Abstract
The neglected zoonotic diseases (NZDs) have been all but eradicated in wealthier countries but remain major causes of ill-health and mortality in over 80 countries across Africa, Asia, and Latin America. The nature of neglect for the NZDs has been ascribed, in part, to underreporting resulting in an underestimation of their global burden that, together with a lack of advocacy, downgrades their relevance to policy-makers and funding agencies. While this may be the case for many NZDs, for rabies this is not the case. The global burden estimates for rabies (931,600 DALYs) more than justify prioritizing rabies control building on the strong advocacy platforms, functioning at local, regional, and global levels (including the Global Alliance for Rabies Control), and commitments from WHO, OIE, and FAO. Simple effective tools for rabies control exist together with blueprints for operationalizing control, yet, despite elimination targets being set, no global affirmative action has been taken. Rabies control demands activities both in the short term and over a long period of time to achieve the desired cumulative gains. Despite the availability of effective vaccines and messaging tools, rabies will not be sustainably controlled in the near future without long-term financial commitment, particularly as disease incidence decreases and other health priorities take hold. While rabies control is usually perceived as a public good, public private partnerships could prove equally effective in addressing endemic rabies through harnessing social investment and demonstrating the cost-effectiveness of control. It is acknowledged that greater attention to navigating local realities in planning and implementation is essential to ensuring that rabies, and other neglected diseases, are controlled sustainably. In the shadows of resource and institutional limitations in the veterinary sector in low- and middle-income countries, sufficient funding is required so that top-down interventions for rabies can more explicitly engage with local project organization capacity and affected communities in the long term. Development Impact Bonds have the potential to secure the financing required to deliver effective rabies control.
Highlights
More than a decade of advocacy has resulted in ambitious control and elimination targets for neglected tropical diseases (NTDs) set by WHO for 2020
Advocacy resulted in the 2012 London Declaration3 and WHO Roadmap to accelerate the work to overcome the global impact of 17 NTDs,4 followed by the World Health Assembly (WHA) Resolution WHA66.12 on NTDS in May 2013
We argue that financing structure of a DEVELOPMENT IMPACT BONDS (DIBs) is well suited to financing rabies control and so provides a highly compelling case to donors interested in controlling NTDs in a highly costeffective manner (Figure 1)
Summary
More than a decade of advocacy has resulted in ambitious control and elimination targets for neglected tropical diseases (NTDs) set by WHO for 2020. Partnerships have been formed to raise funds and provide advocacy for NTD control, including the Global Programme to Eliminate
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