Fighting Rabies in Eastern Europe, the Middle East and Central Asia ‐ Experts Call for a Regional Initiative for Rabies Elimination

Abstract

MEEREB is an informal network of rabies experts from the Middle East, Eastern Europe and Central Asia, seeking to eliminate rabies from the region. They met for the second time to review the current rabies situation, both globally and in their respective countries, highlighting current rabies control problems and potential solutions. Success stories in Latin America, in Western Europe, in some Asian countries, as well as in Croatia and Serbia prove that elimination of human rabies is achievable in the MEEREB region. It requires political willingness and cooperation of all stakeholders, including Ministries of Health and of Agriculture; adequate management of animal bites through post-exposure prophylaxis; pre-exposure prophylaxis for populations at high risk of rabies exposure, animal vaccination and humane control of stray dog populations. MEEREB members called for a regional initiative for rabies elimination in Eastern Europe and the Middle East. They are confident that the elimination of human rabies of canine origin can be achieved in the region through adopting a One Health approach, and that campaigns for rabies elimination will have significant benefit for public health, including strengthening the structure for control of other zoonoses.

Laboratory data of dog rabies in southern Cameroon from 2010 to 2013

“…Rabies surveillance and control programs based on effective vaccination and dog population management have led to the elimination of rabies in domestic animals in Western Europe, North America as well as in some countries in Asia. However, rabies remains a public health issue in developing countries where dogs remain the main reservoir and vector of disease transmission to humans [ 3 – 5 ]. It is estimated that about 55,000 human deaths annually are caused by rabies infection worldwide and 44% occur in Africa [ 3 , 5 ].…”

Surveillance of Human Rabies by National Authorities – A Global Survey

“…There is wide recognition that the lack of robust surveillance is hindering rabies control efforts, but also optimism that these barriers can be overcome (Banyard et al., ). With the recent resurgence of interest in regional rabies elimination plans (WHO, ), there are increased calls for the enforcement of the notification of rabies and accurate reporting of data (Dodet, ; Aikimbayev et al., ; Nel, ; Dodet et al., ). Accurate surveillance data will allow governments to calculate the true human and economic costs of rabies in their countries and to make more informed health budget allocations.…”

Difficulties in estimating the human burden of canine rabies

“…Attempts to develop effective regional databases are beginning though, and country reports from regional rabies meetings have been compiled into datasets for Africa, the Middle East and Eastern Europe and Asia (Dodet and African Rabies Expert Bureau, 2009, Aikimbayev et al, 2014, Gongal and Wright, 2011, Searg, 2014, PARACON, 2015). Whilst these reports can provide insight into the issue, their current dependency on attendance at meetings makes these reports infrequent (annually at best) and data are usually not interpreted or compared to previous data (Dodet and African Rabies Expert Bureau, 2009, Aikimbayev et al, 2014). …”