On May 03, 2018, the World Health Organization (WHO) called upon Member States and partners to accelerate efforts to end rabies which causes 59 000 agonizing and painful deaths globally every year, one person every nine minute, mostly children and the poor1.

Eight out of the 11 Member countries of WHO South-East Asia Region, account for nearly 26000 rabies deaths, 45% of the global rabies toll, as over 1.5 million people in the region remain at risk of rabies. "Human rabies is caused mostly by dogs and can be eliminated by increasing awareness about the disease, vaccinating dogs and most importantly by making the already available life-saving rabies vaccines, medicines, tools and technologies affordable and available to all. We can, and must break the disease cycle and save lives," said Dr Poonam Khetrapal Singh, Regional Director, WHO South-East Asia, at the global meeting 'Driving progress towards rabies elimination'.

The global rabies partners comprising of WHO, the World Organization for Animal Health (OIE), the Food and Agriculture Organization (FAO) and the United Nations International Children's Emergency Fund (UNICEF) and rabies endemic countries from Asia-Pacific and Africa, shared and deliberated on measures to fast-track elimination of dog transmitted rabies by 2030.

Countries from Africa and Asia, including Bangladesh, Bhutan, Cambodia, India, Kenya, Nepal, Sri Lanka and Vietnam, who have assessed access, delivery and distribution of rabies post-exposure prophylaxis, shared outcomes of their studies. These studies were conducted with WHO support to enable GAVI (a global Vaccine Alliance) take an informed decision to support rabies vaccines. The rabies endemic countries are seeking GAVI support to improve affordability and access to rabies vaccines for vulnerable populations, especially children. WHO has been advocating for a shift from intramuscular to intradermal rabies vaccination, which is not only 60 to 80% cheaper, but is of shorter treatment regimen of just one week. Most countries in WHO South-East Asia Region are now using intradermal route for anti-rabies vaccines.

Zero by 30: The Strategic Plan

At the meeting, member countries shared initiatives being rolled out as part of the new 'Zero by 30: The Strategic Plan', to be launched by WHO and its partners to end dog transmitted rabies. The plan centres-on One Health approach and addresses the disease in a holistic and cross-sectoral manner. It aims at:

  • Preventing and responding to dog-transmitted rabies by improving awareness and education, reducing human rabies risk through expanded dog vaccinations, and
  • Improving access to healthcare, medicines and vaccines for populations at risk.
  • It also aims at continued stakeholder engagement at all levels to sustain financing for achieving "Zero by 30". Investing in rabies control and elimination improves equity and access to healthcare and contributes to sustainable development.

The plan calls for generating and measuring impact by implementing proven effective guidelines for rabies control and encouraging the use of innovative surveillance technologies to monitor progress towards 'Zero by 30'.

About Rabies

Rabies is a viral disease that occurs in more than 150 countries and territories – is usually fatal once symptoms appear. Dog-transmitted rabies accounts for about 99% of human rabies cases. It is estimated that 59,000 people die from rabies every year. 40% of people bitten by suspect rabid animals are children under 15 years of age. The world's poorest are the most affected as they cannot afford treatment or transport for care. People's livelihoods are also affected when livestock get rabies, a loss estimated at over US$ 500 million per year globally. However, rabies is 100% preventable by ensuring access vaccines and to life-saving treatment following dog bites; and by vaccinating dogs to reduce risks and ultimately to eliminate the disease.

Footnotes

1 http://www.searo.who.int/mediacentre/releases/2018/1688/en/

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.