Isn’t rabies rare?
In developed countries, such as the United States, rabies is quite rare in dogs because city and state policies require dogs to be vaccinated. Vaccines are also widely available at neighborhood veterinary clinics.
But in many developing countries where the vaccine is not routinely available, rabies is not under control and is spread through dog bites. Globally, more than 99% of human rabies deaths are caused from being bitten by an infected dog—almost all the deaths are in Africa and Asia. Each year an estimated 60,000 people die from rabies, making it the deadliest zoonotic disease on the planet. One-half of deaths are children under the age of 16.
What countries have the highest incidence of rabies?
The per capita rabies deaths are highest in sub-Saharan Africa, with the exception of South Africa. The absolute number of human rabies deaths are highest in India, which accounts for 35% of deaths worldwide. The Rabies Free Africa teams currently work in Tanzania and Kenya. In Africa, there are 25,000 rabies deaths per year.
What are Rabies Free Africa and the Allen School currently doing to help eliminate rabies globally?
Rabies is easily preventable in Africa and Asia when 70% of dogs are vaccinated regularly. Rabies Free Africa, currently in Kenya and Tanzania, focus on scientific research and in-country program development to reach more communities.
In Kenya, led by Dr. Thumbi Mwangi, the Rabies Free Kenya team works with the national government to improve the animal and human health care systems so preventative and post-exposure rabies treatment options are available to all citizens. Dr. Mwangi is leading the team that is piloting the mass-dog vaccination programs in rural and urban Kenya and working with community healthcare providers to create education campaigns for dog bite victims. He also works with public health officials to update health distribution systems to ensure post-exposure prophylaxis is available where needed.
In Tanzania, where vaccine and delivery method research is also conducted, the Rabies Free Tanzania team vaccinates an average of 300 dogs each day. They visit 180 villages every year in seven districts adjacent to the Serengeti National Park. Because of the long-term commitment to the program, these communities provide a consistent platform for research, like the thermo-stability study completed by Dr. Felix Lankester in 2016 that identified thermotolerant vaccines that can be transported and storied in warmer weather.
What can be done to get rabies vaccinations to where they are needed most?
We have all the tools to eliminate rabies, we only need get those tools to where they are needed most. Long-term, our plan is to work with governments to create or expand current health systems so mass dog vaccinations and human post-exposure treatments are reliably available. But for it to be a success, researchers at the Allen School must find a way to reduce the cost of administering the vaccinations.
One strategy for rural areas is to connect community members with veterinary district offices that keep the vaccine on-site, rather than hiring teams to set up clinics in the various communities on an annual basis. Another strategy is to find quick transportation methods for post-exposure prophylaxis so it can be kept in primary medical centers then swiftly transported to outlying areas as need arises. A major overall challenge is creating a reliable vaccine bank that would provide a consistent and orderable vaccine supply for countries to draw on and then replenish. Studies currently show that without an increase in vaccine supply, the goal of eliminating rabies by 2030 cannot be met.
If vaccinating is so successful, why is rabies still so deadly?
There are several reasons why rabies continues to be so prevalent in many parts of the world.
One challenge is getting vaccinations to the most vulnerable people in resource-poor countries. Many areas in rural Africa, for example, do not have electricity and many vaccinations must stay cold to be effective. But Allen School researchers have recently shown that the rabies vaccine is more thermotolerant than previously thought. Most rabies vaccination programs are still designed to keep the vaccine stored at cold temperatures but that may change in the future making the vaccine more easily available to communities without electricity.
Another challenge is cost. The vaccine is also too expensive for many families. Governments in many countries have historically put their resources into treating people after they have been exposed to the rabies virus with post-exposure prophylaxis vaccinations that must be started within the first 24 hours after a person is bitten by a rabid dog. Once symptoms appear, the disease is almost always fatal. Because of the narrow window for treatment, it has not been very effective in reducing deaths and many health care centers do not have it on hand. It is also the costliest option. Post-exposure prophylaxis costs are 20 times higher than the amount spent on dog vaccination in impacted countries.
Previous research in Tanzania and other countries has now convinced the World Health Organization and national governing bodies that canine vaccination can be effectively used for global elimination of rabies.
“Ultimately, rabies elimination in Africa requires regional cooperation. A rabies-free Kenya is only protected from incursions from neighboring countries when they too, control for rabies.”
- Dr. Thumbi Mwangi, Veterinarian and Assistant Professor of Epidemiology for the Allen School
Who does the Allen School work with to solve this problem?
We work with partners around the world including the Global Alliance for Rabies Control as an umbrella organization as well as the World Health Organization, the World Organization for Animal Health, and the Food and Agriculture Organization. Our research in Tanzania is in cooperation with the Serengeti Health Initiative and the University of Glasgow. The research conducted in Kenya is in partnership with the Ministry of Agriculture, Livestock and Fisheries and the Ministry of Health of the Government of Kenya.
What Can I Do to Help?
Rabies Free Africa is working to eliminate rabies with the goal of no human deaths by 2030. Our program focuses on guiding countries to create strategies that are sustainable long-term.
Ten dollars will vaccinate a child’s dog from rabies and distemper, another major cause of mortality in young dogs. A gift of any amount will move us closer to a world where no child dies from canine rabies. Together we can make a difference.