A tool for the planning and evaluation of rabies control programmes

The Stepwise Approach towards Rabies Elimination (SARE) is a new component of the Rabies Blueprint. It was designed in response to questions from national governments of rabies endemic countries such as: How do we start?, What needs to be put in place first? Where should the emphasis be in capacity building while resources are so scarce?

The planning tool was developed by FAO and GARC, in collaboration with WHO and other partners, with the support of the Bill and Melinda Gates Foundation. It provides practical guidance on how to elaborate and implement a national rabies elimination strategy in a stepwise manner - with the ultimate goal to eliminate dog-transmitted rabies. The concept and tool has been subject to various reviews by experts and inputs received during national or regional rabies meetings in Africa and Asia, and will continue to be revised following feedback.

The SARE is not prescriptive nor is it intended to replace existing regional or national rabies control strategies and is composed of six stages, ranging from ‘Stage 0’, where no information on rabies is available for a suspected rabies-endemic area, to ‘Stage 5’, where valid and timely data confirm the elimination of dog-transmitted rabies. Each of the 6 stages is characterized by a set of objectives to be reached and builds on the previous successes achieved, with activities in the main categories: Legislation; Data collection & analysis; Laboratory diagnosis; Information, education & communication; Prevention & control; Dog population related issues; and Cross cutting issues.] Throughout each, suggestions for intersectoral collaboration are included and crucial core activities, such as  targeted dog vaccination, raising awareness of rabies and rabies post exposure prophylaxis are included throughout all stages with progressive increases towards a full scale implementation.

An overview of the stages and keys of the SARE.

As most operational and technical aspects of rabies control activities are already described in the Canine Rabies Blueprint, the SARE planning tool is linked into the relevant sections of the ‘Canine Rabies Blueprint’ as well as other relevant resources.

One way to kickstart a rabies control programme might be to hold a national rabies stakeholder consultation where SARE and the canine rabies blueprint are presented, discussed and national constraints and opportunities of rabies control are identified.

It is planned to continuously improve the tool over time through the sharing of experiences by regions and countries using it, and as relevant documentation of these efforts become available in the future.

This article was written by Dr Lea Knopf, who contributed to the SARE tool on behalf of GARC.