RABIES is a global problem that
causes the deaths of thousands of
humans, dogs and wildlife. Over
55,000 people die of rabies every
year, with over 95% of them in Asia
and Africa.
The World Health Organisation
believes that mass canine vaccination
programmes are the most effective
measure for controlling rabies, and that
vaccinating 70% of the dogs in an area
where rabies is prevalent is necessary
to control the disease in both humans
and dogs.
Rabies represents a unique
opportunity for this generation of vets:
we can make
our mark on
history by
dealing with
it. Rabies
is an illness
that affects
both humans
and animals,
so that
prevention brings both social and
animal welfare benefits.
It’s completely preventable:
science knows how to achieve global
eradication of rabies, and it’s only
political and economic issues that stop
this from happening.
Many organisations are working
to achieve this goal. The Global
Alliance for Rabies Control (GARC)
is the main co-ordinating body: this
has established Partners for Rabies
Prevention, a group that includes
all the major international agencies
involved in rabies, including the World
Health Organization (WHO), the
Food and Agricultural Organization
of the United Nations, the World
Organization for Animal Health (OIE),
the WHO rabies collaborating centres,
research scientists, representatives from
the Bill and Melinda Gates Foundation,
the UBS Optimus Foundation, and
many supporters from industry.
Partners for Rabies Prevention has
an annual meeting every summer where
progress is reviewed, leading up to
World Rabies Day on 28th September,
which is used as an annual focus for
media attention on the problem.
GARC is a well-established multi-
national body, working on principles
of best practice, liaising with national
governments to make it easier to
implement long-term anti-rabies
strategies. It has over 20 full time staff,
as well as around 10 people on its
board of directors.
The organisation has drawn up “The
Blueprint for Rabies Prevention and Control” in association with global
rabies experts to serve as a guide for
countries that would like to prevent
human rabies by eliminating animal
rabies from within their borders.
There is a separate blueprint for
“Dog rabies control” and “Fox rabies
control”; a further blueprint for “Bat
rabies control” is in preparation. The
blueprint is a detailed, step-by-step
guide designed to make it easier for
national governments to implement an
appropriate rabies-control system.
Regional networks
GARC also supports and advises
regional anti-rabies networks across the
world to help them strengthen plans
to eliminate rabies. In the recent past,
mass dog vaccination programmes
have allowed some countries to
become rabies-free: there are many
examples in South America.
In Sri Lanka, this type of programme
has reduced rabies deaths from more
than 350 in 1973 to just 50 in 2010. Yet
in over 150 countries around the world,
death by rabies continues to be a threat
to humans and dogs.
Other groups involved with
hands-on, on-the-ground anti-rabies
programmes include the World Society
for the Protection of Animals (www.
wspa-international.org), and Mission
Rabies (www.missionrabies.com – with
four UK-based employees and many
teams of vets, NGOs and volunteers
overseas) which is aiming to vaccinate
over two million dogs in India against
rabies in the next three years. Their
ultimate goal is to help to set up an
Indian National Rabies Network for
long-term co-ordinated control of the
disease.
India is the country with the biggest
rabies problem, with around 20,000
people – mostly children – dying every
year. So-called “street dogs” are part of
the urban culture.
Their role is complex: to some
extent, they help to deal with garbage
in a country where public amenities
are not always well developed. In
areas where dogs have been forcibly
removed, the urban rat population has
become a major problem. But street
dogs also carry rabies: 99% of humans
who develop rabies pick up the disease
by being bitten by a rabid dog.
The answer to India’s rabies
crisis is well-known but difficult to
implement: vaccination of most street
dogs against rabies combined, where
possible, with sterilisation of dogs to
prevent breeding. This has happened
successfully in some areas, and this is
the approach taken by Mission Rabies,
but the sheer size and scale of India is
daunting.
My own introduction to the rabies
issue in India happened accidentally
earlier this year. As part of a local
church group, my wife and 16-year-
old daughter planned a trip to a Delhi
slum: I was asked to accompany them.
The other members of the group had
their own strengths and skills: human
health workers, educationalists, an
electrician and others.
We had been invited by a slum
charity called ASHA, which works in
around 60 slums, servicing around
500,000 people, or 10% of the total
slum population of Delhi.
ASHA focuses on human needs,
including the provision of basic
medical care, education of slum
children (including support through
university), and the empowerment
of local people, especially women, to create a
local environment that’s
conducive to a steadily
improving quality of life.
Our group had been
asked by ASHA to help
to renovate a run-down
community and health
centre in one of the worst
slums, and to engage with
local young people to
motivate and encourage
them to continue with their
studies.
When I asked ASHA
if there was any possible
veterinary angle, they seemed stumped: why worry about
animal issues when there were such
pressing human concerns? Their
opinion changed when I brought up
the subject of rabies: they agreed that
it was a topic that merited further
investigation.
With the support of the hard-
working Mission Rabies team, I drafted
a pilot study to investigate the situation
with street dogs and rabies in the
Mayapuri slum, home to around 12,000
people. ASHA provided me with
interpreters (one male and one female),
and I set off for a 10-day trip to India
clutching a pile of questionnaires.
- Next month: the challenge of
collecting and collating questionnaires
and a possible answer to rabies control
in Delhi slums.
