A National Rabies Elimination Strategy for Kenya

It is estimated that up to 2,000 human deaths due to rabies occur annually in Kenya and rabies has been ranked as one of the top five priority zoonotic diseases. Now a strategy has been developed with the goal of eliminating dog-associated human rabies in the country.

Success in rabies elimination has been demonstrated in developing countries including Latin Americas and Asia, where sustained mass vaccination of dogs has been shown to be the single most cost effective intervention to control and eliminate canine rabies and consequently human rabies. Studies conducted in sub-Saharan Africa show that most of the rabies cases in animals and humans are caused by canine rabies virus, transmitted by domestic dogs. Wildlife including wild carnivores and stray dogs play an insignificant role in maintenance of the virus. Consequently, comprehensive and sustained dog vaccination is sufficient intervention in reduction and eventual elimination of human rabies in a region.

The strategy aims at eliminating dog mediated human rabies by the year 2030 in Kenya. The strategy provides a guide for systematic reduction of rabies risk through sustained mass dog vaccinations, pre and post-exposure prophylaxis and public education until the country is completely free of dog-mediated human rabies.

The strategy has been developed by the Ministry of Agriculture, Livestock and Fisheries and Ministry of Health through the Zoonotic Disease Unit in collaboration with stakeholders from early 2013. A series of stakeholder’s meetings were held in which the structure and contents of the strategy were discussed incorporated.

 

The National Rabies Elimination Strategy was developed using information form the Canine Rabies Blueprint, and a complementary evaluation tool which will soon be integrated into it.  The evaluation tool helps countries plan and assess progress towards becoming a rabies-free country.It describes six stages (Stage 0 to 5), each with a set of activities that build on each other to continuously reduce the risk of disease, with the country being declared completely free of dog-mediated human rabies when it reaches Stage 5.

The critical steps in the various stages include developing and adopting a national rabies elimination strategy; starting implementation of elimination plan in pilot areas, implementation of the elimination strategy throughout the country; and maintaining freedom from dog mediated human rabies and canine rabies while preventing re-entry. To move from one stage to the one above it, a set of targets must be reached and confirmed. The implementation of the strategy will begin with selected pilot areas to gain valuable lessons in creating and maintaining a rabies-free zone that will be used during the roll-out of the elimination campaign in the rest of the country

Implementations of the National Rabies Elimination Strategy will require resources over an extended period of time including human resources, infrastructure and finances. The major areas of spending will be procurement of vaccines, diagnostics, vaccines, immunoglobulins, vaccine delivery, operational research, coordination and surveillance. The strategy envisions a collaborative effort between government and no state actors in availing the resources and motivation necessary to achieve elimination.

The strategy is planned for launch during the World Rabies Day celebrations on 28th September 2014 in Makueni County.  A copy of the strategy is available at www.zdukenya.org

 

Submitted by Dr. Austine Bitek Orinde on behalf of the Republic of Kenya Zoonotic Disease Unit, a collaboration between the Ministry of Agriculture, Livestock and Fisheries and the Ministry of Health in Kenya.