Global Rabies Elimination - Making the Case

Forty-two participants from 15 different countries traveled to Wolfsberg, Switzerland for the seventh annual Partners for Rabies Prevention (PRP) meeting, held April 1-3, 2014.

The PRP is an informal group convened by GARC that includes all major international stakeholders involved in rabies prevention and control, including representatives from WHO, FAO, OIE, PAHO, the WHO/OIE rabies collaborating centers, regional rabies networks, rabies endemic countries, non-governmental organizations, manufacturers of rabies biologics, research scientists and major donors.

This meeting, entitled “Global Rabies Elimination – Making the Case” reviewed compelling evidence to support a global effort towards canine rabies elimination and discussed how the international rabies community can support countries in their efforts towards canine rabies elimination.

Recent health economic analyses demonstrate the huge economic burden of rabies on endemic countries, and there is clear evidence that investment in mass dog vaccination campaigns reduces both deaths in humans and the impact on livelihoods such as livestock losses.

Canine rabies elimination can realize future economic benefits of reduced social burden, lower post exposure prophylaxis (PEP) expenditure, and lost income associated with rabies exposures.

The group discussed innovative funding mechanisms and how they could be adapted for rabies to engage more donors, and acknowledged the critical role of vaccine banks in supporting countries’ control efforts. Led by the tripartite group (FAO/OIE/WHO) and GARC, the participants contributed to a draft Investment Case, aimed at drawing in future resources and donors to support global canine rabies elimination.

Given that appropriate tools to control and eliminate canine rabies have existed for several decades, the lack of progress towards this goal is unfortunate and paradoxical.

The most significant challenges that countries face in implementing rabies control were identified as: ineffective national surveillance systems, inadequate logistic support for mass dog vaccination programs, a lack of clear national plans and strategies for rabies control, low awareness about and access to effective human PEP, a lack of appropriate information regarding rabies control for all the relevant audiences, low political will at the national level and a lack of One Health capacity in general.

A number of ways that the international community can help to support countries were identified.

• Clear messaging and advocacy on the importance of mass dog vaccination campaigns and intersectoral collaboration will help these to be achieved.
• The promotion and replication of best practices that have been proven effective will demonstrate the feasibility of rabies control in different settings across the world.
• Education and training workshops with an emphasis on a One Health approach and strong intersectoral collaboration will promote an integrated approach to disease management.
• Access to appropriate tools will enable countries to make best use of all available information and guidance, assess the impact of financial investment in rabies control for their specific situation and advocate for it, and to self-assess their progress towards rabies elimination.

Several specific tools will be refined or developed by the GARC and the PRP over the coming months. The value of the PRP’s free online Blueprint for Canine Rabies Control was re-established, and a comprehensive review and expansion of the blueprint is now underway.

There was recognition that a move towards health policy aspects of rabies control requires the engagement of new partners, and rabies needs to be promoted within the wider field of disease management and public health.

There is consensus on how canine rabies can be eliminated and global momentum towards this objective is growing. The work of this PRP meeting will help strengthen the case for future investments by countries, international donors, and new partners.

The tripartite group is committed to moving rabies up the international health agenda, and every member of the global rabies community has a role to play. The PRP participants invite all stakeholders in rabies control to unite their efforts and act now to promote the global elimination of canine rabies as a feasible objective, necessary for the global public good.

Summarised by Louise Taylor, GARC’s PRP coordinator. The full minutes of the meeting will shortly be available on GARC’s PRP Webpage.