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Rabies: The Slumdog killer and the EU

Around 59,000 people die every year from rabies infection, says a major new study (40% of them children). Yet collaboration between doctors and vets could significantly reduce deaths. But Rabies eradication seems to be very low down on the EU’s development aid priorities.

A global study on canine rabies, published Thursday (17 April 2015), has found that 160 people die every single day from the disease. The report is the first study to consider the impact in terms of deaths and the economic costs of rabies across all countries. Even though the disease is eminently preventable, it is a ‘silent killer’ mainly attacking the poor, vulnerable and the isolated.

Rabies kills far more peoples than Ebola yet remains a neglected tropical disease. Rabies kills in a extremely painful manner and kills people in areas where access to painkillers is almost non-existant. One other awful legacy of rabies infection is that it is almost always too late to treat once symptoms start to manifest themselves.

The multi-author study, by the Global Alliance for Rabies Control’s Partners for Rabies Prevention Group, also shows that annual economic losses because of the disease are around 8.6 billion US dollars, mostly due to premature deaths, but also because of spending on human vaccines, lost income for victims of animal bites and other costs. “This ground-breaking study is an essential step towards improved control and eventual elimination of rabies,” says Professor Louis Nel, Executive Director of the Global Alliance for Rabies Control (GARC).

“An understanding of the actual burden helps us determine and advocate for the resources needed to tackle this fatal disease.” Led by Dr Katie Hampson of the University of Glasgow, the study is the first to estimate the impact of canine rabies and the extent of control efforts in every country in the world. Dr Hampson explains, “The breadth of data used in this study, from surveillance reports to epidemiological study data to global vaccine sales figures, is far greater than ever analysed before, allowing this more detailed output.”

The study finds that overwhelmingly the greatest risk of canine rabies is in the poorest countries; the death rate (deaths / 100,000 people) is highest in countries in sub-Saharan Africa, while India has the highest number of fatalities, with over 20,000 human deaths annually. The proportion of dogs vaccinated is far below that necessary to control the disease across almost all countries of Africa and Asia.

Not only is rabies a killer disease in countries in receipt of large amounts of EU aid but it is not even eradicated within the EU. FurtHermore EU citizens are vulnerable to attacks by rabid dogs as tourism expands its reach to the most isolated places in Asia and Africa.

Rabies is close to 100% fatal, but it is also almost 100% preventable, and the best, most cost-effective way of preventing canine rabies is by vaccinating dogs. This needs to be supplemented by improving access to human vaccines. According to the report, this One Health approach to eliminating rabies deaths, with collaboration between the human and animal health sectors, can save many lives and significantly reduce the burden on vulnerable economies.

Indeed, the countries that have invested most in dog vaccination are the ones where human deaths from the disease have been virtually eliminated. The study also emphasises that reporting systems are fundamental to rabies elimination, to monitor and assess the success of prevention efforts.

“No one should die of rabies and GARC and its partners will continue to work together using a One Health approach towards global rabies elimination,” concludes Professor Nel.

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