Sustaining the drive towards rabies elimination in Kenya

As we celebrate the 2016 and the 10th World Rabies Day, Kenya will be observing the second anniversary of the launch of its strategy for elimination of human rabies by 2030. The implementation plan was to start small by focusing on select pilot regions where the elimination strategies would be tested, demonstrate success in those pilot regions, and quickly scale up to the rest of the country achieving the target of zero rabies deaths in humans by 2030.

Although two years is a short period, there have been significant steps and events that have increased momentum towards realizing the vision of a rabies-free Kenya. One of the inspiring stories has been the quick buy-in and commitment to rabies elimination by the County Government of Makueni, a historic hotspot for rabies in Kenya, and one of the five counties identified to serve as pilot regions.

Last year, World Animal Protection partnered with Makueni County Government to start implementation of two of the main pillars of the rabies elimination strategy for Kenya: 1) mass dog vaccination reaching 70% of the dog population and 2) rabies awareness campaigns in schools. In response, the Makueni government matches dollar for dollar funding from World Animal Protection and in addition has committed its own funds to provide free post-exposure prophylaxis for all dog-bite victims reporting to county health facilities.

The Makueni County government has understood that investments in preventing rabies at the source through mass dog vaccination will in the long run save them the money spent on post-exposure prophylaxis. After a year of vaccinations, each campaign conducted during the three school holidays in a year, Makueni County has vaccinated dogs in all the sub-Counties and achieved 70% vaccination coverage in many of them. Importantly, they have conducted these vaccination campaigns using only vaccinators working within the County. If taken up by all the 47 Counties, funding rabies elimination campaigns using County funds will be a significant step towards success in rabies elimination in the country.

Rabies elimination requires coordination structures that bring together efforts from different sectors within government and non-government organizations. Kenya Through the Zoonotic Disease Unit, Kenya has established the National Rabies Elimination Coordination Committee (NRECC), which draws membership from various sectors including public health, animal health, security, education and research among others. In order to be effective, the functions of this coordination body are to be devolved to the Counties with creation of County Rabies Elimination Coordination Committee (CRECC) for each of the 47 administrative Counties. Two of the pilot counties, Makueni and Siaya, have constituted and established their CRECC’s and are coordinating rabies elimination efforts in those areas.

Since the launch, Kenya has received funding that supports rabies elimination from various partners including the European Union through the World Organisation for Animal Health (OIE), the Wellcome Trust in support of operational research, World Animal Protection, CDC through the Global Health Security Agenda and is in discussion with other partners with possible additional funding. This kind of stimulus funding is critical in sustaining the drive towards rabies elimination in Kenya, and is needed to get the remaining three pilot Counties started.

In the last year, rabies has been covered in the local media almost every month (see Youtube Videolink and article link). This much-needed media attention to rabies is key in highlighting the burden of the disease and in increasing support for the implementation of the elimination strategy. Kenya now runs a rabies elimination website (rabiesfreekenya.org) and is active on social media through Facebook and Twitter (@rabiesfreekenya).

In December 2015, the World Health Organization (WHO), OIE, Food and Agricultural Organization of the United Nations (FAO) in collaboration with GARC set the global goal for the elimination of dog mediated rabies at 2030, as aspiration and achievable target for the participating countries. This global push for rabies elimination provides additional drive to individual countries including Kenya to act; the time is now.

Thumbi Mwangi is a Wellcome Trust Fellow at Kenya Medical Research Institute leading rabies operation research in Kenya, an Assistant Professor at Washington State University and a 2016 Aspen New Voices Fellow