabies in the ASEAN Member States and the Plus Three Countries’ in 2008 was the catalyst for the regional elimination of rabies in ASEAN.

Through an AEGCD-ASWGL joint consultative workshop on 30-31st March 2015 in Chiang Mai, Thailand, the ARES Action Plan was developed to identify and prioritize the regional activities to be able to develop and ARES Operational Plan and mobilize technical and financial support from relevant stakeholders/partners to effectively implement ARES.

As part of the ASEAN World Rabies Day celebration in 2015, copies of the final version of ARES will be distributed to all ASEAN member states.

Contributed by Sarah Jayme, GARC’s country representative in Philippines, with excerpts from the ASEAN news story, the ASEAN Rabies Elimination Strategy and Malaysia’s outbreak notification to OIE.