Rabies continues to kill despite effective animal & human rabies vaccines

Rabies control needs to go beyond human and animal health services

Rabies – a preventable but fatal disease - for which effective vaccines have existed for over 100 years – still takes the lives of an estimated 60,000 people each year, mostly children in rural Africa and Asia. Evidence suggests that the threat is especially prominent in areas struck by conflict and natural disasters. Experts warned that unless coordination and awareness raising go beyond the ministries of health and agriculture, too many animals and humans will continue to die unnecessarily from this painful, killer disease.

“People live, work and flee with their dogs. We need to change the way ministries work together to roll out regular mass dog vaccination campaigns, to provide more protection in times of peace, conflict and natural disasters.” said Prof. Louis Nel, Executive Director of the Global Alliance for Rabies Control (GARC). “We have the vaccines and we know they work, so how is it possible that so many people and animals continue to die from this painful, long-known disease?”

Though rabies is present in wildlife, over 95% of rabies is spread via dogs.

On the basis of data / evidence collected by the OIE, a rise in rabies cases among dogs has been observed in parallel to political instability periods in some North African countries during the last decade.

“To fight against rabies, we need to vaccinate around 70% of stray and domestic dogs in at risk areas. Instability and natural disasters can really disrupthuman and animal health systemsand dog populations go uncontrolled. This is why we actively work with governments to provide them with dog vaccines through the OIE Rabies vaccine bank and help them coordinate the implementation of massive dog-vaccination campaigns. The quicker we eradicate dog-mediated rabies, the fewer rabies-related deaths we will see, especially in times of disruption.” said Rachid Bouguedour, Sub-Regional Representative for North Africa, World Organisation for Animal Health (OIE).  

Natural disasters also have an effect. Nias Island, North Sumatra, Indonesia was free of rabies until the 2005 Tsunami / earthquake. In 2010, just five years later, they declared an outbreak as rabies had killed 26 people.

But rabies is entirely preventable.

“Prevention of bites in the first place should be an emphasis of any rabies programme. When a child gets bitten the mother needs to know to wash the wound and to contact a local health worker. Most people who get bitten are too poor to pay for treatment and for transportation to facilities that carry the vaccine. We also need to help countries with forecasting their vaccine needs and building emergency stocks,” said Bernadette Abela-Ridder, World Health Organization (WHO) Head of Zoonotic Diseases, on World Rabies Day. 

Each year, it is estimated that more than 29 million people receive post-exposure prophylaxis (PEP) to prevent rabies at a direct cost of over $1.7bn and yet so many people still are dying that it indicates an unmet need for vaccines and immunoglobulins. While PEP is an effective way to prevent rabies in humans after exposure, thisis only addressing the symptom, not the cause.

However far more effective – and cost effective - is tackling rabies at the source of the problem – by vaccinating dogs. For every PEP course on the shelf, veterinary specialists can vaccinate hundreds of dogs.

“Most national veterinary services focus on livestock diseases. Dogs don`t have the same economic and social value as cows or goats, so addressing rabies in dogs is less of a priority. However, if rabies is not controlled in dogs, then humans, livestock and other farm animals can become infected, with serious consequences for the lives and livelihoods especially of rural communities and farming families,” said Dr. Juan Lubroth, Chief of the Animal Health Service of the Food and Agriculture Organization of the United Nations (FAO)

Today on World Rabies Day, agencies working together to combat rabies urged human and animal health authorities around the world to step up and more effectively address the disease.

The theme for this year’s World Rabies Day on September 28 is “Educate. Vaccinate. Eliminate.” Human, agricultural and veterinary international agencies are working across ministries to try to change policies and practices and to help people to protect themselves and their animals. It is especially important to build more awareness among dog owners in resource poor countries and with disenfranchised communities with little access to public health care or veterinary services.

As part of the United Nations Sustainable Development Goals, in December, 2015, WHO, OIE, FAO, GARC together with countries and partners, agreed a framework to eliminate human deaths from the disease by 2030 and called on a wide range of stakeholders to participate in the “End Rabies Now” campaign.