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Taking up the fight against rabies in Africa through training research

Taking up the fight against rabies in Africa through training research

28/09/2019

Each year, rabies causes an estimated 74 000 human deaths worldwide. More than 95 percent of all deaths from human rabies occur in Asia and Africa, mainly in rural areas where access to post-exposure prophylaxis is limited or non-existent. The majority of these victims (60 percent) are children bitten by rabid dogs.

In many African countries, rabies remains endemic despite numerous efforts aimed at preventing rabies in both human and canine populations. In December 2015, a strategic plan that provided a phased, all-inclusive, intersectoral approach to eliminate human deaths from rabies “Zero by 30: the global strategic plan to end human deaths from dog-mediated rabies by 2030” was launched by United Against Rabies, a collaboration of four partners: the World Health Organization (WHO), the Food and Agriculture Organization of the United Nations (FAO), the World Organisation for Animal Health (OIE) and the Global Alliance for Rabies Control (GARC). This initiative marked the first time that the human and animal health sectors came together to adopt a common strategy against this devastating and neglected disease.

In 2019, FAO launched the frontline In-Service Applied Veterinary Epidemiology Training (ISAVET) programme to build the field epidemiology capacity of the veterinary sector of countries in West and Central Africa. This has led to numerous studies, which support the goal of rabies elimination by 2030. These studies have provided (in many instances for the first time) detailed data on the prevalence and distribution of animal and human rabies cases, dog bites (as a proxy for rabies exposure) and the use of post-exposure prophylaxis (PEP) treatment. These studies also highlighted measures that need to be in place in study countries for rabies prevention and control.

The first of its kind in Africa, ISAVET is a four-month training programme consisting of four weeks of formal training followed by three months of field project work. In 2019, ISAVET targeted more than 20 frontline veterinarians from ten countries in West and Central Africa: Burkina Faso, Cameroon, Côte d’Ivoire, the Democratic Republic of the Congo, Ghana, Guinea, Liberia, Mali, Senegal and Sierra Leone.

FAO strengthens National Veterinary Systems to prevent the rabies cycle

Some of the studies carried out by the frontline ISAVET-graduates includes retrospective studies of rabies and dog bites in humans and animals in Mali and Senegal, the level of human population exposure to canine rabies and the use of rabies post-exposure prophylaxis (PEP) in Burkina Faso and rabies surveillance and the evaluation of a rabies vaccination programme in Côte d’Ivoire.

As stated by Dr Maguette Ndiaye, an ISAVET trainee from the Veterinary Service of Fatick region, Senegal: “The innovative results of ISAVET studies on rabies will provide evidence to support the need to invest in anti-rabies programmes, which is crucial to inform national strategies and achieve zero deaths from human rabies by 2030”. ISAVET fieldwork has greatly contributed to the fight to eliminate the rabies cycle and to strengthen national animal disease surveillance systems thanks to research results.

In addition to ISAVET training, in recent years FAO has reinforced rabies strategies and action plans in several countries of the region in accordance with the rabies elimination objective by 2030:

  • In Sierra Leone, FAO supported the acquisition of 1 200 canine rabies vaccines and the implementation of rabies awareness campaigns as part of the execution of the National Strategy for the Elimination of Rabies and the Improvement of the Management of the canine population (2015 - 2030);
  • The emergency plan for anthrax and rabies control has been supported by the Global Health Security Agenda (GSHA) with 10 000 doses of rabies vaccines and vaccination kits in Guinea;
  • In Senegal, the multisectoral rabies surveillance plan has been developed and appropriate data on rabies has been collected and geo referenced through the Kobo Toolbox – a free tool that collects field data with mobile devices or computers, and makes information accessible in real time to veterinarians anywhere in the field.
  • In the Democratic Republic of the Congo, the Central Laboratories of Kinshasa, Lubumbashi and Goma have received four batches of equipment, including reagents, consumables for cell culture and rapid rabies test kits and to contribute to a more reliable rabies diagnosis.
  • Liberia has strengthened its rabies response mechanism by validating the Practical Work Plan towards Achieving Rabies Elimination (PWARE) by the One Health platform.

Since 2016, countries in the West and Central Africa region have increased the incidence of their campaigns against rabies thanks to the implementation of the Global Health Security Agenda (GSHA) programme, which aims at strengthening both the global capacity and nations’ capacity to prevent, detect and respond to human and animal infectious disease threats. This success has been achieved mainly through the development and implementation of effective national strategies and programmes that focus on coordinated dog vaccination campaigns, raising public awareness and widespread availability of reagents and consumables in national laboratories.

FAO, with its partners, WHO, OIE and GARC, is developing an expensive action plan to reach zero human deaths by 2030. This plan covers policies, human and animal interventions, awareness raising and promotion, capacity building and the respective resources needed to eliminate the disease in countries that still suffer from rabies.

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