Rabies the One Health Model - Opportunities and Challenges of a Neglected Tropical Disease


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GRF 2nd One Health Summit 2013: Presentation by KNOPF, Dr. Lea Gabriele Global Alliance for Rabies Control

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  • Why is that? We know that rabies is a fatal viral disease; that close to 99% of all human deaths are caused by the bite of an infected dog and almost all cases of human rabies occur in Africa and Asia.We also know that rabies is virtually 100% preventable by administering rabies vaccine, even after a person has been bitten by a rabid animal, they can be saved by receiving post-exposure prophylaxis. This is because rabies is a ‘slow’ virus and it takes a while for the virus to travel from the bite wound to the brain and if a person is vaccinated even after exposure to the virus, their own immune system quickly kicks into gear and will provide the necessary antibodies to save them. Comparing the cost of interventions, on average the cost for one person to be vaccinated in Asia and Africa is between 30 to 100 US dollars compared to vaccinating a dog against rabies (and focusing on eliminating rabies at the source of infection) which is about $2 - 5.
  • This brief presentation has only shown you a small part of what we are doing, but it gives you an idea of the impact that we have had by being able to provide encouragement, tools, education, and some funding to people living in rabies endemic countries that actually want to prevent rabies in their own neighborhoods. It continues to be a remarkably successful story.The lessons we have learned about controlling and preventing rabies are encouraging and yes, we are facing many challenges. For example, we know that:Rabies can be prevented and no one need die of this horrific disease.By working together and pooling our resources, we can have a bigger impact.Communication tools are powerful and by utilizing them, we can save lives and empower communities to improve their own situation.We have many tools in place that can make a difference, including vaccines, reduced cost regimens, new diagnostic tools like the dRIT etc.
  • Rabies the One Health Model - Opportunities and Challenges of a Neglected Tropical Disease

    1. 1. GRF Davos One Health Summit 2013 One Health - One Planet - One Future Risks and Opportunities 17 - 20 November 2013 in Davos, Switzerland Rabies the One Health Model Opportunities and Challenges of a NTD L. Knopf, M.E. Miranda & D.J. Briggs Global Alliance for Rabies Control (GARC)
    2. 2. Rabies: The disease • Fatal viral disease mainly transmitted through dog bites - 100% preventable by vaccination • Every dog bite in canine rabies endemic countries must be considered a risk of exposure • 22 million people exposed annually • Estimated global economic costs $124 billion each year • Elimination of rabies in dogs would reduce the current number of human rabies deaths by > 95% Knobel et al. Bull World Health Organ. 2005;83:360-8. Hampson et al. OIE Conference on Rabies Control. 2011. Shwiff et al. Antiviral Research 98(2013)352–356. 2
    3. 3. Rabies – a Neglected Tropical Disease Challenges: - Affects marginalized populations - Affordability and accessibility of vaccines - Responsibilities in cross-sectoral collaboration - Animal source (dog), countries‟ other disease priorities and donors‟ priorities Opportunities: - Model for a „One Health approach‟ - Vaccine preventable (life saving) - Rabies elimination as a global public good - Education and community engagement - Communication (WRD) and new technologies
    4. 4. Some lessons learned from a GARC perspective • Rabies prevention is possible – Essential to support and encourage cross-sector and cross-community partnerships – Public/private partnerships are critical – pooling of resources • Many tools are already in place – Vaccines, reduced regimens, dRIT, websites, etc. – Dog rabies vaccination, en masse • Communities & governments – Both are necessary! Build on existing structures – Education and awareness about rabies are crucial to communities and sustainability of programmes. • Communication networks are powerful
    5. 5. Some observations “Only 0.6% of overseas development assistance for health is allocated to NTDs, despite such diseases affecting at least 1 billion people” Time frame Nov 2002 – Nov 2012 The Lancet Malaria Tuberculosis HPAI (H5N1) SARS Rabies Leishmaniasis Leptospirosis Chagas Disease
    6. 6. DALYs Global (in Mio.) 90 80 70 60 50 40 30 20 10 * 0 Malaria TB Influenza Rabies Leish Chagas * Estimates based on 2010 data K.Hampson et al.
    7. 7. Partners for Rabies Prevention (PRP) Informal group of stakeholders – established 2008 • Public and private: Bring time, talent, treasure to table, GARC secretariat • FAO, OIE, WHO, PAHO, CDC, Animal welfare, Universities, Donors etc. • Discuss common strategies and synergies Five pillars: 1. Advocacy; 2. Communications; 3. Research; 4. Capacity building; 5. Pilot projects Activities: • Road map for rabies prevention & control: 2008 → One Health – human and animal rabies prevention • Blueprint for Canine Rabies Control: 2009–2010 → First One Health SOP on rabies prevention • Global health economics group 2011 → Re-evaluating the global burden of rabies (country basis) → Health economic evaluation of on-going rabies prevention projects • Stepwise Approach to Rabies Elimination for canine rabies endemic countries 2012 → Develop a stepwise approach to assist countries in rabies control with the ultimate goal of canine mediated human rabies elimination • Global rabies policy action group 2013 → Investigating on models how to translate evidence into policy changes
    8. 8. For more information Global Alliance for Rabies Control www.rabiesalliance.org World Rabies Day http://rabiesalliance.org/world-rabies-day/ Rabies blueprint www.rabiesblueprint.com