Rabies Free Tanzania
The original goal of the program in Tanzania was to protect wild carnivore species in the Serengeti National Park from rabies. However, what began as an initiative to save wildlife soon transitioned into a program to protect people.
The research clearly demonstrated that vaccinating the dogs living around the perimeter of the Serengeti not only eliminated the disease in the dogs, but also controlled the disease in the wildlife species. But what happened in the human communities surrounding the Serengeti was even more powerful. The number of cases of human rabies deaths in the research area drastically decreased. The vaccination team had created a rabies free zone that covered approximately 11,000 square kilometers.
“Human incidence of rabies in the vaccination zone has been reduced to almost zero since the project began,” said Dr. Felix Lankester. “Before the program there would have been 50 to 100 cases of rabies each year and most people would have witnessed someone with the disease.”
Today, the focus of the program in Tanzania is to research ways to decrease the cost of delivering the vaccine to communities, especially those in rural areas. Because of the long-term commitment to the program, these communities provide a consistent platform for research.
For example, Dr. Lankester’s research demonstrated that the rabies vaccine used to inoculate dogs is thermo-tolerant and can be stored for extended periods of time outside of refrigeration units without losing its ability to protect dogs against rabies. This led to a multi-year research project, launched in 2019, that leverages Tanzanian field officers and one health champions as vaccinators using rabies vaccines stored in rural districts. The goal of the project is to study new delivery methods using existing government resources to decrease the cost of mass-dog vaccination campaigns.
Rabies Free Kenya
The program in Kenya represents the second phase of the work by WSU faculty to identify community-based programs that are replicable not only across a country, but across the globe. In order to reach the goal set in Zero by 30, governments in each country must invest in interventions for their citizens.
The research underway by Dr. Thumbi Mwangi, is in strategies and tools that governments can use to determine the resources needed to undertake a country-wide rabies elimination campaign. “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,” states Dr. Mwangi.
Dr. Mwangi calculated the human-to-dog ratios for both urban and rural environments and determined that children bring the dogs – not adults – to the vaccination clinics. When vaccination clinics are designed around school holidays, the likelihood of reaching the 70% threshold to break the transmission cycle increases greatly.
Most countries with a high incidence of rabies have limited resources to put toward public health initiatives. Knowing this, the team created a planning tool that countries can use to estimate resources, both financial and staff, needed to design and execute rabies elimination programs. They also developed enhanced surveillance systems for canine and human rabies in health facilities and communities to measure impact of vaccination campaigns and provide rabies burden data that helps governments prioritize rabies elimination. The next phase of the campaign in Kenya includes an enhanced education campaign for dog bite victims and updated human health systems for easier access to post-exposure prophylaxis.