Rabies control costs at the provincial level: Who should pay more, the community or the government?

Abstract

Background and Aim: Rabies is a zoonotic disease that persists endemic in numerous countries worldwide. In Vietnam, the main sources of rabies are dogs and cats, and they caused 76 human deaths annually by 2017–2021. Long An province has recently experienced an increasing burden of rabies, with seven fatal cases reported in the past 5 years. Various rabies control measures have been implemented in this province, including mass vaccination of the animal population, post-vaccination monitoring, diagnostic testing of suspected rabid dogs, dog bite investigation, animal management, pre-exposure treatment, post-exposure treatment (PET), and awareness programs. This study aimed to estimate the cost of rabies control measures for animals and humans in Long An province in 2022. Materials and Methods: An economic model was developed to estimate the costs of rabies control under two scenarios, with and without external financial support from the private sector. Inputs for the model included data from published literature, publicly available reports on rabies, government data, expert opinions, and a pilot study conducted in Vietnam. Results: The total annual costs of rabies control, with or without external support, were estimated to be VND 62.62 and 62.77 billion (equivalent to USD 2.67 and 2.68 million), respectively. The highest proportion of costs was related to PET in humans (84.50% and 84.30%), followed by the cost of mass vaccination paid by animal owners (14.28% and 13.90%). Most of the expenses were paid by the private sector (98.87% and 98.98%) rather than the public sector (1.14% and 1.20%). Conclusion: This study described a transparent and reproducible method for estimating the economic costs of rabies control at the provincial level. The economic model developed showed that control of rabies by mass vaccination is more cost-effective than using PET to prevent human death. The model can be applied to future economic analyses of rabies control in other provinces of Vietnam and other rabies-endemic countries. Keywords: animals, control measures, deterministic economic model, humans, rabies.