The World Organisation for Animal Health reminds us that rabies continues to kill around 59,000 people a year, with a case fatality rate of almost 100% in both humans and animals. Dogs are the main reservoir, and the established goal of eliminating dog-mediated rabies by 2030 is within sight, but not without continued, One Health-driven efforts. Here we examine WOAH’s goals and explore how vaccination campaigns can contribute to the target of 2030 elimination.
WOAH suggests that examples of successful programmes involve the following elements at once:
- Surveillance and reporting
- Mass canine vaccination: if 70% of dogs in high-risk areas were vaccinated, it is believed that we would have no human cases.
- Dog population control
- Public awareness and education
Several countries have already achieved elimination through the application of “strict preventative measures”. However, in other areas it continues to circulate, mostly affecting wild host species. WOAH indicates that in areas where the disease is endemic, measures should be taken to “control and reduce the risk of infection” in vulnerable populations such as wildlife and stray or domestic animals, to create a barrier between the animal source and humans.
The measures listed above must be implemented “alongside access to human medical care and post-bite treatments”.
“Collaboration with human health authorities, under a One Health approach, is crucial to their success.”
WOAH Vaccine Bank
In 2012 WOAH established a Vaccine Bank for canine vaccination against rabies. Members can receive support upon request, with high-quality vaccines provided “in a timely manner” and at a “globally competitive price”. WOAH has already facilitated the delivery of these vaccines to 37 countries, many in Africa and Asia, with financial support from Australia, Canada, the EU, France, Germany, and Japan.
Vaccination within 0 by 30
Drawing on momentum started at a conference for the elimination of dog-mediated human rabies, The WOAH, WHO, FAO, and the Global Alliance for Rabies Control (GARC) developed the Global Strategic Plan Zero by 30. At the heart of this plan is each country, empowered to progress through “global tools, structures, and the needed support”.
Within the Strategy the first objective is “to effectively use vaccines, medicines, tools, and technologies”. Under this umbrella objective are several outcomes:
- Rabies is prevented through increased awareness and improved education.
- Rabies is prevented through increased and effective dog vaccination.
- Human deaths from rabies exposure are prevented by ensuring equitable, affordable, and timely access to health care, medicines, and vaccines.
The Strategy contrasts the cost per patient of treatment in endemic countries with the cost per dog of mass vaccination. Treating a patient can cost around $108.7, while vaccination is only $4.03. Vaccination, therefore, is an obvious tool.
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