WHO Aims for Regional Elimination of Rabies by 2020

In Southeast Asia, it is estimated by the World Health Organization (WHO) that approximately 25,000 people die from rabies each year. WHO is working with Food and Agriculture Organization of the United Nations, the World Organization for Animal Health, and the Global Alliance for Rabies Control to reduce rabies infection in endemic countries.

The Bill & Melinda Gates Foundation along with WHO have made differences in the Philippines, South Africa, and Tanzania. The current goal is to expand rabies control into new locations. One of the most successful approaches is to stockpile dog and human rabies vaccines. Several successful locations (elimination of rabies transmitted from dogs to people) include Chile, Costa Rica, Panama, and Uruguay.  

Elimination campaigns are starting in Southeast Asia. Bangladesh started an elimination program in 2010 and in three years human rabies deaths decreased by 50%. The Bangladesh elimination program includes managing dog bites, dog vaccinations, and free rabies vaccines.

Regional Director, WHO South-East Asia Region, Dr. Poonam Khetrapal Singh said, “National strategies are needed for rabies elimination with the focus on increasing public awareness and making cost effective post-exposure vaccination available to all. Ensuring post-exposure rabies vaccination to all in an equitable manner should be a key element of rabies elimination efforts. Communities have an important role to play in rabies elimination. Simple but important measures such as vaccinating pet dogs and cats against rabies, thoroughly washing dog bite wounds with soap and water, and taking rabies vaccination when exposed to bite of a rabid or suspected animal, will strengthen rabies elimination efforts.” 1

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Rabies Contracted From Domestic Dogs Continues to Kill People

Rabies is a fatal viral disease that kills people; especially in low-income countries. Typically rabies is transmitted to humans from bites by infected domestic dogs. Rabies infection is preventable in humans with timely post-exposure prophylaxis vaccinations. Another control measure is mass vaccination of domestic dogs. Unfortunately, in low-income areas, people and animals often have limited access to health care. Due to the inability to receive medical care victims often die at home which causes rabies infections to be under-reported.

Recently several researchers performed a study (Estimating the Global Burden of Endemic Canine Rabies) to estimate the public health and economic burden of rabies circulating in domestic dog populations. The researchers found that canine rabies kills approximately 59,000 people and causes an $8.6 billion USD economic loss each year.

Vaccinating dogs is the most effective way to reduce rabies infection and death in humans. However, in low-income areas the availability and affordability of preventative vaccinations remains a limiting factor. As a result, people in low-income areas are most at risk of contracting and dying from a rabies infection. The authors of the study recommended that collaborative investments by medical and veterinary sectors could reduce the unnecessary burden of rabies across the world. Mass dog vaccinations have the potential to eliminate rabies in the primary vector for human infection and reduce the need for expensive post-exposure prophylaxis vaccinations.

Functional relationships estimated between A) rabies incidence in domestic dogs and average biannual dog vaccination coverage and B) probability of receiving post-exposure prophylaxis and the Human Development Index.

Reference: Hampson K, Coudeville L, Lembo T, Sambo M, Kieffer A, Attlan M, et al. (2015) Estimating the Global Burden of Endemic Canine Rabies. PLoS Negl Trop Dis 9(4): e0003709. doi:10.1371/journal.pntd.0003709

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