Discussion on a Selection of Key Scientific Articles

By John Atkinson,
Associate Director, Intergovernmental Veterinary Health
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New global strategic plan to eliminate dog-mediated rabies by 2030. Minghui, R., Stone, M., Semedo, M.H., Nel, L. The Lancet Global Health. 2018

Key Thoughts:
There are many diseases that we do not have the answers to. However, rabies is one disease that we really do have the tools and knowledge to eliminate. The theory is simple: vaccinate enough dogs and transmission to humans will be stopped, which will save hundreds of thousands of lives. Whilst there will be challenges in putting theory into practice, the Global strategic plan gives focus to what’s needed to achieve elimination by 2030. Now that’s one goal we all need to work towards, regardless of whether we live in a rabies-free or rabies-affected area.

Article Summary:
Rabies kills 59,000 (citation needed) of the world’s poorest people every year, with nearly all human cases being caused by dog bites (citation needed). However, rabies can be eliminated, as has been proven in regions such as western Europe and North America. Other parts of the world, such as South East Asia and East Africa have seen localized rabies control programmes successfully reduce rabies cases.

A target of 2030 has now been set for the elimination of dog-mediated human rabies, which can be achieved through vaccinating dogs in the implementation of the Global strategic plan to end human deaths from dog-mediated rabies by 2030. This plan takes a One Health approach and has been developed by the World Health Organization (WHO), Food and Agriculture Organization of the United Nations (FAO), World Organisation for Animal Health (OIE), and the Global Alliance for Rabies Control (GARC), collectively known as United Against Rabies.

Close coordination is needed between the human and veterinary sectors to engage communities, build awareness, manage dog populations and provide post-exposure prophylaxis. There are many benefits of eliminating rabies: saved lives, improved living conitions, saved economic resources ($8.6 Billion U.S. annually), plus progression of affected countries towards Sustainable Development Goals (SDG). United Against Rabies invites other organisations to join together to end human deaths from dog rabies.

A milestone towards eliminating rabies Mouezy, J. Veterinary Record; 2018; 182(26), pp. 732-733.

Key Thoughts:
Engaging the educational sector in regions such as Africa to raise awareness about the risks of rabies is essential to stop children dying from this preventable disease. By working together, and spreading the word about rabies control, it is possible to increase the number of children who know how to protect themselves which will help towards stopping human deaths from canine-mediated rabies by 2030.

Article Summary:
Mission Rabies has been working in Malawi’s primary schools since 2015 and has now taught one million children about rabies, including how to protect themselves by washing dog bite wounds and seeking immediate medical care.

This is important because rabies is a fatal viral disease, because it is preventable through dog vaccination, and because children share the messages with their community.

The teams from Mission Rabies will continue to work in Malawi, which has seen a dramatic decrease in child deaths reported by one hospital in the target region of Blantyre. Work is also continuing in other parts of the world, including dog vaccination campaigns in India. 

Spatial and temporal risk as drivers for adoption of foot-and- mouth disease vaccination Railey, A.F., Lembo, T., Palmer, G.H., Shirima, G.M., Marsh, T.L. Vaccine. 2018; 36: 5077-5083

Key Thoughts:
Vaccination is a key tool in the fight against many diseases affecting many different species, so it is important to understand perceptions about vaccination in order to overcome barriers and increase vaccination uptake. Clear communication with all stakeholders, especially animal owners is essential and must be timely and involve the appropriate channels for the community involved.

Article Summary:
Understanding the factors involved in decision-making about adopting vaccination is important to increase vaccination and reduce infectious diseases. For livestock diseases such as FMD, vaccination decisions can have a wide-ranging impact on households that have a high dependence on livestock, because FMD reduces milk production, draught power, access to markets, income ,and food security.

In Tanzania, 432 pastoralist households were surveyed on FMD vaccination. A standard survey approach was used to analyze willingness to pay and determine underlying adoption factors for a routine vaccination strategy applied biannually, and an emergency strategy applied in response to outbreaks.

When disease is perceived to be imminent, households place a higher value on vaccination. Income and diversity of income are also important factors. The unpredictable nature of the spread of FMD and concerns about the effectiveness of vaccines to prevent disease contribute to uncertainty about the benefits of vaccination.

Clear and consistent messaging about the benefits of vaccination to households, and the wider population is needed for any vaccination strategy in order to increase vaccination adoption. Such communication should take place early, ahead of outbreaks and involve informal social networks. Possible directions for future work is suggested, including investigations into vaccine attributes to further enhance vaccination uptake.  



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