The document discusses the "One Health" approach to rabies elimination in Asia. It provides context on rabies and advocates for a collaborative effort between human and animal health sectors. Key points include:
1) Rabies kills over 55,000 people annually, with over 90% of deaths occurring in Asia where rabies is endemic in dog populations.
2) A "One Health" approach recognizes the links between animal, human, and environmental health. Coordinating sectors is necessary to effectively control zoonotic diseases like rabies.
3) Eliminating rabies in dogs through vaccination programs is the most cost-effective way to prevent human rabies. However, challenges remain in implementation due to a
💰Call Girl In Ludhiana 📞9815777685📞 💰Dilpreet📲 Best Ludhiana Call Girls Serv...
NDWC Chennai 2013 - The One Health approach towards Rabies elimination in Asia - Dr Abdul Rahman
1. The “One-Health” Approach
Towards Rabies Elimination in
Asia
S. Abdul Rahman
President, Commonwealth Veterinary Association
President, Association for Prevention and Control of Rabies in India (APCRI)
Chairman, OIE Animal Welfare Working Group
Former Dean, Bangalore Veterinary College, Bangalore
1
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
2. Ignorance is the main problem..
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
3. What is One Health?
The collaborative effort of
multiple disciplines
working locally,
nationally, and globally –
to attain optimal health
for people, animals and
our environment
-American Veterinary Medical
Association, 2008
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
4. Connectivity Between Animal and Human
Disease and the Environment
- Ancient civilisations
- Middle Ages: Black Death
- Rinderpest Outbreaks
C18th Europe
- Human Conflict: American
Civil War 1861-1865,
WWI, African Context
Questions of the animal origins of human disease lie behind
the broadest pattern of human history, and behind some of
the most important issues of human health today”
-Jared Diamond, in Guns, Germs and Steel
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
5. Early Pioneers of Comparative Medicine
- C19th: Hazards associated with
infected meat/milk gaining
recognition (TB and scarlet fever),
confirmation tapeworm associated
with muscular cysts in the cattle and
pigs.
- Rudolf Virchow coined the term
zoonosis to “indicate the infectious
disease links between animal and
http://www.creationism.org/books/TaylorIn
MindsMen/TaylorIMMhdRudolfVirchowM.j human health” (Cardiff et al, 2008)
pg
“Between animal and human medicine there are no dividing
lines – nor should there be. The object is different but the
experience obtained constitutes the basis of all medicine”
- Rudolph Virchow (1821-1902)
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
6. Calvin Schwabe (1927-2006)
- “Modern Advocate of One Medicine”
(Cardiff et al, 2008)
- 1984:Veterinary Medicine and Human
Health echoed the visions of integration
between human and veterinary medicine
- Advocated for the improvement of
human livelihoods through animal disease
control via examples such as CE, and
non-ZD e.g Rinderpest in EA
vetmed.ucdavis.edu
“The final objective of veterinary medicine does not lie in the
animal species that the veterinarian commonly treats. It lies very
definitely in man and above all in humanity” - Schwabe, 1984
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
7. One Health in the 21st Century
Promotion of One Health for the control of Emerging
Infectious Diseases
- 61% of human infectious diseases are of animal origin
(Taylor et al 2001), 75% of EID over the last 30 years
are zoonotic (Osburn et al et al 2009, AMVA 2008).
- Many hypotheses for this “spike” in zoonotic infectious
disease emergence worldwide; including increasing
human population , placing natural resources under
pressure and increases the contact between wildlife,
domestic animals and humans
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
8. Control of Endemic Zoonoses
for Poverty Alleviation
2000: 6th MDG - “To Combat HIV/AIDS,
Malaria, and Other Diseases” - large scale
financial interventions addressing ID and their
contribution to poverty
Neglected Tropical Diseases – Include WHO
recognised “NZDs” - Anthrax, BTB,
Brucellosis, Cysticercosis/NCC, CE, Rabies
and HAT (WHO, 2009c)
Poverty, reliance on livestock, close proximity
between animals and people all favour the
spread of ZD
Livestock productivity losses/death from ZD
places even greater strain on poor
communities
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
9. Moving Forwards with One Health in
Developing Countries
Several high profile meetings to promote policy and
advocacy for the NZDs - Integrated Control of Neglected
Zoonoses in Africa (ICONZ) - EC funded project
involving 21 partners - collaborative project to address
knowledge “gaps” currently existing on NZD burdens –
www.iconzafrica.org
“By simultaneously saving lives and securing livelihoods,
the control of neglected zoonotic diseases offers a real
and highly cost-effective opportunity for alleviating
poverty, especially in remote rural communities”
WHO Meeting Report “Integrated Control of Neglected
Zoonoses in Africa” Nairobi, 2007
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
10. Challenges of Implementing a One Health
Approach in Developing Countries
Advocacy and public
awareness for NZD
Constraints to the
diagnosis (prioritisation)
of zoonotic disease
Who Pays? National
funding “falls between
the cracks” of MoH/MoA
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
11. Rabies
3.1 billion people live in 15 countries in Asia that are
endemic for dog rabies
Rabies kills 55 000 people every year and also has the
highest case-fatality ratio of infectious diseases.
Approximately 31000 (90% ) occur in Asia
99% of deaths occur in Asia where Rabies is endemic in
dog population
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
12. Human Mortality Due To
Rabies
97% of human rabies
deaths come from bites
of rabid dog
Children (40%approx)
are more affected.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
13. Rabies
Rabies is a vaccine preventable disease. The most cost
effective strategy for preventing rabies in people is by
eliminating rabies in dogs through vaccination
~ World Health Organization (WHO) 2010
The control and elimination of rabies in dogs through
vaccination remains the only cost effective way to
sustainably protect humans from contracting the disease.
~ World Organisation for Animal Health (OIE) 2011
Vaccinating dogs against rabies is the key to stopping this
terrifying disease. It protects the dogs from rabies and
creates a barrier between the disease and the people
~ Global Alliance for Rabies Control (GARC) 2012
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
14. Why Do People Still Die of Rabies?
Lack of awareness on all levels about
Responsible pet ownership – vaccinating pets
Need for post-exposure prophylaxis (PEP)
Primary wound care
Rabies immunoglobulin (RIG) not available
Rabies vaccines not available
Greater cost of travel
Increased risk of rabies onset
Rabies vaccines are too expensive
Likelihood of giving up
Delays because of need to raise money
Control of Dog Reservoir
Slide courtesy of Dr Katie Hampson, University of Glasgow
14
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
15. Human Rabies in Asia, 2010
Rabies-free
Up to 150 cases
151-300
301-2000
2001-10 000
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
16. Afghanistan
40 in 2010
(37) 150-200
2000-2500 1-4
20 000
Urban:24%
2000-2500
Rural: 76%
Rabies Free
Rabies Free
58 (2009)
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
17. Rabies Situation in Asia
WHO estimation of rabies deaths in 2005 in Asia was
32,000 as compared to 41,000 in 2001 and it could still
be less now. This is mainly due to:
Implementation of comprehensive rabies control programs
Phasing out of Nerve tissue vaccine from all Asian
countries except Pakistan and Mongolia
Availability of tissue culture vaccines and immunoglobulins
Awareness programmes especially with World Rabies Day
Role of International and Regional Organisations such as
WHO,OIE,FAO,GARC,RIA etc.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
18. Adoption and implementation of OIE
Recommendations and Standards
Rabies should be considered as a priority by all
governments
Public awareness and education on rabies
Active contribution of Veterinary Services to the goal of
eliminating human rabies at the animal source with the
appropriate financial support (public budget/Ministries of
Health)
Design and implementation of comprehensive and
sustainable national programmes for rabies elimination,
Harmonisation of control/ elimination programme
strategies between neighbouring countries until rabies
has been successfully eliminated.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
19. Rabies Control Initiatives In Asia
2004 2007
1st AREB Meeting, Cebu 4th AREB Meeting,
Island, Philippines Bangkok,Thailand
2005 First Rabies in Asia Conference
(RIACON 1) Bangalore, India
2nd AREB Meeting, Shanghai,
China
OIE/WHO/EU Intl conf Towards
the Elimination of Rabies in
2006 Eurasia
3rd AREB Meeting, New Delhi, First World Rabies Day
India The Philippines enact into law
Establishment of the Rabies in the Anti-Rabies Act
Asia Foundation Vietnam: Decree Enacts a
Establishment of the Alliance Rabies elimination program
for Rabies Control (ARC)
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
20. Rabies Control Initiatives In Asia
2008 2011
Creation of the Partner for Rabies OIE Global Conference on Rabies
Prevention group Incheon, Korea
Resolution of eliminating rabies by Third Rabies in Asia Conference
2020 adopted by the ASEAN Plus (RIACON 3) Colombo, Sri Lanka
Three Countries 8th AREB Meeting, Bangkok,
5th AREB Meeting, Ho Chi Minh City, Thailand
Vietnam Establishment of Global Alliance for
Rabies Control Asia
2009
6th AREB Meeting, Manila, 2012
Philippines Ilocos Norte Philippines: 1st
Second Rabies in Asia Conference Provincial Rabies Summit and
(RIACON 2) Hanoi, Vietnam CARE Project Launch
Creation of a National Rabies
2010 Control Programme in 12 Five Year
7th AREB Meeting, Goa, India Plan Govt. of India
9th AREB Meeting, Yogyakarta
Indonesia
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
21. Rabies Control Programme in
Asia
Recent positive developments in South Asia and
South-East Asia towards rabies elimination need
to be enforced and supported through
international partnerships and funding.
Political commitment, development and
execution of comprehensive rabies elimination
programmes and community participation are
prerequisites for successful rabies elimination
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
22. Rabies Control Programme in
Asia
Necessary tools and methods for control and
prevention of dog and human rabies are
available, and human rabies elimination has
been demonstrated in Europe, America and
some countries of Asia.
Coordination among major stake -holders,
international partnerships, political commitment
and regional cooperation are major challenges
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
23. Rabies Control Programme in
Asia
The ASEAN Secretariat has taken a bold
decision to eliminate rabies by 2020; while
SAARC is also trying to
move towards human rabies elimination. Though
many international non-government and humanitarian
organizations are involved in animal birth control and
rabies vaccination activities in urban areas in some
countries, a strong international
partnership will be needed to execute a
comprehensive rabies elimination programme in the
South-East Asia region.
OIE and WHO has been providing technical support to
member countries to launch such a programme
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
24. Rabies Control Programme in
Asia
New projects with international funding
WHO-coordinated Bill & Melinda Gates Project for
Dog Rabies Elimination (Visayas Islands) : 10m US$
funding
Bohol Rabies Prevention and Eradication Program
(ARC, Bohol Provincial Gvt, Private Swiss Foundation)
Rabies retained in the final list of GAVI investment case
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
25. The Need for a One-Health
Approach
In the fight against rabies, the priority is to safeguard
human welfare but it should not be at the unnecessary
expense of dogs
One health approach will provide good animal welfare
which will have direct benefit to human health
To ensure sustainability, dog vaccination programmes
will need political support and will need to integrate
public health, veterinary, livestock and animal welfare
agencies
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
26. Examples of “One Health” Initiatives
for Rabies Control in Asia
India : 1. Adopt a Village Programme
2. Pilot Project on Prevention and Control of
Human Rabies
3. Proposed National Rabies Control Programme
in 12th Plan
Indonesia: Indonesian Project –The Bali Case Study
Bangladesh: WSPA’s Red Collar Campaign in Cox’s Bazar
Philippines – Bohol Project
The CARE Project in Ilocos Norte, Sorsogon and Metro Manila
in Philippines and Nias in Indonesia
WHO – Bill & Melinda Gates Foundation Project in The
Philippines (Visayas)
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
27. INDIA
1. Adopt a Village Programme
Ten villages surrounding Bangalore and Pune,
India have benefited from a programme aimed
at reducing the incidence of human and animal
rabies through improved educational awareness
and mass vaccination of dogs.
A large number of medical and veterinary
partners worked together in the target villages to
educate people in their own language with
sensitivity to their customs.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
28. Model Rabies Prevention Programme:
(Based on one health experiment )
Medical Veterinary
Messenger: Medium:
•Primary health care Behavioral •Rabies video film
volunteers Change •Rabies Calendar
•School children & Communication
•Posters
Teacher
•Wall paintings
•Local leaders
•Snake & ladder game
•Rabies rally
Rabies •Book labels
Awareness
•Folk Media
Post exposure prophylaxis Animal Welfare Activities
Laboratory Diagnosis by dRIT
& • Responsible pet ownership
Pre exposure vaccination • Anti rabies vaccination of
by ID route dogs
• Deworming
Rabies prevention
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
29. N
Bangalor
Subjects and Methods: e
Ramohall
y Bhimanakup S
e Project Villages
Vinayak
nagara
India
Control Gerupaly
Villages a
Rabies deaths in Animals
Village name 09 08 07
Kumbalgodu
A A A Study
Ramohally 1 1 - Villages
Bhimanakupe 1 - 1
Vinayak nagara 1 - 1
Tagachgup
* No Human Rabies death
e
Rabies Death in Human & Animals
Location of
Project Villages Bangalore
Village name 09 08 07 06 05 04
H A H A H A H A H A H A
Gerupalya - 1 - 1 - 1 - NA - NA - NA
Kumbalgodu - 2 - 2 1 2 - NA - NA 1 NA
Tagachgupe - 2 - 2 - 2 - NA - NA 29 - NA
H=Human
29
Mysore
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
A=Animal
30. INDIA
1. Adopt a Village Programme
Empowering local
communities to take
action against rabies
Building partnerships
& providing expertise
Using existing
networks to improve
public health
Human, veterinary &
animal welfare
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
31. Rabies Awareness Activities
Wall Paintings – Wall Paintings –
Objectives of the project Calendar for the Year 2011
Rabies education
Rabies Volunteer educating the Snake & ladder game for rabies
community Painting Competition education
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
32. Poster on Post Exposure Poster on responsible pet
Prophylaxis ownership Rabies public awareness video in
Kannada
FGD with rabies volunteers
Rabies Awareness - Jatha
& SHGs members
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
33. Laboratory Methods in Rabies Diagnosis & Hands
on training in Direct Rapid Immunohistochemistry
Test (dRIT)
Dr. S Abdul Rahman -Addressing the Dr. S N Madhusudana , NIMHANS –
participants -Auditorium, Government Discussion on dRIT .
Veterinary College, Bangalore.
Brain sample for
dRIT
Ms. Lillian Orciari, CDC, Atlanta
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
Rabid cow explaining about dRIT procedure
34. Results
Animal bite/Exposure - Incidence
Incidence in 1 year Baseline End line Z P
Study villages (N=1735) 47 (2.7) 33 (1.9) 2.05 0.0398
Control villages (N=1080) 31 (2.8) 27 (2.5) 0.59 0.5501
Note: Overall there was 30% reduction in incidence of animal bite /exposures in study villages.
Human rabies Incidence: There was no case of human rabies
reported in study and control village.
Animal Rabies Incidence: There were six cases from study village
and one case from control village of animal rabies confirmed by
dRIT
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
35. Results Summary
Significant improvement in the KAP of people in the
study villages following implementation of rabies
prevention strategies.
Incidence of animal bite/exposure reduced by 30 % in
study villages when compared to control villages.
Post exposure prophylaxis was provided to all animal
bite/cases in the study villages. Dog, particularly pet dog
was found to be the most common biting animal and
majority of the cases were category III exposures.
Pre exposure vaccination by Intradermal route to school
children & other risk groups using PCECV was safe &
immunogenic.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
36. Results Summary
There were no human rabies cases in project villages
during the two year project period.
Laboratory diagnosis of animal rabies using direct rapid
immunohistochemical test (dRIT) was feasible at field
conditions.
The animal welfare activity involving collar, anti rabies
vaccination & deworming was well accepted by the
community in study villages. Adequate RVNA titer in
dogs was observed with annual booster dose of rabies
vaccine.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
37. Notifiability and Education Project
Rabies is not a notifiable disease in
India but only Reportable
Mass information campaign to
sensitize 545 Members of Parliament
with translation of Rabies information
in 12 different Indian languages
Media campaign to highlight the need
for making Rabies a notifiable disease
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
38. Pilot Education Project in Karnataka State
TACTICAL OBJECTIVE/GOAL
To relieve the burden of Rabies in animal
population especially in dogs in India and
eliminate human rabies deaths.
Project is based on the premise that children are
best medium to adopt the concept of responsible
pet ownership Furthermore up to 60% of all
people who die of rabies are children.
Target beneficiaries: 54,529 primary schools
with 252,875 teachers and 8.495 million
students. 9,498 secondary schools with 92,287
teachers and 1.384 million students
Goal: Incorporation of rabies education into
54,529 primary schools by 2013 and 9498
secondary schools in Karnataka state by 2015.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
39. Project On Evaluation Of Neutralizing Activity
Monoclonal Antibody Combination Against Rabies
For reasons of safety and availability, alternative
products to HRIG and ERIG are advocated, and the
development of rabies virus-specific monoclonal
antibodies has been recommended by WHO
Genotypic characterisation of Rabies virus from different
geographical locations in India
The aim of the project in India will be to provide an
alternative therapy to rabies immune globulins (RIGs) by
developing a human monoclonal antibody (mAb) cocktail
for Post Exposure Prophylaxis
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
40. INDIA
2. Pilot project on Prevention and Control of
Human Rabies
Objectives
Prevention of human deaths due to rabies.
Sensitization of veterinary and animal husbandry departments for reducing the
transmission of disease in animals.
Strategy
Enhancing awareness regarding timely and appropriate Post exposure treatment
Ensure availability vaccines and anti-sera
Training health professionals
Operationalise ID route in selected centres
Strengthen diagnostic capabilities
Interface with animal husbandry department
Involvement of NGOs and Community
Pilot Project Cities
Ahmedabad
Bangalore
Delhi
Pune
Madurai
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
41. Challenges faced in Surveillance and
Intersectoral coordination
• No single administrative unit
thus collection and collation
of data from all the agencies
involved in animal bite
management is a challenge
• Involvement of Intra-city
multiple stakeholders
• Continues to remain a
disease of low priority with
Dept of Animal Husbandry
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
42. INDIA
3. Proposed National Rabies Control Programme
in 12th Plan of Government of India
Components:
Human Health : to reduce mortality due to rabies
Animal Health : to cut down transmission of disease
Strengthening Intersectoral coordination
Maintaining rabies -free areas as rabies -free
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
43. Coordination of Rabies control
Activities in India
NGO’s
WHO FAO OIE APCRI RIA ARC
Ministry of Ministry of
Health
Mun Corp Agriculture Dept. of
Vet
Services
AWBI -Min. of
Envr. Forest &
Anim. Welfare
Rabies Control
Programmes
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
44. World Rabies Day Programmes
Education campaign
involving Media and
Celebrities such as
Film Stars and Sport
persons (Cricket)
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
45. Vietnam Government’s
Commitment
Instruction No.92/TTg signed by Prime Minister
on 07/12/1996;
Ordinance on Animal Health was adopted by the
National Assembly in 2004;
Decree No.05/2007/ND-CP signed by Prime
Minister on 09/01/2007.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
46. INDONESIA
Indonesian Project –The Bali Case Study
In 2010, the Bali Animal Welfare Association (BAWA),
funded by the World Society for the Protection of
Animals (WSPA) and the Australian Agency for
International Development (AusAID), initiated island-
wide mass vaccination campaigns for free, targeting the
outside dog population.
The result was a marked decline in the new reports of
rabies infections in humans. The Indonesian Directorate
of Animal Health, seeing the concrete results, reached
out to FAO for technical support to maintain the
momentum and build upon the lessons learned battling
the rabies virus in Bali.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
47. INDONESIA
Indonesian Project –The Bali Case Study
FAO's Assistance
In early 2011, the FAO began working with the
veterinary services to develop a targeted strategy to
combat rabies, coordinating at various levels: local,
provincial and with central authorities in Jakarta.
In addition, human health services, local NGOs and
animal welfare groups have also been involved in
mounting a united front against rabies.
FAO supported the government by helping to bring all
sides to the table to launch an effective control
programme against rabies.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
48. INDONESIA
Indonesian Project –The Bali Case Study
Island wide mass vaccination programme
commences.
In the first round of vaccinations
implemented by BAWA, some 239,000 dogs
were vaccinated.
During the second round, coordinated by
the Bali Province Livestock Service and the
central government's Directorate of Animal
Health, with funding from FAO, Australia
and United States, another 235,000 dogs
were vaccinated within four months.
A third round of vaccination is ongoing now
and will cover another 250 000 dogs.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
49. The vaccination of dogs
Human and Dog Rabies Cases, Bali (Oct 2009 – March 2011)
STOP Dog Culling
START of 1 st mass dog
vaccination
14 90
13 13
213 176
doses 80
12 Humans 77
Human deaths
70
Dog cases
68 (70% dog pop)
10 10 62 60
8 8 8 50
7 7
6 38 6 38 40
5 5 5 5 30
4 28
4 28 4
23 22 24
3 19 3 20
2 Dogs 2 14 12 2
9 10 9 9 9 10
133 169 doses 115 326 doses
0 0
Oct- Nov- Dec- Jan- Feb- Mar- Apr- May- Jun- Jul- Aug- Sep- Oct- Nov- Dec- Jan- Feb- Mar-
09 09 09 10 10 10 10 10 10 10 10 10 10 10 10 11 11 11
Months
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
50. INDONESIA
Indonesian Project –The Bali Case Study
Herd Immunity
With more than 70 percent of dogs vaccinated, the
dogs have ‘herd immunity'.
At this level of vaccination coverage, the rabies virus is
unable to spread in a dog population that has immune
protection, and it eventually dies out.
Rabies deaths in humans have declined from 83 in
2010 to 26 in 2011. So far in 2012, just seven people
have fallen victim to rabies.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
51. BANGLADESH
WSPA’s Red Collar Campaign in Cox’s Bazar
WSPA’s mass vaccination project in
Bangladesh is helping to protect
thousands of dogs, as well as local
families, from rabies.
The teams put red collars on
vaccinated dogs, or sprayed their
backs with toxin-free yellow paint, to
indicate that the animals were
protected against the deadly disease.
Further, the teams educated the
community about the importance of
vaccination in the fight against rabies.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
52. The Global Alliance for Rabies Control
“Striving to free people and animals from rabies”
Collaborative programs:
World Rabies Day Campaign
It is a global campaign, celebrated every 28th September of the
year, to raise awareness and give a voice to people at most
risk on rabies
Bohol Rabies Project, demonstrated that rabies can be
eliminated and children saved by:
empowering communities to take responsibility
mobilizing local resources
developing & sharing adequate tools for sustainability
working with global experts
Other programs where we share our expertise and support
governments to monitor their rabies program
(i.e. Adopt a Village in India)
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
53. PHILLIPINES
The Bohol Project
Luzon
Luzon
Partnership with government and the
Global Alliance for Rabies Control
Manila
Manila
PHILIPPINES
PHILIPPINES
Additional funds from WHO and other
Samar
Panay
Samar
Panay
Cebu
NGOs
Leyte
Cebu
Ley
Palawan Bohol
Negros
Palawan Negros Bohol
Initiated in 2007
Mindanao
Mindanao
Basilan
Basilan
Cost estimate conducted in 1991
Jolo
Sulu
Jolo
Sulu
Estimated $2.5 million/year in cost-
savings by eliminating dog rabies in
Philippines
Costs would be repaid in 4 –11 years
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
54. Bohol Project Philippines:
Controlling Canine Rabies and Preventing
Human Deaths
Community mobilization
140 to >15,000 persons involved in program
Vaccination
70% of dog population
Increased access to postexposure prophylaxis (PEP)
New clinics
Expanded training
Integration of rabies education into school curriculum
All elementary school children educated (182,000 children)
CDC training of direct Rapid Immunohistochemical Test (dRIT)
and evaluation of diagnostics
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
55. Bohol Project Philippines:
Controlling Canine Rabies and Preventing
Human Deaths
No human or dog rabies deaths reported since Oct
2008
In 2 prior years, 10 cases/year reported
Program strategy to be self-sustainable when
outside funding no longer available
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
56. Bohol Updates
Galing Pook Award 2011 for Outstanding Local
Government Program for Governance and
Innovation
presented by the President of the Philippines and every year
recognizes 10 local governance projects for excellence
held up as an example for other communities to emulate in their
rabies control.
It is powerful endorsement of the project model and a step forward
in global rabies control.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
57. The CARE Project in Ilocos Norte,
Sorsogon and Metro Manila in Philippines
and Nias in Indonesia
Project Components:
prevention of dog bites and human rabies;
establishment of sustainable diagnostic and surveillance
systems;
elimination of rabies in the vector species (dogs);
community awareness and mobilization;
integration of rabies prevention education into
elementary schools
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
58. CARE Project Sites
Indonesia and Philippines
Ilocos Norte – 547k people, 40k dogs
Sorsogon – 709k people, 64k dogs
Metro Manila – 690k people, 20k dogs
(Cross border Marikina & Cainta)
Nias
750k people
45k dogs
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
59. A One Health Example – Metro Manila
To demonstrate the benefit of a one health approach,
WSPA and the Global Alliance for Rabies Control
(GARC) will jointly deliver a cross border dog rabies
elimination project in Metro Manila
Objective is to eliminate canine and human rabies in 3
years
Department of Agriculture and the Department of Health
are supportive and local veterinary and animal welfare
agencies will be brought on board
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
60. WHO – Bill & Melinda Gates Foundation
Project in The Philippines (Visayas)
From a short-list of ten countries, sites in three
countries have been identified to demonstrate the
feasibility, cost-effectiveness and benefits for
human health of controlling and eliminating
canine rabies in five years.
Selected countries:
Tanzania (South Eastern part)
South Africa (Kwa Zulu Natal) and
The Philippines (Visayas)
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
61. Project area in the Philippines
Visayas group of islands
covering 25% of the total
number of animal rabies cases,
28% of the total human rabies
and 27% of the animal bites in
the entire country.
The project will serve almost 19
% of the country’s human
population (with 17 million
inhabitants in the area) and an
estimated 9 million dogs.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
62. Challenges for Rabies Control in Asia
Generating the political awareness and will for
large-scale control programme – Ownership
for dog rabies control
Development and implementation of a national
rabies control strategy
Devolving responsibility to local government
authorities
Legislation: Registration/Licensing and
vaccination of dogs.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
63. Government
Public
Legislative
awareness
Support -
and education
Notifiability -
on rabies
Funding
Municipality &
Community Involvement
Involvement, of Veterinary
Media and Services
Celebrities
RABIES
CONTROL
Wound
Dog
Management
Population –
and Post
Management
Exposure
and Control
Prophylaxis
Surveillance Involvement
and of Animal
Laboratory Welfare
Diagnosis Organizations
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
64. Future plans to control Rabies at
Source in Asia
General Considerations
Prevention: Introduce cost-effective public health
intervention techniques to improve accessibility,
affordability and availability of post-exposure prophylaxis
Promotion: Improve understanding of rabies through
advocacy, awareness, education and operational
research
Partnership: Provide coordinated support for anti-rabies
drive with the involvement of community, civil society,
government and non-government sectors and
international partners
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
65. General Considerations
Establish surveillance on human as well as animal side
and identify Rabies as a Notifiable disease
Strengthen State-level coordination committees
Identify and fill gaps in current implementation
programmes eg. Rural and peri-urban areas pose a
major threat to the success of rabies control efforts
Document Rabies intervention as a model for replication
Draft a blueprint that can guide the national disease
control programme to combat rabies and other zoonoses
in the country
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
66. Future plans to control Rabies at Source
in India
Specific Considerations
• Human rabies prevention is possible
through promotion of responsible dog
ownership, mass dog vaccination and
animal birth control programme with
partnership approach
Mass vaccination campaigns targeting dogs
of all age group to develop herd immunity.
Mass dog vaccination alone is effective but
providing additional dog population
management interventions can help
overcome the challenges
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
67. Strengthening Of Available Laboratory Facilities
For Rabies Diagnosis In Animals And Humans
Currently very few facilities for Rabies Diagnosis are
available:
For rabies diagnosis in humans:
NIMHANS, Bangalore
NCDC, Delhi
NIV, Pune
For rabies diagnosis in animals
Dedicated Rabies Laboratory has
Been set up at Bangalore Vet Col
Which will be twinned under OIE
Twinning programme with CDC
: Laboratories in different states and
at Veterinary colleges
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
68. Conclusion
A Rabies Control programme focused on
mass vaccination of dogs and animal birth
control is largely justified by the future
savings in human rabies prevention.
This is where dog owners, civic societies,
animal welfare and non-government
organizations need to play a proactive role.
A concerted effort between the human and
animal health sectors can achieve the goals
of rabies elimination.
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
69. We are not alone!
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
70. Thank You For Your Attention
Merci de votre attention
Paper presented at The National Dog Welfare Conference India. 27-28 Feb 2013. Chennai, India
Editor's Notes
Thirty years ago, cell culture rabies vaccines became available to treat humans exposed to rabies. These vaccines are among the most efficacious in the world as is clear from the very few human rabies deaths reported in patients that receive the WHO recommended PEP in a timely manner. Therefore we have to wonder why is it that people across the world still die of rabies 30 years after these excellent vaccines were initially marketed? Reasons include a lack of awareness about pet vaccination, need for PEP and primary wound care. In resource poor countries, vaccine and RIG may be scarce, patients may not know where to find vaccines and may have challenges to travel to a clinic. For example, this family had 5 children exposed to a suspect rabid dog and have had to walk many miles to a clinic to find vaccine. But, they only have enough money to buy vaccine for 1 child. They must make a choice as to which child they will vaccinate. Often families they must sell their possessions and/or livestock to pay for the vaccine, thus leaving them vulnerable to a loss of nutrition or shelter.
This graph shows the number of human rabies cases (orange), dog cases (blue line) and the blue bars show the umber of dogs vaccinated. As you will from the start of the vaccination programme there has been a continual and consistent decline in the number of reported dog and human rabies cases – and as you will see this graph only illustrates the findings for the first six months of the programme
And here is what has been accomplished: 70% of the dog population has been vaccinated. New clinics have been established thus increasing access to PEP, and training has been expanded. Over 182,000 children have been educated about how to prevent rabies. This represents all of the children enrolled in elementary schools across the island province CDC has provided training of the direct Rapid Immunochistochemical Test and is our major partner to evaluate rabies diagnostics for the program.
And here is what has been accomplished: 70% of the dog population has been vaccinated. New clinics have been established thus increasing access to PEP, and training has been expanded. Over 182,000 children have been educated about how to prevent rabies. This represents all of the children enrolled in elementary schools across the island province CDC has provided training of the direct Rapid Immunochistochemical Test and is our major partner to evaluate rabies diagnostics for the program.
WSPA – animal health , GARC public health will come together to deliver a cross border project in Marikina City and the Municipality of Cainta. Marikina has already made a serious commitment to reducing rabies, but their hard work is constantly threatened by the constant reintroduction of cases from neighbouring cities – this can be addressed through a cross border programme Our objective is elimination of rabies in 3 years and to have created a sustainable programme which will continue beyond the 3 years. And this can only be achieved if we have support from public health and livestock Provincial Government are supportive of this and have already committed funding for the three years and at the outset of the project GARC will bring on board relevant local agencies to ensure there is full community support for this programme