Canine Rabies Control: Progress Towards Integration


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GRF 2nd One Health Summit 2013: Presentation by ABSON, Frances Elisabeth, World Society for the Protection of Animals

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  • Thanks for the introduction, as noted by the chair, I represent the World Society for the Protection of Animals, WSPA.We are a global animal welfare organisation, whose aim is to move governments at all levels and their partners to improve the lives of animals and the communities in which they live, through ending animal cruelty and making animal welfare matter.Through one of our core programmes of work, we are working with governments to encourage them to adopt the only humane and sustainable solution to rabies control – mass dog vaccination. Here, we present the evidence-based case behind our position. We will do this by showcasing various projects and explaining how progress towards integration is helping to control diseases such as canine transmitted rabies.
  • Every day 150 people die of rabies; most of these people are children under 15 years of age. Dog bites are responsible for >95% of these deaths.In developing countries this equates to someone dying every 10 minutes from this horrific disease. Every year, millions of dogs are inhumanely culled in an attempt to stop the spread of rabies.But killing dogs is not the solution as it does not stop the disease.WSPA works with governments to examine their proposed reasons for culling and help them to develop vaccination plans that involve local communities and are tailored to the problems they face.Today we will focus on case studies to see how cullingdoes not stop the spread of this fatal disease.If dealt with correctly and holistically, rabies is wholly preventable.Mass dog vaccination is proven to be the only effective and sustainable response to rabies – it works by addressing the disease at its source.WSPA is calling for a holistic One Health approach which sees human and animal health as connected and works through inter-sector cooperation to vaccinate dogs in the fight against rabies.References: WHO Technical report 2004World Health Organization Factsheet (accessed January 2012)Hampson, K. et al. (2011). Reassessment of the Global Burden of Canine Rabies: Human & Animal Costs. Presented by S. Cleaveland to OIE Global Conference on Rabies Control: Towards sustainable prevention at source, 7-9 September. (accessed October 2012).Hampson, K. et al (2009).Evaluating the cost-effectiveness of rabies post-exposure prophylaxis: A case study in Tanzania.Vaccine, 27, 7167-7172.
  • So how can One Health be applied to humane rabies control? Based on what we’ve seen,read and I’m sure will learn more about at this conference, we understand it to be a globally-endorsed concept that encourages multiple disciplines to work together locally, nationally and internationally to attain the best possible health for people, animals and the environmentSo in short, it is about pooling efforts, resources and expertise Addressing animal health, through humane dog vaccinations is key to an effective rabies response When this collaboration is supported by political will and other key elements such as PEP, advocacy, education, diagnostics etc. mass dog vaccination can eliminate rabies from an affected area for good
  • One of the common problems with zoonotic diseases, such as rabies, is that it can be difficult to determine which government agency should lead control effortsHuman health agencies can be reluctant to support animal vaccination programmes, whereas animal health agencies alone may not be able to manage the human health consequences of the disease and administration of PEP etcIt is also difficult to determine support when addressing competing disease burdensThe key, of course, is for all relevant sectors and their partners, to work together under a coordinated framework
  • Mass dog vaccination, approached holistically, benefits us all in three ways:Animal welfare: It stops crueltyMillions of dogs are saved from needless inhumane culling that is driven by a fear of rabies; Many cases of rabies in dogs can also be prevented; vaccination promotes a more responsible and less fearful attitude towards dogs within communities.Human health: It protects the communityBy removing this main source of infection, rabies cases in dogs and other animal populations can be eliminated and human rabies deaths vastly reduced.Economic: It saves moneyVaccinating dogs is not only more effective than culling dogs for controlling rabies, but it is also very cost-effective.As more dogs are vaccinated, fewer people are bitten by rabid dogs and this can greatly reduce the demand for costly human vaccines given for post-exposure treatment.
  • WSPA contribute to global efforts to integrate mass dog vaccination into national action planning. I’ll run through a few examples:Vietnam is currently lead country for ASEAN’s 2020 rabies elimination goal. WSPA signed an MoU in October with the Vietnamese Government to support their rabies control efforts. Bangladesh: WSPA are working with Government to assist with capacity building and blanket mass dog vaccination. China: WSPA are supporting the Chinese Government with technical expertise at three pilot vaccination sitesIndonesia: WSPA are working with Global Alliance for Rabies Control on a GARC/WSPA vaccination project in Nias. Latin America: WSPA are providing opportunities for governments in Latin America to promote the success of their mass dog vaccination programmes to other regions through case studies and cross regional study tours. As part of WSPA’s working relationship with the Pan American Health Organisation (PAHO) and GARC, we have developed an education resource for teachers on the ‘five keys for the prevention of dog bites’. Kenya: WSPA were invited by Kenya Government to participate in the first key stakeholder consultation to review Kenya’s ‘National Rabies Control Strategy’. The initiative is hosted under the Government’s ‘One Health’ banner and partners include WHO, IOE, FAO, Kenya Veterinary Associations (part of CVA) and others.WPSA have a continued relationship with the Government of Zanzibar through WSPA support of the ‘Zanzibar Rabies Prevention and Elimination Programme’. Progress and sustained success has led to Zanzibar Government plan to eliminate rabies from Unguja and Pemba Island within the next 2-5 years
  • BangladeshIn 2011 the government of Bangladeshand WSPA worked together to vaccinateover 70 per cent of the dog populationin the southern beach resort ofCox’s Bazar.The area has since seen a significant reduction in both dog and human rabies cases In 2012 the government set an ambitioustarget to eliminate rabies by 2020. WSPAsupported a government workshop aimedat developing a coordinated national actionplan against rabies: implementing a massdog vaccinationprogramme alongsidemore effective delivery of PEP, communityadvocacy and communication, monitoringand surveillance. Crucially, several key government ministrieswere involved – health, livestock andlocal government – plus academics andrepresentatives from international organisationsincluding the World Health Organization (WHO)and the Food and Agriculture Organization ofthe United Nations (FAO).
  • ZanzibarRabies was reintroduced to the island ofZanzibar in 1991. Over the last four yearsWSPA and the Government have beenimplementing a project to establishsustainable humane dog populationmanagement. Building on this, thegovernment are working on appropriateinfrastructure and seeking the assistanceof supporting agencies to help eliminaterabies from the area through increaseddeployment of vaccination programmes.Wider workBased on lessons learned from WSPA’son-going support of the programme inZanzibar, WSPA are now, alongside keypartners, supporting the Government ofKenya’s policy development for the controlof canine and human rabies sharingcross-continent learnings and networks. (NOTE ABOUT SPECIAL SESSION)Additional note:It’s prudent to say at this point, following the summary on Zanzibar, that although reducing the density of dogs maynot be critical for effective rabies controlthere are many benefits to dog populationmanagement. There isn’t time in this presentation to go into detail, but combining dog populationmanagement and responsible pet ownershipprogrammes can help combat a spectrumof problems associated with roaming dogs.WSPA are part of the International CompanionAnimal Management (ICAM) Coalition, whichdraws together cross-sector groups to offer unifieddog population management guidelines forgovernments and responsible authorities.
  • The initial success of a coordinated responseto rabies in countries such as Bangladeshand Zanzibar demonstrates the value ofnational rabies elimination planning. It willend the needless practice of dog cullingand help protect human lives.WSPA is calling on governments to stopkilling dogs, and as an alternative, implementeffective dog vaccination programmes.We work with global organisations like theGlobal Alliance for Rabies Control, WHO, OIE,Pan American Health Organization and FAOto promote mass dog vaccination over culling,raise awareness and educate people aboutrabies in communities. We’ve helped manycountries stop inhumane culling of dogs butwe want to end it worldwide.
  • Thank you for listening. Any questions?
  • Canine Rabies Control: Progress Towards Integration

    1. 1. Canine rabies control: progress towards integration One Health Summit, Davos, 2013 Frances Abson, Beryl Mutonono-Watkiss, Mark Kennedy
    2. 2. Background • Every day 150 people die of rabies; mostly children under 15 years old; (Hampson, K et al, 2009) • dog bites are responsible for >95% of these deaths. (WHO, 2005) • Millions of dogs are inhumanely culled in an attempt to stop the spread of rabies; • evidence suggests that culling of dogs does not stop the spread of disease. • WSPA’s vision is of a world where dogs are no longer needlessly killed in response to the fear of rabies. • Mass dog vaccination as part of a wider ‘One Health’ approach can help save people’s lives as well as protecting animals and saving money.
    3. 3. Applying the concept Vaccination within a One Health framework • • One Health: encourages multiple disciplines to work together to achieve the best possible health for people, animals and the environment (American Veterinary Association, 2008) In action: applying the model to rabies control; • addressing animal health, through humane dog vaccination is key to an effective rabies response; • there needs to be strong political will supporting the approach, plus appropriate public health support, such as advocacy, PEP, education, diagnostics and surveillance etc., to make it work.
    4. 4. The Challenges One Health • • • Difficult to determine which government agency should lead control efforts Difficult to determine support when addressing competing disease burdens The key of course is for all relevant sectors and their partners to work together under a coordinated framework
    5. 5. The Benefits Mass dog vaccination, approached holistically, benefits us all in three ways: • • • Animal welfare: it stops cruelty Human health: it protects the community Economic: it saves money
    6. 6. Contributing to global efforts • Vietnam: WSPA and Government MoU to support their rabies control efforts • Bangladesh: Working with Government to assist with capacity building • China: Supporting the Government with technical expertise at pilot vaccination sites • Indonesia: Working on a GARC/WSPA vaccination project in Nias • Latin America: Helping governments to promote their successes and partnering with PAHO and GARC on educational resources • Kenya: Participating in the first key stakeholder consultation to review Kenya’s ‘National Rabies Control Strategy’ under the Government’s ‘One Health’ banner • Zanzibar: Continuing support of the government ‘Zanzibar Rabies Prevention and Elimination Programme’
    7. 7. One Health - Focus on Bangladesh • Successful pilot on Cox’s Bazar • National target to eliminate rabies in Bangladesh by 2020 through a coordinated national action plan • Several key government ministries involved – health, livestock and local government • Plus academics and representatives from international organisations “It is proved around the world [that] culling doesn’t work. It’s an ineffective tool for the prevention of rabies… It is proved that [dog] vaccinations can prevent rabies.” Dr Aung Swi Prue Marma, government rabies specialist, Bangladesh (September 2012)
    8. 8. One Health - Focus on Africa Case example, Zanzibar • Rabies reintroduced in 1991 • WSPA supported the government to implement a project to establish sustainable humane dog population management • Infrastructure and support from other agencies is being sought to help eliminate rabies from the area through increased coverage
    9. 9. Conclusion What have we learned? • • • The value of national rabies elimination planning based on examples and crossregional knowledge sharing The value of vaccination programmes as a humane and sustainable alternative to dog culling The value of partnership working
    10. 10. Thank you for listening Any questions?