FAO’s Technical Cooperation Project in Bali

Rabies was introduced to Bali some time in 2008 and spread undetected in the canine population until the first person died of rabies in November 2008. 

Initial efforts by government to control the disease, while well intentioned, were not effective in preventing further spread of rabies across the island. The virus attacked relentlessly, and the human death toll continued to rise.  In October 2010 alone, 11 people died from rabies.

At this time, a local NGO, the Bali Animal Welfare Association, demonstrated that mass vaccination of dogs was possible in Bali and that dog vaccination could reduce human deaths from rabies. 

In 2011, FAO was requested by the Ministry of Agriculture to assist the Bali provincial government to conduct mass dog vaccinations to progressively control the disease.

FAO facilitated an initial stakeholders meeting of all government and NGO stakeholders involved in rabies control in Bali, which developed a control strategy and a comprehensive work plan with roles and responsibilities clearly assigned to members of provincial and district governments of Bali. 

A rabies control programme was then established based on the principles of comprehensive mass dog vaccination, community awareness, establishment of strong links between human and animal health services to follow-up bite cases, and a reduction in dog culling. 

In all 234,974 dogs received rabies vaccine across all villages of Bali.  Integrated Bite Case Management (IBCM) protocols allowed nurses in the hospitals where bite victims seek treatment to call in a rapid response team of veterinarians who immediately travel to the patients’ villages, find the biting dog and send samples for testing. If testing proves the dog was rabid, emergency vaccination of dogs in the area is carried out to prevent any further spread of the virus.

5 year old Komang Sentana, pictured with his parents, was playing in his yard when a rabid dog entered the yard and bit him above the eye.

The integration of health and veterinary service into a rapid response not only saved his life, but doubtless protected others from the spread of rabies.

 

The success of this initial campaign catalyzed further commitment and massive investment in rabies control on Bali by the Government of Indonesia and by the 2013 rabies mass vaccination campaign, over 95% of funding was being provided by Government. 

As a direct result of the Bali rabies control programme, human cases decreased from 82 human cases in 2010 to only 1 case in 2013.  With further commitment and investment from the Government of Indonesia, the rabies virus may be eliminated from the island of Bali. 

The rabies control strategy used on Bali is being enshrined in a Master Plan for the control and elimination of rabies in Indonesia, currently being developed by the Director of Animal Health.

This includes mechanisms for stakeholder coordination and facilitation, rabies surveillance, response and control, rapid and accurate laboratory diagnosis, community engagement and heightened rabies awareness, and the building of increased capacity among livestock service staff to address the disease.

This plan will play a key role in the development of a sustainable and comprehensive rabies control programme across the twenty-three rabies-infected provinces of Indonesia, and will support expansion of the Bali-style rabies control programme to the islands of Flores and Lembata.

Beyond Indonesia, the dog vaccination-focused rabies control strategy is being adopted by other countries in Asia and is expected to make a considerable contribution to ASEAN rabies control policy and to the ASEAN Road Map for Rabies Control by 2020.

Submitted by the FAO Emergency Centre for Transboundary Animal Diseases (ECTAD) Indonesia