28th September 2022 is World Rabies Day, with this year’s theme being “One Health, Zero Deaths”. To mark this day, we are reflecting on progress towards the “Zero by 30” goal. This was established in 2015 and aims for the elimination of human rabies deaths by 2030. The Rabies Alliance suggests that this is a “positive message”, a “refreshing break” from the COVID-19 pandemic.
WHO in Namibia
WHO’s interview with Dr Rauna Athingo in September 2022 explored how it has been identified as a rabies hotspot for humans and animals. She started working as a state veterinarian in 2006. She observed that vulnerable children were exposed to rabid dogs, specifically puppies. She has been pivotal in developing Namibia’s National Rabies Control Strategy.
“My vision is of a Namibia free from dog-mediated rabies, saving human lives and saving the livelihoods of farmers who also suffer as a result of mass livestock losses due to rabies.”
Central to Namibia’s approach has been a One Health mindset, implemented in 2015. WHO describes the identification of “collaboration between sectors” and “communication at the human-animal-environment interface” as key to this. International communication and cooperation has also been important, such as partnerships with neighbouring countries like Angola. Working towards the “zero by 30” goal Namibia has been “increasing awareness” and “improving accessibility to post-exposure prophylaxis”.
The implications of a rabies infection for victims are multiple. These include financial burdens like travel costs and loss of income. Furthermore, the WHO suggests that “rabies exposure can inflict a heavy psychological burden”. With these factors in mind, it is cheaper to control rabies “at the source” than to provide prophylaxis. It also “helps to empower communities”. The message from Dr Athingo to the community is one of action:
“Kick out rabies from Namibia – vaccinate your pet.”
FLI oral vaccines
The Friedrich-Loeffler-Institut (FLI) in Germany has been supporting Namibia for over 5 years. With assessments, analyses, and capacity on the laboratory side, “vaccination has been a particular focus”. The WHO identifies the reliance of elimination on “mass dog vaccination by the parenteral route”. This means owners have to actively seek out vaccination and excludes free-roaming and stray dogs. To achieve herd immunity, these excluded dogs must be targeted, and oral rabies vaccination (ORV) is an appealing solution.
Dr Conrad Freuling of the FLI describes ORV as a potential “game changer”. During a field trial, both staff and dog owners “expressed their appreciation” for the ORV approach. However, the WHO recalls the importance of “bait acceptance”: “dogs will only go for ‘tasty’ baits”. Luckily, during the trial this proved a success. Dr Thomas Muller of the FLI described this partnership with Namibian colleagues as “fruitful”.
“We are confident that the promising results from our field assessments of ORV will pave the way for other countries in Africa and elsewhere to integrate ORV into their rabies control programmes.”
Cote d’Ivoire rabies course
Another report from the WHO describes “multiple partners” collaborating to create a “comprehensive rabies course”. As part of this, an “intensive 11-day programme in Cote d’Ivoire” united health professionals from Burkina Faso, Cote d’Ivoire, Mali, Niger, Rwanda, Senegal, Chad, and Togo. It covers strategic planning, access to post-exposure prophylaxis, mass dog vaccination, and laboratory work. Dr Madi Savadogo is the training facilitator and Head of Rabies Free Burkina Faso. He hopes this will “foster the emergence of collaborations” across “different disciplines and sectors” from African countries.
This is a “key pillar” of the “zero by 30” goal. The course promotes dog vaccination as “a matter of human public health as well as animal health”. Participants “gained practical knowledge” of vaccination techniques, dog behaviour and handling, and how to identify vaccinated dogs.
The participants were able to “put theory into practice” in a campaign led by authorities in Bingerville. Local radio announcements and social media messaging advertised the local vaccination points. Participants also helped to vaccinate free-roaming dogs. Animals that had been vaccinated were marked with a ribbon collar.
To hear more about alternative production systems for rabies at the World Vaccine Congress in Europe 2022, click here.
For more on Oxford University’s successful vaccine trial results click here.