The Covid-19 pandemic set back many of the global health goals for 2030. One of the most feasible to recover is the target of eliminating human deaths from rabies, thanks to an effective, inexpensive vaccine for dogs.
Yet this ambition, backed by the United Nations, is in jeopardy because public health budgets for controlling the disease are often directed toward treatment for people exposed to it, even though the greatest public health risk comes from infected dogs.
Strategies for controlling rabies in dogs, wildlife, and people have long existed, but have too often been applied in isolation, which is why the disease continues to kill almost 60,000 people every year.
By implementing policies and strategies that treat rabies as a shared “One Health” threat — preventable in people through prevention in dogs — the world can get back on track and reach zero deaths from it by 2030.
Over the past two years, most countries in which rabies is endemic, such as South Africa and the Philippines, have seen a resurgence of rabies cases. This has coincided with a decline in dog vaccination. Some 60% of countries reduced funding for canine rabies vaccination in 2020, while only 5% carried out vaccination campaigns as planned.
Progress made against rabies before the Covid-19 pandemic emerged demonstrates the value of best practices that are based on the principles of One Health, which account for the connections between people, animals, and the environment.
Investing in canine vaccination as a public health policy is the cornerstone of rabies control. An integrated program for eliminating rabies in the Filipino province of Bohol, which cost just $450,000, vaccinated 70% of dogs within a year of launching in 2007, bringing to zero the number of human cases within 18 months. The program drew on expertise across agriculture, education, environment, interior and local government legal affairs, and public health and safety to deliver a vaccine-led package of interventions.
More recently, thanks to dog vaccination, the state of Goa in India managed to eliminate human rabies and reduce cases in dogs by 92%, saving more than 2,000 years of life that might otherwise have been lost to the disease. Latin America has also come close to eliminating canine rabies entirely by shifting efforts from treatment to prevention, with Brazil recording no human cases from dogs in more than five years.
In addition to vaccinating dogs, educating communities, especially children, about rabies and its risks raises awareness of the connections between animal and human health. Dedicated information campaigns also reduce the risk of misinformation about the disease and empower individuals to seek vaccination for their pets and for dogs in the community.
Rabies lessons have been incorporated into the curriculum for public elementary schools in parts of the Philippines, with the resulting increase in awareness linked to a decrease in the incidence of dog bites. Children with greater knowledge about rabies are more likely to take greater care with dogs and report a bite, while also developing an understanding about responsible pet ownership.
Developing effective systems that monitor dog bites and canine rabies cases can help direct vaccination programs and community health programs more effectively and more strategically, especially in regions and countries with limited resources. For example, a bespoke vaccination tracking device developed by the Global Alliance for Rabies Control, which I work for, and an integrated rabies surveillance system were instrumental in targeting vaccination efforts for dogs in Tanzania’s Unguja island, where the incidence of rabies fell by more than 70% within 16 months.
Advances in rabies surveillance among wild animals, such as raccoons in the U.S., can allow authorities to target their control efforts using oral bait vaccines and reduce the risk of rabies spreading to domestic animals and people. Even a 0.5% increase in positive identification of rabies in wildlife can improve efficiency in allocating resources to vaccination or disease monitoring, helping reach the goal of rabies elimination.
With better integration across veterinary and human medicine under the umbrella of One Health, the world can finally be rid of one of its oldest, most traumatic lethal diseases.
Terence Scott is the technical lead at the Global Alliance for Rabies Control.
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