Challenges to the Fight against Rabies—The Landscape of Policy and Prevention Strategies in Africa

Abstract

Nearly 59,000 human deaths worldwide are attributable to rabies annually, of which more than a third occur in Africa. In recent years, progress has been made in both action and collaboration including implementation of surveillance and prevention measures. In this review we assess the scale of surveillance, preventive, and control efforts of canine-transmitted human rabies in African countries. We reviewed literature published from 2014 to 2018, retrieved from electronic databases including MEDLINE, Global Index Medicus, BIOSIS, Science Citation Index, and EMBASE. WHO reports, national disease control program reports, and conference proceedings were also reviewed. The database search was conducted using keywords including rabies, control, and prevention. In forty countries (40/54), some level of rabies control and prevention strategy was available while in fourteen (14/54) countries, no specific national control and prevention strategy for human rabies could be retrieved. Thirty-four (34/54) countries utilized the Stepwise Approach towards Rabies Elimination (SARE) tool to monitor the national rabies control efforts—five of these countries were at the lowest tier (0/5) of the SARE scoring system while no country had achieved the highest score (5/5). High burden countries need to step up the implementation of context specific national rabies control, prevention, and monitoring strategies. As a zoonosis, rabies control and elimination require coordination between human and veterinarian health sectors under the “One Health” umbrella and with national master plans on the prevention and control of neglected tropical diseases ending in 2020, the time to act is now.

Public Health Policy Pillars for the Sustainable Elimination of Zoonotic Schistosomiasis

“…As highlighted by the WHO, providing centralised data access will facilitate understanding, expediting analyses and consequently the decision-making process (3). An example of this is the Pan-African Rabies Control Network, which established a platform for centralised rabies data collection and analysis, with an option for open data sharing (38,39). We see opportunity in extending such a framework to other zoonotic diseases across a wider geographic area.…”

Rabies Virus in Sierra Leone: Challenges and Recommended Solutions for Elimination by 2030

“…Since By-laws are rules or laws established by an organization or community to regulate itself, hence authorities and community members may establish and enforced by-laws to own and manage dogs [25]. Such acts and regulations should be enforced by the state veterinary services, and statutory animal welfare standing advisory committee should be in place to advise the government.…”

“…The death of thirteen people from 1968 to 1973 warranted government to vaccinate 4700 dogs in 1974 [12] which in turn gave prominence to control of rabies through a national vaccination of dogs which was short-lived due to the hosting of the Organization of African Unity (OAU) conference in the 1980s. The Government diverted meager resources to the hosting leaving most government departments unable to discharge their normal duties and service.…”

“…Animal welfare occupied a lower primordial position on the list of national priority and family. This is also true across Africa where there is a lack of coordination and collaboration regarding dog ownership management, rabies control, and elimination activities, both within and across countries [12]. Most homes could no longer afford three meals a day and dogs have to cater for their daily survival.…”

Public Health Policy Pillars for the Sustainable Elimination of Zoonotic Schistosomiasis

“…As highlighted by WHO, providing centralised data access will facilitate and expedite analyses, and consequently the decision-making process (8). An example of this is the Pan-African Rabies Control Network (PARACON), which established a platform for centralised rabies data collection and analysis, improving on the WHO recommendation with an option for open data sharing (34,35). We see a great opportunity in extending such a framework to other zoonotic diseases across a greater geographic area.…”