One health approaches for rabies control
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The document discusses a technical conference on rabies control and the One Health approach to manage risks at the animal-human interface. It emphasizes the critical role of vaccination and strategic planning in reducing rabies cases, particularly highlighting the challenges faced in developing countries with high stray dog populations. The content also outlines the necessity of inter-sectoral collaboration, governance, and community engagement for effective rabies control and prevention efforts.
One health approaches for rabies control
- 1. Chiang Mai, 11-13 December 2012 ONE HEALTH APPROACHES FOR RABIES CONTROL Dr Marta Martínez Avilés Veterinary epidemiologist OIE Scientific and Technical Department m.martinez@oie.int First Technical Conference of the Participatory Epidemiology Network for Animal and Public Health
- 2. All mammals are susceptible (at least 130 species documented, 110 of them wild animals) Stray dog control medics or vets’ problem?? Different administrative levels involved Different expertise required: diagnostics, epidemiology, ecology, sociology THE IDEAL CANDIDATE FOR ONE HEALTH
- 3. Rabies is a notifiable disease and one of the oldest known zoonoses Highly fatal and no treatment, yet 100% preventable Transmitted by the saliva of rabid dogs Apart of the dog, the virus cycles in bats and in some wild carnivore populations (i.e. red fox in Europe) INTRODUCTION
- 4. Rabies cases (domestic animals) never occurred or reported clinical disease/infection no information date last case unknown last case reported 1 25 years ago last case reported 25 years ago RABIES CASES IN DOMESTIC ANIMALS (OIE, 2005-2011) 14 000 14 000 14 000 14 000 Human deaths due to rabies (PRP/GARC new estimate) 2 2 2 2 50 50 50 50 150 150 150 150 30 000 30 000 30 000 30 000 and and and and risk risk risk risk to to to to humans humans humans humans
- 5. 95% of human deaths caused by rabies (mostly children) have a canine origin. Dogs are the major transmitters of rabies in developing countries 70% of vaccination coverage in a population of dogs sufficient to control canine and human rabies CONTROL IN DOGS
- 6. CONTROL TOOLS AND STRATEGIES ARE WELL KNOWN Pasteur and rabies vaccines, 1880-1885 BIOLOGICALS BIOLOGICALS BIOLOGICALS BIOLOGICALS http://www.historyofvaccines.org/content/timelines/pasteur CONTROL STRATEGY CONTROL STRATEGY CONTROL STRATEGY CONTROL STRATEGY COMMUNICATION COMMUNICATION COMMUNICATION COMMUNICATION AWARENESS AWARENESS AWARENESS AWARENESS comprehensive online compilation of tools available for rabies control and prevention
- 8. RABIES IS A NEGLECTED DISEASE We have no budget to vaccinate dogs Our stray dog population is too large Wildlife is responsible! The Ministry of Agriculture thinks the Veterinary Services should not care about dogs Dog owners do not participate in vaccination campaigns It’s the task of the ministry of public health, not ours
- 9. WHO TAKES CARE OF THE DOGS? Rabies predominantly affects the poorest segments of the population, living in remote, rural areas Rural 80% Urban%
- 10. DIFFERENT FACTORS Competition Coordination Movements Global collaboration Inter-sectoral collaboration
- 11. Infected dog Action Long incubation period Diagnosis Infectious dog: clinical signs Human exposure Human clinical signs
- 12. OIE 5TH STRATEGIC PLAN 2011-2015 NEW ACTIONS The One Health Concept A worldwide strategy for managing risks at the animal-human interface ecosystems OIE, FAO and WHO renewed their commitment with the Tripartite Concept Note created in 2010 Rabies control is a priority model to apply the ‘One Health’ concept by countries and intergovernmental organisations as seen at the OIE Global Conference on Rabies Control in September 2011 (Republic of Korea) Rabies control as a model for intersectoral control approaches (Mexico, HLTM, 2011) Resolution 27/2012 (80 GS)
- 13. Coordinated planning Standards, Legislation Political will Trust Common objectives Shared benefit Implementation Cross-sectoral coordination Routine communication Joint simulation exercises Data sharing Joint risk assessment Active cooperation KEY KEY KEY KEY SUPPORTING SUPPORTING SUPPORTING SUPPORTING AND AND AND AND OPERATIONAL OPERATIONAL OPERATIONAL OPERATIONAL ELEMENTS FOR ELEMENTS FOR ELEMENTS FOR ELEMENTS FOR CROSS CROSS CROSS CROSS- - - -SECTORAL SECTORAL SECTORAL SECTORAL COLLABORATION COLLABORATION COLLABORATION COLLABORATION
- 14. POLITICAL WILL, TRUST, COMMON OBJECTIVES AND SHARED BENEFITS Governments must recognise rabies as a major problem and as a public good. Notifiability Keep motivating national governments to invest in rabies control at the source of infection WHAT IS THE SITUATION OF RABIES IN THE COUNTRY? = SURVEILLANCE LEARN LESSONS.Achieved rabies free areas can transfer its skills to neighbouring region, consolidated elimination and prevention of reintroduction INNOVATE. Establish sustainable ways of working and reaching consensus RABIES CONTROL STRATEGY APPROVED
- 15. RABIES PRESENT BUT RABIES PRESENT BUT RABIES PRESENT BUT RABIES PRESENT BUT LACK OF DATA LACK OF DATA LACK OF DATA LACK OF DATA PROPOSED PROGRESSIVE CONTROL PATHWAY TOWARDS RABIES ELIMINATION FURTHER RABIES FURTHER RABIES FURTHER RABIES FURTHER RABIES RISK REDUCTION RISK REDUCTION RISK REDUCTION RISK REDUCTION MAINTAIN RABIES MAINTAIN RABIES MAINTAIN RABIES MAINTAIN RABIES ELIMINATION IN HUMANS ELIMINATION IN HUMANS ELIMINATION IN HUMANS ELIMINATION IN HUMANS AND ANIMALS AND ANIMALS AND ANIMALS AND ANIMALS STAGE STAGE STAGE E NO MORE DOG NO MORE DOG NO MORE DOG NO MORE DOG RABIES CASES RABIES CASES RABIES CASES RABIES CASES NO MORE HUMAN NO MORE HUMAN NO MORE HUMAN NO MORE HUMAN RABIES CASES RABIES CASES RABIES CASES RABIES CASES GAIN UNDERSTANDING ON GAIN UNDERSTANDING ON GAIN UNDERSTANDING ON GAIN UNDERSTANDING ON THE EPIDEMIOLOGY OF THE EPIDEMIOLOGY OF THE EPIDEMIOLOGY OF THE EPIDEMIOLOGY OF RABIES AND ASSESS RABIES AND ASSESS RABIES AND ASSESS RABIES AND ASSESS RABIES RISKS RABIES RISKS RABIES RISKS RABIES RISKS IMPLEMENTATION OF A IMPLEMENTATION OF A IMPLEMENTATION OF A IMPLEMENTATION OF A RABIES CONTROL STRATEGY RABIES CONTROL STRATEGY RABIES CONTROL STRATEGY RABIES CONTROL STRATEGY STAGE STAGE REPORTING OF THE OCCURENCE OF RABIES TO INTERNATIONAL ORGANIZATIONS 4 4 4 4 NATIONAL RABIES PREVENTION AND CONTROL STRATEGY FINALIZED AND FINANCED DEVELOPMENT OF A DEVELOPMENT OF A DEVELOPMENT OF A DEVELOPMENT OF A RABIES RABIES RABIES RABIES CONTROL STRATEGY CONTROL STRATEGY CONTROL STRATEGY CONTROL STRATEGY STAGE RABIES RISKS ASSESSED AND CONTROL PLAN DRAFTED 5 5 5 5
- 16. Activities at the national level, including enacting legislation to facilitate cross-sectoral collaboration, should be based on the governance and standards issued from the international organizations STRONG GOVERNANCE, LEGAL SUPPORT AND RECOGNITION OF INTERNATIONAL STANDARDS Cross-sectorial legislative framework Sustainable funds Technical capacities
- 17. Chapter 8.10. Chapter 8.10. Chapter 8.10. Chapter 8.10. on on on on rabies rabies rabies rabies Chapter 5.11. Model veterinary certificate for importation from rabies infected countries Chapter 1.4. Animal health surveillance Chapter 3.1 Veterinary Veterinary Veterinary Veterinary Services Services Services Services Chapter 1.1 Notification Notification Notification Notification of diseases and epidemiological information Chapter 7.7. Stray dog population control OIE TERRESTRIAL CODE STANDARDS RELATED TO RABIES Guidelines for disease control (web: « our scientific expertise »)
- 18. The updated chapter (diagnostic methods) updated chapter (diagnostic methods) updated chapter (diagnostic methods) updated chapter (diagnostic methods) on rabies from the Terrestrial Manual was adopted in May 2011 On the working programme of the Biological Standards Commission: ad hoc Group on Rabies Vaccine Quality Rabies Vaccine Quality Rabies Vaccine Quality Rabies Vaccine Quality Standardisation programmes for reagents reagents reagents reagents (harmonisation of diagnostic testing) Work on scientifically acceptable criteria for validation of diagnostic tests in wild animal diagnostic tests in wild animal diagnostic tests in wild animal diagnostic tests in wild animal species species species species (on-going) OIE STANDARDS ON DIAGNOSTIC TESTS AND VACCINES
- 19. STRONG HEALTH SYSTEMS Strengthening Good Governance of Veterinary Services: PVS Pathway Regular training of OIE Delegates Establishment and repeated training of topic-specific national Focal Points in each OIE Member Country
- 20. SUPPORT TO OIE MEMBER COUNTRIES Network of OIE Reference Laboratories and Collaborating Centres 9 OIE RL for rabies, 5 or which are also WHO CC Laboratory twinning initiative = enhance technical capacity in the regions affected Turkey- UK China- UK Nigeria- South Africa
- 21. OIE manages a vaccine bank in Asia with the financial support of the European Union and under the framework of the regional cooperation programme on Highly Pathogenic and Emerging and Re-emerging Diseases in Asia (HPED) It operates at the request of countries RABIES REGIONAL VACCINE BANK
- 22. Vaccination costs ≠ cost of the vaccine only Logistics costs to administer the vaccine to every possible dog in the villages; costs of coordinated regional programmes; costs of planning programme Sampling and testing costs: can samples be correctly taken, dispatched, transported, tested and results communicated without delay Communication and participation of the community are key Is PEP indicated, available and within reach? THE EXPENSES OF RABIES CONTROL
- 23. Without a target that is sustained over time, as soon as disease frequency is reduced, the vaccination is stopped. Patchy and irregular vaccination along a number of years results in loss of commitment and interest AND increase of risk of canine rabies as a consequence of herd immunity decrease MASS VACCINATIONS OF DOGS IN ENDEMIC COUNTRIES
- 24. IMPROVE DOG VACCINATION COVERAGE Understand the ecological parameters of dog population Strategies must be adapted to the epidemiological situation and the resources available Lack of resources + knowledge + fear of rabies have led some communities to try to control dog populations through poisoning, electrocution or drowning - High cost to capture and sterilise - Complicated logistics involved in wild dog packs vaccination - Oral vaccination not always straightforward: dominating male could be the only one accessing the bait; live vaccine: children at risk - Location of dogs: Rural/urban - Religious reasons
- 25. Understanding dog ecology: Identification of dogs and potential rabid cases New introductions Vaccination registries/identification Immediate action on human and animal cases Rabies Action Group; Mr and Mrs Rabies initiative Communication channels between administrative levels ROLE OF THE COMMUNITY, IN COLLABORATION WITH NGOS AND LOCAL AUTHORITIES
- 26. THANK YOU! 12 rue de Prony, 75017 Paris, France - www.oie.int – oie@oie.int Organisation mondiale de la santé animale World Organisation for Animal Health Organización Mundial de Sanidad Animal