Progress towards eliminating canine rabies: policies and perspectives from Latin America and the Caribbean

Abstract

Human rabies transmitted by dogs is considered a neglected disease that can be eliminated in Latin America and the Caribbean (LAC) by 2015. The aim of this paper is to discuss canine rabies policies and projections for LAC regarding current strategies for achieving this target and to critically review the political, economic and geographical factors related to the successful elimination of this deadly disease in the context of the difficulties and challenges of the region. The strong political and technical commitment to control rabies in LAC in the 1980s, started with the regional programme coordinated by the Pan American Health Organization. National and subnational programmes involve a range of strategies including mass canine vaccination with more than 51 million doses of canine vaccine produced annually, pre- and post-exposure prophylaxis, improvements in disease diagnosis and intensive surveillance. Rabies incidence in LAC has dramatically declined over the last few decades, with laboratory confirmed dog rabies cases decreasing from approximately 25 000 in 1980 to less than 300 in 2010. Dog-transmitted human rabies cases also decreased from 350 to less than 10 during the same period. Several countries have been declared free of human cases of dog-transmitted rabies, and from the 35 countries in the Americas, there is now only notification of human rabies transmitted by dogs in seven countries (Bolivia, Peru, Honduras, Haiti, Dominican Republic, Guatemala and some states in north and northeast Brazil). Here, we emphasize the importance of the political commitment in the final progression towards disease elimination. The availability of strategies for rabies control, the experience of most countries in the region and the historical ties of solidarity between countries with the support of the scientific community are evidence to affirm that the elimination of dog-transmitted rabies can be achieved in the short term. The final efforts to confront the remaining obstacles, like achieving and sustaining high vaccination coverage in communities that are most impoverished or in remote locations, are faced by countries that struggle to allocate sufficient financial and human resources for rabies control. Continent-wide cooperation is therefore required in the final efforts to secure the free status of remaining countries in the Americas, which is key to the regional elimination of human rabies transmitted by dogs.

Optimal frequency of rabies vaccination campaigns in Sub-Saharan Africa

“…If reintroduction could be substantially reduced, campaign frequency could be reduced to biennial campaigns in both districts, and resources saved from less frequent campaigns could be allocated to expanding campaigns geographically. Cross-national coordination of rabies vaccination campaigns has been highly effective in Latin America, reducing human rabies by 97%, from 350 cases in 1980 to less than 10 in 2010 [9]. Research regarding the movement of rabid dogs and the rates of reintroduction after a vaccination campaign would facilitate validation of the likely benefits of such international coordination.…”

The Pan-African Rabies Control Network (PARACON): A unified approach to eliminating canine rabies in Africa

“…The implementation of the "One Health" approach within each country in the PAHO region ensured the necessary resources and inter-sectoral collaboration required to successfully control rabies (Vigilato et al, 2013). This continental collaboration and unified approach fostered intracontinental collaboration between countries and attracted global attention, with support from a variety of international organisations and partners.…”

“…A pan-African approach encourages collaboration among countries to consolidate their efforts and effectively control rabies in a progressive and wide-ranging manner. Especially when a country has been declared canine rabies free, regional collaboration is essential in order to protect the country's borders and ensure the maintenance of the rabies-free status (Vigilato et al, 2013). The pan-African network, with the support of industry, animal welfare NGO's and the tripartite (World Health Organization (WHO), World Organisation for Animal Health (OIE) and Food and Agriculture Organization of the United Nations (FAO)) creates the capacity to influence governments and other decision-makers to commit to improved rabies control and elimination programmes within their country and region.…”

The science of rabies in tropical regions: From epidemiological pandemonium to prevention

“…A high proportion of people who were affected in South American cities were low-income individuals (Vigilato et al 2013). As a result, a number of canine vaccination programs have been arranged in South American cities.…”